If your baby is 1 year old and has a fever of 38 or more, it needs to be lowered with medication. Do not wrap the child and drink plenty of fluids. If it is impossible to lower the temperature yourself, call an ambulance.
High temperature is always a signal of changes in the body. Children aged 1 year and older are at risk of contracting viral diseases, colds and other ailments. In a child at 1 year old, the normal body temperature is 36.5-36.9 degrees. At this age, it is quite acceptable when you can see indicators of 37.3-37.5 on the thermometer. In this case, you do not need to try to bring down such a temperature. But if a one-year-old child's temperature rises to 38, then this means the beginning inflammatory process in the body, or the baby is too tired. Many mothers do not know what to do if a baby at 1 year old has a temperature of 38 degrees and above. In this case, you do not need to panic, but you must act immediately.
If a one-year-old child has a temperature of 38 or higher
Many are accustomed to that heat appears with a cold or other viral disease... But without symptoms, the temperature can rise to 38, not only in a one-year-old child. This indicates the presence of a latent inflammatory process or severe fatigue. Currently, children's doctors disagree about artificially lowering high temperatures. Some say that at high temperatures, the body independently begins to fight inflammation and the virus, and you need to wait a while. And shoot down only when there is a mark of 38.5 degrees on the thermometer. Others say that it should be shot down at 38 degrees. In each case, you need to look at the condition of the baby. With a sharp increase in temperature, you can start knocking down at 38 degrees. If your baby has a high fever that lasts for a long time, you need to contact your local pediatrician or call an ambulance.
How to bring down a high temperature in a 1 year old child
The body temperature can rise at different rates. Sometimes slowly, 1-2 degrees in a few hours, but it happens very quickly. Parents start to panic when a one-year-old child has a temperature of 39 and they don't know what to do. At such moments, babies should not be wrapped up, but on the contrary, undressed to cool the body. You can wipe your body with a towel soaked in room temperature water, and you should also give plenty of warm liquid to drink. Various antipyretics are sold in pharmacies. Many mothers know that a medicine based on paracetamol or ibuprofen can be given to a child of 1 year old from a temperature. For example, Panadol or Nurofen. These products come in different forms: syrup or suppositories. Candles do not contain unnecessary ingredients in the form of sweeteners and dyes, but not every kid will agree to their use. Then you can give sweet syrup. If the temperature does not drop for a long time, you need to contact medical help to specialists. And it is better to find out in advance from your local pediatrician how you can bring down the temperature of a one-year-old child.
The temperature in a newborn baby is one of the indicators of the normal state of the baby in the first month after birth. An increase or decrease in body temperature during this period in a child can cause pathology. Therefore, control of body temperature in the first month of a child's life is very important as an indicator of his general condition.
Epidemiology
The statistics on the prevalence of the problem of increased body temperature indicate that this is the most frequent symptom that makes parents seek help. Regardless of the temperature rise figures, this causes concern for parents. More than 87% of parents consider any increase in body temperature to be pathological, and only in 65% of cases elevated temperature is a sign of infection. This indicates insufficient diagnosis and preventive work with parents in relation to the child's body temperature problem.
Causes of temperature in a newborn baby
First of all, you need to figure out what body temperature means and when it rises. Temperature standards in newborns range from 36.5 to 37.4. It must be said that the temperature in a child in the first month of his life is very labile and can change under the influence of many factors. A decrease in body temperature, as well as an increase in it, is dangerous for the child and may indicate an illness.
Speaking about lowering the temperature, you need to know that in young children it can be very common during a walk on the street, when swimming. The most common cause of such a decrease in body temperature is the cooling of the child. Indeed, during this period, the center of thermoregulation in the baby's brain has not yet fully matured, so any temperature fluctuations are very critically perceived by the body. Therefore, if during a walk the child is poorly dressed or if he gets cold while bathing, then the body temperature may decrease. Even in the maternity hospital, immediately after birth, the baby's body temperature may decrease under the influence of hypoglycemia. When a baby is poorly fed or sleeps for more than three hours without feeding, it can cause a decrease in body temperature. This is a defensive reaction of the baby's body in response to a decrease in blood glucose levels.
There can be many more reasons for an increase in body temperature in a child, and this does not always signal a disease. Most often, an increase in body temperature in a baby in the region of 36.8 - 37.4 can be with simple overheating. This happens in summer or winter if the child is not dressed for the weather. It can also be at home, when the body temperature is too high in the room without ventilation. It is imperative to remember that being outside in direct sunlight is harmful and dangerous for a child, as this can cause not only an increase in body temperature, but also sunstroke.
An increase in body temperature to subfebrile numbers in a baby of the first month of life can cause ordinary colic. This is not very typical for such a problem, but given the immaturity of the center of thermoregulation, this can be considered normal. Also, if the baby has constipation or diarrhea, this can cause a slight rise in body temperature.
If we talk about an increase in body temperature as a sign of a disease, then we can say that, depending on the pathogen, there are different indicators. A viral infection may be the cause of an increase in body temperature in a newborn. It can be a simple runny nose or pharyngitis. In this case, there may be an increase in body temperature up to 38-38.5 degrees, which is typical for viral infection... If the temperature is higher than these values, then you should urgently consult a doctor, because this often indicates a bacterial infection. The localization of inflammation in this case can be different, but more often the cause is pneumonia, bronchitis, or an infection of the urinary tract.
Pathologically high body temperature can be in the pathology of the central nervous system of a congenital or acquired nature. These can be transient fluctuations in body temperature after suffering a birth brain injury. Then there may be fluctuations that pass after a while. If the child was born in hypoxia or there were problems during childbirth, this can also be a factor in such a transient increase in temperature against the background of normal well-being.
The pathogenesis of an increase in body temperature during infection lies in the work of the thermoregulation center. This center is located in the medulla oblongata and is responsible for controlling body temperature. When a light viral agent enters the child's body, the body temperature rises in order to destroy this virus. After all, this virus can live normally and multiply only at temperatures up to 36.8. Thus, a protective reaction is activated. If the cause is a bacterial agent, then in order to destroy it, the body temperature must be slightly higher than with a bacterial infection. Therefore, when bacteria enters the body, inflammation factors, which are released into the blood, increase the activity of the thermoregulatory center and increase body temperature.
Risk factors
The risk factors for a decrease in body temperature are the following:
- low temperature in the room where the newborn baby is;
- hypoglycemia or long intervals between feedings;
- congenital or acquired pathologies of the central nervous system with impaired thermoregulation.
Risk factors for fever in a newborn:
- overheating of the child or the wrong temperature regime in the room;
- hypoxia or asphyxia after birth;
- viral and bacterial diseases;
- the presence of chronic foci of infection or other pathologies;
- concomitant stool disorders or colic.
These factors can, under certain conditions, become the causes of serious pathology, so they need to be corrected in time.
Temperature symptoms in a newborn baby
Fever symptoms in a newborn baby may be combined with other symptoms, or it may be the only symptom. There are several types of hyperthermia.
Types of temperature rise:
- subfebrile - 37-37.9 ° C
- febrile 38-38.9 ° C
- pyretic 39-39.9 ° C
- hyperpyretic ≥ 40 ° C.
If the temperature of a newborn child is increased to 37.5 degrees and there are no more manifestations, then most likely this indicates that the child is simply overheated. If there is no such reason, then it may just be such a feature due to the imperfection of the thermoregulation center. In this case, it will go away by itself by the end of the first month of life.
If there are other symptoms, then this indicates a disease. Low-grade body temperature in a newborn can be with a viral infection. As a rule, the common cold begins with general malaise, sneezing, sore throat, nasal congestion or a runny nose, which are well pronounced on days 2-3 of the disease. Often ARVI is accompanied by fever, aches all over the body, muscles, joints, headache, chills. Sometimes coughing, hoarseness or a change in the timbre of the voice, congestion of the ears join. In children, due to disturbed nasal breathing and hacking dry cough, sleep may be disturbed. When the baby cannot sleep at night, he can snore, cough, and eat poorly. All these signs can be with simple rhinitis caused by a viral infection. If the process of inflammation extends to the pharynx, then this can be combined with pharyngitis. At the same time, symptoms of coughing, painful sensations or scratching in the throat appear. But the baby cannot complain about this, therefore, with a simple sore throat, he eats badly and is capricious. It is these viral infections that are most often accompanied by subfebrile temperature body.
A high temperature in a newborn baby, which reaches 39 degrees, is very dangerous and requires immediate action. Most often this happens with a bacterial infection. respiratory tract, urinary tract infections, or any other infection. Pneumonia is the most common cause of high body temperature in a newborn baby. In this case, inflammation occurs in the alveoli with a violation of the outflow of sputum due to the physiologically horizontal position of the child. Therefore, along with an increase in body temperature, other symptoms of intoxication quickly appear. The child begins to eat poorly, is capricious, does not sleep, a cough appears. At the beginning of the disease, it may be dry, but then it becomes deep and moist, especially after sleep. Along with these symptoms, signs of shortness of breath appear. For pneumonia, the first or second degree of shortness of breath is characteristic. In newborns, this is manifested by pallor of the skin and cyanosis around the mouth, which appears when the child is anxious. In addition, additional muscles take part in the act of breathing - you can notice in the child the inflation of the wings of the nose, the retraction of the supraclavicular regions. If there is even one of the symptoms of shortness of breath or cough, which are combined with a high body temperature, then there is a very high probability of pneumonia.
Wheezing in a newborn baby without fever can also indicate pneumonia, since it is precisely because of the incomplete development of the center of thermoregulation that it may react incorrectly. Therefore, the absence of body temperature against the background of symptoms of respiratory failure or cough does not exclude pneumonia.
A urinary tract infection in newborns has few symptoms because it is difficult to track your baby's urination at this age. But any increase in body temperature without signs from the outside respiratory system can be regarded as a possible urinary tract infection. The only symptom that a mother may notice is a violation of the urination process. The child may urinate less or vice versa more often, and the color of the urine may be cloudy. But it is difficult to diagnose if the baby is wearing a diaper. There may be a small amount of blood in the urine, which is also difficult to see. If we are talking about a girl, then the development of cystitis of an ascending etiology is more likely than another pathology. Then, against the background of an increase in body temperature, there may be drops of blood in the urine or discharge from the vagina.
A temperature in a newborn child of 38 without symptoms can be like a transient condition that occurs when the child overheats. But sometimes this can be the first sign of a pathology that has not yet ripened to manifest itself and then you need to wait for the appearance of other symptoms today or tomorrow.
You need to know about another complex condition that can cause a significant increase in body temperature in a newborn child. This condition includes omphalitis. This is an inflammation of the skin and tissue around the navel caused by bacterial flora. For newborns, this is a particularly dangerous condition, since children are often discharged home and their umbilical wound has not yet healed, or the navel has not disappeared at all. This can be a gateway to an infection that spreads very quickly here. Clinically, against the background of an increase in body temperature, you can see that fluid begins to emerge from the navel or it turns red. If he already begins to fester, then this already threatens with sepsis. Therefore, when the body temperature rises, you need to pay attention to the navel and its condition.
It is necessary to distinguish between two types of fever - white and red. They differ in clinical features and treatment approaches. White fever is characterized by an increase in the child's body temperature and peripheral vascular spasm. Clinically, this is manifested by the fact that, against the background of temperature and a hot forehead, the child has pale and cold hands and feet. This type of fever requires an immediate drop in body temperature. In case of red fever, the peripheral vessels, on the contrary, expand and therefore the child is all hot and red. This contributes to the fact that the temperature drops faster than with constricted vessels. Therefore, it is a less dangerous type of fever.
A low temperature in a newborn baby may indicate hypothermia or hypoglycemia. If a child's body temperature drops sharply against the background of full health, then you need to make sure that he is not cold and not hungry. Then after eating and dressing everything can be normalized.
Complications and consequences
The consequences of increased body temperature in newborns can be very serious. Hyperpyretic fever (\u003e 41 ° C) - increases the tone of the sympathetic nervous system, the respiratory center, the need of organs for oxygen, sodium, chlorine and water are retained, edema develops, vasospasm occurs, blood circulation is centralized. There is myocardial hypoxia with a decrease in contractile ability, brain hypoxia with its edema, convulsions.
The most common complication of high fever can be seizures. Since the child has not yet fully matured neural connections in the brain, too high a jump in body temperature can lead to increased activity of the cerebral cortex and the development of seizures. It can be just simple muscle twitching or it can spread to the whole body. As a rule, this does not cause any complications, the parents are just very scared. Therefore, a decrease in high body temperature is mandatory for a newborn.
As for the complications of pathologies that cause an increase in body temperature, very often there may be other infectious complications. Pyelonephritis or cystitis in such early age may be complicated by the development of kidney abscesses, dysfunction of the bladder in the future. Pneumonia can cause a lung abscess or pleurisy. The most common complications of omphalitis are sepsis, since bacteria spread very quickly from this focus of infection. Therefore, any inflammation of the navel with a high temperature is very dangerous and requires immediate treatment.
Diagnosis of temperature in a newborn baby
Diagnosis of temperature in a newborn baby must begin with a correct measurement. It often happens that there is no reason for a decrease or increase in body temperature, but the thermometer shows the opposite. Then you need to make sure exactly in two points: that the measurement process is correct and that the thermometer itself also shows correctly.
How to correctly measure the temperature of a newborn baby? To answer this question, you must first figure out what kind of thermometers are. The most commonly used mercury thermometer is considered to be the most accurate. Its main mechanism of action is an increase in the concentration of mercury vapor with an increase in body temperature, which is determined by the gradient of values. Such a mechanism provides almost perfect temperature measurement, but with the right technique. For measuring mercury thermometer it is necessary that the child does not move and fixes the handle with the thermometer as much as possible. The measurement duration must be at least ten minutes. With this correct technique, the result is considered the most correct. In addition to the armpit area, you can measure the temperature of newborns in the groin. To do this, you also need to fix the leg for at least ten minutes. This thermometer can also measure the temperature in the rectum. But you need to do this very carefully, because the child can spin and damage can easily be done. It should be remembered that the temperature on the mucous membranes is 1 degree higher than on the skin. This must be taken into account when measuring temperature in oral cavity.
Electronic thermometers are now gaining more and more popularity due to their ease of measurement. You can hold such a thermometer for just a minute and it will show the result. But it is very important that after the beep, the thermometer remains in place for at least 10 seconds. This is a very important rule that is not always followed, but which greatly affects the result. There is also one drawback of such thermometers - they often give an error, so they need to be calibrated some time after use. Therefore, it is better to measure it with an ordinary mercury thermometer and be sure of the result.
An infrared thermometer is considered the fastest and most accurate. This device is capable of detecting infrared radiation from the skin or mucous membranes, which increases when the child's body temperature rises. It can be simply applied to the skin or to the area of \u200b\u200bthe eardrum, then you can immediately see the result in a few seconds. But the cost of such a device does not allow every family to purchase it. Therefore, the main thing is that the measurement technique is correct, then you can not worry about the correctness of the result.
When it is known for sure that the temperature is increased, then you need to further diagnose and look for the cause. The doctor must carefully examine the child and listen, because more often the cause may be a pathological process in the bronchi or lungs. If there is pneumonia, it is possible to hear crepitus and asymmetric moist rales in the lungs on auscultation. Percussion marked dullness of sound. In severe pneumonia, oxygen saturation may decrease. If there are auscultatory signs, then it is imperative to conduct further examination. A blood and urine test must be taken at the onset of the disease before starting treatment. With pneumonia, there may be changes in the blood test - an increase in the number of leukocytes in dynamics and an increase in rods, an increase in ESR. Instrumental diagnosis in confirming pneumonia is the main method. To do this, an x-ray of organs is performed. chest cavity and you can see inflammatory foci in the lungs in the form of infiltrative shadows.
If there are no symptoms from the respiratory system, then another cause of an increase in body temperature may be pyelonephritis or cystitis. Therefore, the main diagnostic method here is urine analysis. Now for newborns, there are special containers for collecting urine. They have a comfortable clasp and are sterile for accurate analysis. Therefore, it is better to collect urine in this container. General analysis urine with urinary tract infection can determine the following changes: cloudy color, mucus, increased white blood cell count, bacteria, and you can also identify a specific pathogen. This allows one to suspect a problem with inflammation of the urinary tract, and instrumental diagnostics are performed to confirm. For this purpose, ultrasound examination of the kidneys and bladder is used. If there is an expansion of the pelvic system, then this indicates pyelonephritis. Dependency or additional inclusions in the bladder indicate cystitis.
Differential diagnosis
Differential diagnosis temperature should primarily be carried out between two types - "red" and "white" fever. This is necessary to determine the tactics for reducing the temperature. Next, you need to differentiate the reason that caused such an increase. It is very important to decide on time with additional research methods in order to say about the pathology.
Treatment of temperature in a newborn baby
If the temperature of a newborn child has risen above 38.5 degrees, then it must be brought down to prevent the development of seizures. It is important to determine the type of fever - red or white. Medicines to lower the temperature are given with both types and the other, but then the treatment tactics are slightly different.
To understand medicines and how they should be given, you need to know about the main principles of increasing body temperature. There are successive stages of temperature decrease:
- the stage of an increase in body temperature is the period when the temperature rises;
- the "plateau" stage is the stage when the temperature reaches its maximum values. It is at this stage that drugs should be given to lower body temperature, if the value is higher than 38.5 degrees, then the temperature cannot decrease on its own.
- stage of temperature decrease - this can occur independently if it is below 38.5. Therefore, a decrease in subfebrile temperature is not used, since this process is controlled by the body independently.
Antipyretic drugs come in the following dosage forms:
- Tablets - but not all patients can swallow, slow effect, irritation of the mucous digestive tract, allergy from ballast substances.
- Fast dissolving - effervescent tablets.
- Microgranular capsules.
- Syrups / suspensions.
- Suppositories / suppositories.
Usually, the use of antipyretics begins when the body temperature rises above 38 ° C. Children of the first 3 years are prescribed antipyretics at 38 ° C if they have had convulsions before. For infants, the use of drugs in the form of suppositories is more acceptable, but suppositories are not used in the presence of diarrhea. Before the introduction of the suppository, it is necessary to cleanse the intestines with an enema.
The drugs that can be used to lower body temperature in children are limited.
- Paracetamol Is a drug that belongs to analgesics-antipyretics from the group of non-hormonal anti-inflammatory drugs. The main mechanism of action of paracetamol is inhibition of the synthesis of prostaglandins. These substances potentiate the inflammatory response through the synthesis of inflammatory substances. The drug blocks the release of these substances and reduces fever and other symptoms of inflammation. Also, in addition to lowering body temperature, paracetamol has an analgesic effect. For newborns, the best way to use is in the form of a syrup. The dosage is 10-15 milligrams per kilogram of body weight at a time. You can repeat the reception at least 4 hours after the last time. The syrup is available in a dose of 120 milligrams in five milliliters, which is further calculated by body weight. Side effects - from the gastrointestinal tract in the form of dyspeptic disorders, erosions and ulcers of the stomach and duodenum, there may be bleeding and perforation.
- Ibuprofen Is the second antipyretic drug that can be used in pediatrics. The antipyretic effect of ibuprofen is detected only with fevers, the drug does not affect normal body temperature. Like any of this group of drugs, ibuprofen has analgesic properties. The dosage of the drug is 5-10 milligrams per kilogram of the child's body weight. It comes in a syrup of 100 milligrams in 5 milliliters. Side effects of the drug - it can have a direct effect on the structure of the kidneys, cause interstitial nephritis. Precautions - do not use in children with kidney disease.
- For the treatment of rhinitis, which may be accompanied by low-grade fever, it is very important to properly care for the child, then medications to lower the body temperature may not be needed. A mandatory procedure for treating rhinitis in children is rinsing the nasal passages. saline solutions or infusions (decoctions) of medicinal herbs. The use of decongestant is permissible only in cases of severe nasal congestion, especially at night. Preference is given to solutions in the form of drops, spray and in a concentration corresponding to the age of the child. It is not recommended for newborn babies to inject oil solutions into the nasal passages, since as a result of entering the lungs, this can lead to the development of pneumonia.
Nazol-baby Is a drug that narrows the vessels in the nasal cavity. The active ingredient of the drug is oxymetazoline. For newborn babies, nasal drops of oxymetazoline 0.01% solution are used. Dosage - one drop no more than three times a day, but it is better to use this drug only at night. Side effects - the development of addiction and mucosal atrophy with prolonged use is possible.
- Antiviral drugs can be used to treat a viral infection even if the temperature is subfebrile, then the course of the disease will be easier.
Imunoflazid - this is antiviral agent, the main active ingredient of which is proteflazid. This is a substance that is obtained from extracts of sod pike and reed grass. The drug has a direct antiviral and immunomodulatory properties. The method of administration is in the form of a syrup, and the dosage is 0.5 milliliters for newborns twice a day. Side effects - headache, allergic manifestations.
Vitamins can be used after the child recovers to prevent respiratory and other diseases.
Alternative treatment of temperature
Traditional methods of treating fever in adults are used very widely, but it should be remembered that such methods are very limited in children.
When a child is sick, it is necessary to follow a healthy diet for the mother if she is breastfeeding. It is very important to comply with sanitary standards (twice a day - wet cleaning, constant ventilation).
- If a child has a "red" type of fever, then at the height of the temperature the child should be opened or wiped off with water at room temperature. This will help lower the temperature while it comes to medication.
- In case of "white" fever, the child's hands, on the contrary, must be rubbed with their own hands until they become warmer. This will help improve blood flow in the peripheral vessels of the skin. Such actions must be carried out even when giving medicines.
- At a temperature, the child should be given a lot to drink. For a newborn, it can be a special baby chamomile tea or baby water. It should be given from a teaspoon every twenty to thirty minutes in the acute period.
Herbal treatment can be used in the acute period with an increase in body temperature, as well as for infectious diseases. Herbal medicines can be taken by a child or mother if she is breastfeeding.
- Linden is a well-known tree that has antiseptic and antitoxic properties, therefore it can be used for colds, bronchitis or pneumonia. To prepare a tincture in a glass of hot water, you need to take 20 grams of dry leaves with inflorescences. After insisting, you can give your child a teaspoonful to drink several times a day.
- Chamomile tea should be drunk for colds, rhinitis or pharyngitis. It has antiseptic properties, so it can kill viruses in the mouth. To make tea for a child, it is better to take baby chamomile tea and dilute with boiled water. You need to give half a teaspoon every half hour.
- An infusion of marigold herb also has antiseptic properties and helps to normalize local immunity in case of viral respiratory tract infection. To prepare the infusion, you need to take 50 grams of grass and add 250 grams of boiled water. After the solution is infused for two hours, mom can take a teaspoon in the morning and evening if she is breastfeeding. Exceeding the dose may cause allergies.
Homeopathy is not used to treat body temperature in the acute period. It is possible to use antiviral and immunomodulatory agents for viral infections.
- Aflubin is a complex antiviral drugwhich contains extract of aconite, bryony and other substances. The drug has antiviral and immunomodulatory activity. Method of application - in the form of drops. The dosage for children under one year old is 1 drop seven to eight times a day. Side effects - dizziness, drowsiness.
- Vocara is a complex homeopathic preparation that can be used in small children with pharyngitis with severe hyperemia. back wall pharynx. Dosage - one drop three times a day. Side effects are very rare, there may be increased salivation.
- Viburcol is a complex homeopathic suppository with pronounced antiviral activity. The drug is used to treat acute pathologies and prevent their complications. The dosage is one candle twice a day, and in the elimination of acute symptoms, it can be used once a day.
- Influcid is a complex six-component homeopathic medicine with antiviral activity. It is used in the acute period to treat colds, and also lowers body temperature due to its immunomodulatory effect. The dosage of the drug is one tablet five times a day. Method of application - for children, it is better to grind the tablet into powder. Precautions - Use in newborns only on the advice of a doctor.
Prevention
Prevention of an increase in body temperature in a child includes all preventive measures aimed at a healthy lifestyle for mom and baby. It is very important to properly accustom the child to the thermal regime and to the weather immediately after birth, not to overheat him and not to provoke hypothermia. Contact with sick people should be avoided and all vaccinations should be carried out to prevent infectious diseases.
Medical Expert Editor
Alexey Portnov
Education: Kiev National Medical University. A.A. Bogomolets, specialty - "General Medicine"
References
- Neonatology - A.K. Tkachenko, A.A. Ustinovich, A.V. Sukalo, A.V. Solntseva, L.V. Grak, E.K. Khrustaleva. 2009
- Clinical neonatology - Khazanov A.I. 2009
- Newborn Resuscitation - Kattwinkel J. 2007
- Neonatology - R. Roos, O. Gentsel-Boroviceni, G. Prokitte - Practical recommendations. 2010
Thermoregulation and body temperature
Body temperature - one of the indicators of the body's vital activity, which depends on many physiological processes. The maintenance of optimal body temperature and its change under certain conditions is provided by the thermoregulation system, the center of which is located in the hypothalamus. It regulates the balance between the formation of heat in the body and its loss, that is, between heat production and heat transfer.
A child is born with an imperfect thermoregulatory system. Newborns and children under 3 months of age cannot maintain a constant body temperature and are sensitive to fluctuations in ambient temperature - both indoors and outdoors. Therefore, with improper care, rapid overheating or hypothermia of the baby can occur.
In some newborns, on the 3-5th day of life, the temperature rises to 38-39 ° C, since they do not cope with temperature regulation in the process of adapting to existence outside the mother's womb.
By the age of three months, the baby develops a system of thermoregulation, the formation of circadian rhythms of body temperature begins. The minimum temperature is observed late at night and closer to morning, the maximum - in the afternoon, evening hours. When measuring the temperature of a child, you need to know that the temperature of different parts of the body varies significantly. In order to navigate the temperature readings obtained by various measurement methods, you must always keep in mind that the temperature in armpit 0.3-0.6 ° C, and in the mouth 0.2-0.3 ° C lower than in the rectum.
Normal baby body temperature:
- In armpits 36-37 ° С
- Rectal (in the rectum) 36.9-37.4 ° C
- Oral (in the mouth) 36.6-37.2 ° C
How to measure temperature
A mercury medical thermometer, an electronic thermometer and a temperature indicator are used to measure body temperature in infants. Nowadays, there are also new convenient tools, such as nipple thermometers.
With a mercury thermometer, the temperature is measured only in the armpit. For this, they take the child in their arms, place the thermometer under his arm and fix the child's handle with their hand, holding the thermometer so that it does not slip out. It is better to perform this procedure while sitting on the sofa (and not on a chair) so that the thermometer does not break if it falls. To obtain objective results, it is enough to hold the thermometer for 3-5 minutes. After finishing the temperature measurement, the thermometer should be shaken or held under running cold water.
The electronic thermometer is safer and easier to handle. It gives fast and accurate readings that are displayed in the display window. It is not used to accurately measure the temperature in the armpit, since this type of thermometer requires closer contact with the body to take readings, but it is indispensable for measuring oral and rectal temperature... Although recently, electronic thermometers have appeared that are able to accurately measure the temperature in the armpit or in the ear, and in just a few seconds. Their peculiarity is that a round rubber suction cup serves as the tip of the thermometer, and not a narrow metal rod. To measure oral temperature, an electronic thermometer is placed in the mouth under the tongue for 1 minute (most electronic thermometers beep when the temperature has been measured).
To measure rectal temperature, you need to lubricate the tip of the thermometer with baby cream or petroleum jelly, put the baby on the back, raise his legs with one hand (as when washing), with the other hand carefully insert the thermometer into the anus to a depth of about 2 cm (it is advisable to read the instructions for the thermometer, since the depth of insertion may depend on its design). Then you need to fix the thermometer between the middle and forefinger, and hold the baby's buttocks with the other fingers.
The temperature indicator is a strip with heat-sensitive squares or graduations with digital marks. When measuring the temperature, the squares change color sequentially. The last square that changed its color and the corresponding digital value indicate the body temperature. The indicator strip is applied to the child's forehead for 15 seconds (sometimes there are strips that should be placed under the tongue - so be sure to read the instructions before using the indicator!). The indicator strip does not give accurate results, therefore, the temperature increase can be reliably judged only when the indicator shows 37.5 ° C and above.
In order to correctly evaluate the temperature measurement results, you need to know what temperature is normal for your child. And in order to determine this, you need to measure it in a calm atmosphere in the morning and in the evening with a healthy child and remember the indicators. After you have fixed "your" norm, never measure the temperature of a healthy child for no reason, "just in case." And even when the child is sick, you should not do this more often than prescribed (see below for how often the temperature of a sick child should be measured). Each procedure for measuring temperature worries the child, contributes to the formation of a negative reaction to the thermometer.
How to suspect a child's fever and roughly estimate it
Young children may react differently to an increase in body temperature. Their reaction will depend primarily on the cause of the rise in temperature. Signs of an elevated temperature can be:
- lethargy or anxiety;
- thirst;
- dry mucous membranes (lips, tongue);
- increased heart rate; increased breathing;
- bright blush on the face, "flaming" cheeks (and sometimes, on the contrary, pallor);
- red, sore, or overly shiny eyes; chills;
- sweating.
The normal heart rate of a child is 100-130 beats per minute during sleep and 140-160 during wakefulness. When crying, the pulse is 160-200 beats per minute.
As the child grows up, the pulse slows down and by the age of two it is usually 100-140 beats. As for the respiratory rate, newborns usually take from 40 to 60 breaths per minute, one-year-old children - only 25-30. You need to know that some children do not react at all to an increase in temperature.
If you suspect a rise in temperature, you must first touch your cheek to the child's forehead (you should not evaluate the temperature with your lips or palm). If you feel that your forehead is hotter than usual, you should measure the temperature with one of the thermometers described above.
Most common reasons temperature rise
Fever (fever), which is not a sign of illness, can reach 38.3 ° C. It can be caused by:
- overheating of the child due to excessive wrapping or exposure to direct sunlight; violation of the drinking regime (especially in children under 3 months);
- constipation;
- high physical activity;
- physical stress (prolonged screaming);
- teething;
- constitutional features.
Well, and the best thing is to avoid such situations at all, so the child should be dressed according to the ambient temperature, in the summer be in the shade of trees or under awnings. It is necessary to observe the diet, drinking, hardening. However, it must be remembered that an increase in temperature above 38 ° C is most often a sign of a disease. Most often, various childhood infections (measles, rubella, mumps, etc.) are accompanied by a febrile state, colds (ARVI), intestinal infections, inflammatory diseases of the ear, throat, nose, lungs, kidneys, etc. Preventive vaccinations can also be accompanied by fever. There is also a group of diseases that can cause a child's fever. These are hypoxic, traumatic, inflammatory and hereditary lesions of the central nervous system.
Speaking about diseases, it should be noted that the temperature does not always correspond to the severity of the disease. In general, an increase in temperature in itself is not a disease, but a way of fighting the body against it.
This is especially true for infectious diseases. However, in babies, the protective functions are not yet perfect, therefore, children react to the disease in different ways: the temperature can rise strongly or moderately, remain normal or even decrease.
How to respond to a child's fever
An increase in temperature due to any disease requires a doctor's consultation. But before the doctor arrives, if the child has a fever, it is necessary to use one of the non-medicated ways to lower the temperature, described below.
Temperatures that do not rise above 38 ° C usually do not need to be reduced.
A higher temperature, especially when accompanied by other symptoms, a violation of the child's behavior, as a rule, requires a decrease. Of course, the temperature must be reduced above 38.5 ° C in all children under one year old and above 38 ° C in children with a history of seizures or other lesions of the central nervous system. However, the final verdict on the issue of lowering the temperature always rests with the doctor.
Parents should prepare the following information for the doctor's appointment:
- their assumptions about the cause of the fever;
- a list of used medicinal and non-medicinal methods of lowering the temperature with an assessment of their effectiveness;
- a sheet with numbers of the measured temperature indicating the method and time of its measurement.
When do you need to immediately call a doctor
In the following cases, a child under the age of one year needs an urgent examination by a pediatrician or an ambulance doctor:
- An increase in temperature is noted in a child under 3 months of age.
- The temperature in the armpit is above 38 ° C. If you cannot call a local pediatrician (for example, on weekends or holidays, at a late hour), and the temperature rises above 38.5 ° C, you need to call an emergency or ambulance.
- If you find that your child has a high temperature, try measuring it again in a calm environment after 20-30 minutes. If the thermometer reading remains the same, call your doctor.
- Convulsions appear (the body is tense, the eyes roll back, twitching of the limbs is visible, the skin may turn pale), or the child has had seizures before (that is, the temperature has increased against the background of seizures).
- The baby's neck seems tense, and he does not allow his chin to bend to the chest.
- An increase in temperature is accompanied by noisy, frequent, arrhythmic breathing, and a severe runny nose.
- The child is crying incessantly or has become unusually lethargic, apathetic.
- The child refuses to eat for more than 6 hours in a row.
- The child has vomiting or diarrhea.
- The child does not urinate for a long time, or the color of his urine is changed.
- The child has a rash on the skin.
- The methods you are using to lower the temperature do not give the desired effect.
- The child has a chronic illness.
Rules for caring for a febrile child
First of all, it is necessary to create conditions for the flow of fresh air into the room where the child is. For this, the room must be periodically ventilated (the child should be taken out for this time). In the children's room, the air temperature should be 18-22 ° C, while sleeping 17-20 ° C. Central heating is preferred, since electric heaters dry the air. When the temperature rises, it is necessary to refrain from sleeping in the air and walking. A feverish child should not be wrapped in a blanket, use plastic mats and mattress covers. The child's daily bathing should not be stopped, but the temperature should not be lower than 36-37 ° C.
There is no need to worry if the child is reluctant to eat and little during illness. You can't force feed him. Frequent small meals are the best option. Drinking is the most important thing for a sick child, so it is necessary to drink it as often as possible.
It is necessary to protect the child's sleep. You can't wake him up to feed him or measure his temperature: during an illness, sleep is more important to him than food.
Non-medicinal ways to lower the temperature
To lower the temperature in young children, rubbing with a sponge moistened with warm water is effective. When rubbing, the baby's skin cools due to the evaporation of moisture from its surface. It is better to start rubbing from the face, neck, then you should go to the arms, legs and torso. Do not rub with alcohol, vinegar or cold water - this causes a rapid decrease in skin temperature and vasospasm, which leads to a decrease in heat transfer and, accordingly, an increase in temperature. In addition, vinegar and alcohol penetrate the skin, and they are toxic to the baby. If the temperature rise is accompanied by chills, the child can be covered warmly.
Drinking plenty of fluids also helps to reduce the temperature. It is clear that you will not be able to convince the baby to drink more, so you need to insistently offer him breasts or his favorite drinks more often. When sweating, it is necessary to change linen more often (for bed and body).
Be sure to follow the rules for caring for a feverish child!
Medicinal ways to lower the temperature
To reduce fever in children under one year old, are used medicines, the active ingredient of which is paracetamol. When you buy an antipyretic drug, pay attention to the packaging: next to the trade name of the drug in smaller, often Latin letters, the name of the active substance should be written - that is, the component that has a therapeutic effect. Candles, syrups, drops, solutions are most acceptable for babies.
Antipyretic drugs that are suitable for your child must be purchased in advance, after the obligatory consultation with the doctor watching the baby!
Do not mix medicines into milk, formula or drink.
And most importantly, what parents need to know about medicated fever management, especially in children under 3 months of age: medications and their dose should only be a doctor!
Nina Brashnina. Associate Professor of the Department of Children's Diseases No. 1 of the Russian State Medical University, Ph.D.
Probably, there is not a single mother, neither young nor experienced, who would not be afraid sharp rise temperature of the baby, and the actions of a frightened mother are sometimes unpredictable and not entirely adequate. Let's try to figure out what should be done and in what cases.
First of all, it is worth separating the concepts of fever and increased body temperature when the body overheats. Overheating can be observed for a variety of reasons - with an increase in air temperature, with active muscular work (jumping on a trampoline will also be referred to here), when using two bowls of grandmother's hot soup, etc. In these cases, the body retains the mindset to normalize body temperature, and even if your child has jumped to 37.5-37.8 degrees, no emergency measures need to be taken. Just make sure after half an hour that the temperature has returned to normal.
Fever is much more complicated. In order not to overload ourselves and our suspiciousness with unnecessary information, in this article we will confine ourselves to a fever of an infectious genesis, leaving everything else to specialists.
First of all, every mother should know that fever is not only evil, but also good. Fever of infectious genesis is a protective-compensatory reaction of the body, as a result of which the immune response is enhanced: a rise in temperature leads to an intensification of metabolism, an increase in the synthesis of interferons, increases the bactericidal activity of the blood due to increased phagocytosis and an increase in the activity of leukocytes, and stimulates the formation of antibodies. On the one hand, everything looks good - the baby's body is learning to fight the infection, and on the other, the fever itself can be dangerous for the child.
There are two types of fever - "red" (or "pink") and "white".
Signs of a red (pink) fever: the baby's skin is pink, warm, the baby responds well to antipyretic drugs and non-drug antipyretic measures. Heat transfer corresponds to heat production, the child feels relatively well.
With white fever, there is a pronounced centralization of blood circulation and spasm of peripheral vessels: the child's skin is pale, the head and trunk are hot, the feet and palms are markedly cold, tachycardia and an increase in systolic (upper) blood pressure are observed, the heat transfer of heat production does not correspond, delirium and convulsions are possible, antipyretics have no effect, or their effect is negligible.
So, what temperature needs to be lowered, and which is better to just wait out, armed with a bottle of valerian?
Most viruses are neutralized at 39 degrees. Therefore, it is obvious that for an initially healthy child (over 1 year old), an easily tolerated temperature (pink fever) up to 39 is not a reason for taking antipyretics and is quite easily maintained at the same level with the help of plenty of drinking. With an increase above 39, this temperature is usually easily knocked down by a simple wiping with a sponge soaked in warm water. You can take paracetamol and ibuprofen. For babies under one year old and children with a history of febrile seizures, the upper bar of non-breaking temperature is reduced to 38 - 38.5 degrees.
With white fever, the unbreakable temperature bar is lowered. If the child does not tolerate the temperature, complains about headache, trembles, this temperature must be brought down, even if it has not stepped over the 38.5 bar. The problem is that the usual methods of lowering the temperature for white fever don't work. As a result of the pronounced centralization of blood circulation, heat production exceeds heat transfer, and in order to effectively reduce the temperature, it is first necessary to restore microcirculation. At home, you can use the no-shpa and corvalol that are present in almost every home, put the baby on a woolen blanket, rub the arms and legs, put on woolen socks, and when the child gets warm, use ordinary antipyretic drugs. In addition to no-shpa and corvalol, it is possible to use papaverine, nicotinic acid, dibazol to relieve spasm of peripheral vessels at home. It is worth knowing which of these drugs are in the home before calling a pediatric ambulance substation.
Febrile convulsions are a common occurrence in white hyperthermia. The first thing that parents should do at the onset of paroxysm is to pull themselves together, put the child on their back and turn their head to one side, free them from clothes, measure the temperature, call an ambulance in the process and wait, carefully watching the child. The temperature during an attack can only be reduced by rubbing off with warm water and cooling the head (a cool wet towel is enough). Under no circumstances should you try to give your child medications, open your jaws, drink and distract chocolates during an attack. As a rule, attacks of simple febrile seizures last no more than 15 minutes, but even if the attack has passed, you should not cancel the emergency call - be sure to wait for the doctor.
Another unpleasant phenomenon, which mothers rarely pay attention to, concerns not an increase, but a decrease in temperature. A normal decrease is considered to be a decrease of 1-1.5 degrees per hour, a sharp decrease in temperature by 2.5-3 degrees or more is called critical and can lead to a life-threatening collapse of the child. If your little one is reactive and prone to sudden changes in temperature, you may need to seriously consider the doctor's offer to continue treatment in the hospital.
What can not be done in any case.
Our grandmothers and even mothers widely used vinegar and vodka to reduce the rubbing temperature. Do not heed these tips - firstly, these procedures increase intoxication, and secondly, rubbing with a sponge moistened with ordinary warm water (32-35 degrees) is much more effective.
Another sad experience of the older generation is gastric lavage with cold water and cold enemas. Both that, and another can provoke the development of seizures.
The third thing to avoid is taking antipyretic drugs, which at one time lowered our temperature. You should not give your baby amidopyrine, aspirin and analgin. The drugs of choice for our children are paracetamol and ibuprofen, which does not interfere with platelet function.
Fourth - probably, among modern Russian mothers there is not one who, at least once in early youth during an illness, was not given an antipyretic pill for the night "for prevention." Don't repeat the mistakes - it doesn't work that way. Antipyretic drugs are taken only in the presence of fever.
Fifth is honey. You should not give a child under 5 years old honey during an illness. Especially it is not worth giving it during an illness for the first time. This is a fairly strong allergen and during an illness with an enhanced immune response, its use is simply dangerous.
Sixth. You should not rely on the experience of Internet communities and stuff your child with antipyretics for five days, piously believing that a temperature with a viral infection for 5 days is normal. This is not normal (this time). And don't trigger a bacterial infection by delaying antibiotics (that's two). Make it a rule to write down all significant events (episodes of fever, changes in cough discharge from the nose, changes in appetite, etc.) - it will be much easier to see the dynamics and notice the development of a bacterial infection in time. Why record? Because the child's illness is stressful for the mother. And not a single mother can objectively assess the dynamics from memory - the temperature rises merge into one, an attempt to remember the number of doses of drugs is reduced to memories of accompanying tantrums, etc. Write down)
Seventh. Do not change thermometers - now it is quite difficult to find a thermometer that shows the reference temperature. By measuring the temperature all the time with the same thermometer, you will at least see the dynamics. Also, do not measure the temperature with ear infrared thermometers for angina and otitis media - you will measure the temperature in the inflammation focus, and not at all the body temperature. With angina, even at a temperature of 37 degrees, an ear infrared thermometer will show you a minimum of 39. And it will be right. If you are looking for an infrared thermometer for all occasions, check out infrared forehead thermometers.
Eighth. You should not lean on antipyretics while taking antibiotics for a bacterial infection - by combining the intake of these drugs, you deprive the doctor (and yourself too) of the chance to understand whether the antibiotic is working or not.
Ninth. Do not persuade the child too actively to eat if he does not want to. Loss of appetite is absolutely normal during illness and a hungry body fights infection much more successfully than a full one.
But the tea made from raspberry leaves and raspberry fruit juice, which are not dangerous for babies, have not lost their relevance and are quite suitable for our children.
This article is by no means an instruction on self-medication and is intended only for you to know how to act in a given situation, what to expect from doctors, what not to do and what to talk about when you call your doctor or pediatrician. ambulance substation (telephone in Novosibirsk 225-35-13)
A high body temperature in a child always causes anxiety and concern for parents. I would like to immediately take action, to do at least something to reduce it. However, this is not always good for the baby.
Increase in body temperature with acute infectious disease is a reasonable reaction of the body. Responding to the invasion of microbes or viruses, it tries to activate metabolic processes, trigger the production of protective proteins, and deliver them to the site of inflammation as soon as possible. All this is happening faster. Therefore, during infection, special substances are produced in the tissues - pyrogens, which cause an increase in heat production. In this case, heat transfer increases slightly or even decreases.
An increase in body temperature during infectious processes is a good prognostic sign. It is believed that a sufficiently pronounced temperature reaction indicates a high level of activity of the immune system.
Elevated body temperature is defined as follows:
Subfebrile - up to 38 degrees;
moderately febrile -38.1-39 degrees;
high febrile - 39.1-41 degrees;
hyperpyretic - above 41 degrees.
When microbes and viruses enter the body, heat transfer is first limited: blood vessels are narrowed, sweating and evaporation are reduced, blood flow to the skin and mucous membranes decreases. The child develops pallor, "goose bumps", he becomes cold or even begins to chill. This is the first stage of fever - the stage of temperature rise, or white hyperthermia.
When the temperature reaches a certain level, heat transfer increases: the vessels of the skin expand, it becomes pink and hot. There is a feeling of heat ("pink hyperthermia"). This is the second phase of the febrile process, in which the fever can persist for several hours or days.
After the cessation of the production of pyrogens, the hypothalamic centers return to their normal level of regulation. The body temperature drops. This can happen gradually, over several days (lytic decline) or abruptly, quickly - over several hours (critical decline). With the latter, profuse sweat and rapid breathing appear.
To decide when to lower the temperature in a child, it is recommended, first of all, to focus on the general condition of the child.
Children usually tolerate mild hyperthermia well. When the body temperature rises to 38 degrees, an adult man sometimes cannot reach a mug of water, and the child plays as if nothing had happened.
With good tolerance, it is not necessary to lower the temperature below 38-39 degrees, because only with it, the body begins to produce its own protective proteins - interferons, which have antiviral and antimicrobial activity. The child's use of antipyretic drugs interferes with the body's fight against infection. Where he could cope in 3 days, when using antipyretics, 7 will be required - and even taking interferons from the outside.
Some children (as a rule, with the pathology of the nervous system obtained during childbirth), even at low temperatures, may experience convulsions. If this has happened before, it is advised not to allow a significant increase in temperature.
If the temperature becomes very high, it in itself can worsen the child's condition: the appearance of lethargy, changes in the heart and blood vessels, and cerebral edema. Therefore, it is imperative to give antipyretics:
Children under 2 months old with a body temperature of more than 38 degrees;
children with a burdened history - at 38.5 and above;
all children at a temperature of 39 degrees or more.
Physical and medical methods can be used to lower body temperature. There is no need to strive to normalize body temperature, a decrease of 0.5-1 degrees to febrile numbers is quite enough.
Physical cooling methods are aimed at increasing heat transfer by enhancing evaporation. At home, it is recommended to use a plentiful warm drink and rub the body with a sponge moistened with water at a temperature of 30-32 degrees. Rubbing the body with a mixture of water and vinegar, so popular among the people, should not be used on infants. At an older age, they are used only with the permission of a doctor.
The drugs of choice for hyperthermia in children are paracetamol and. If the temperature does not decrease 20-30 minutes after taking the medicine by mouth, antipyretics can be injected intramuscularly. For this, ambulance doctors usually use a mixture of two to three drugs. Children with a body temperature of more than 41 degrees must be hospitalized.