When the baby is hot
Shiny eyes, red cheeks, poor appetite, little desire to move and, above all, a hot forehead.
There is no doubt: your child has a fever and a thermometer - by the way, according to the guidelines of the Paesena Society of Pediatricians (SIP) it is better to use the digital one, to be put under the armpit - confirms. But be careful, even if exceeds 38,5 ° C in general you shouldn't be scared.
"Fever is a natural defense mechanism of the organism against pathogens, which at high temperatures find it harder to function and multiply "warns the professor Gian Luigi Marseglia, director of the pediatric clinic of the - Policlinico San Matteo. "In this sense it is a positive phenomenon, but obviously it must be kept under control, to see how it evolves".
The first interventions
If the child with a fever has less than a month old should be taken to the emergency room as soon as possible, while in a month and a year - if it is in good general conditions - just schedule a same day visit, even at the pediatrician. "Maybe it's nothing, but it could be a serious infection, like pneumonia or meningitis," the doctor points out.
If, on the other hand, it is bigger, you can simply do it keep in observation. "Usually the cause of the fever is infectious diseases of little relevance, almost always sustained by viruses typical of the winter period (flu, parainfluenza, adenovirus, rhinovirus) or, more rarely, by bacteria "explains Marseglia. Often in these cases a little rest is enough and the fever should pass in 3 or 4 days, even without antipyretic. Indeed: according to the SIP guidelines, the antipyretic should only be used in case of general malaise.
Drugs: which ones yes, which ones not
"Precisely because it is a defense mechanism, fever it should not be lowered at all costs, but only when it causes a high degree of discomfort "underlines Maurizio De Martino, director of the Pediatric Clinic 1 of the Meyer Hospital in the city. severity index: "You can have very light infections with a very high fever and, vice versa, more serious situations with slight rises in temperature".
When the drug is needed, you can choose between paracetamol or ibuprofen (never together). Remembering that in children at risk of seizures, antipyretics do not avoid them: the fever is lowered, but the possibility of seizures remains. Instead, no to acetylsalicylic acid and cortisone. The drugs should be administered by mouth, but in case of vomiting, the rectal route is better.
The convulsions
It is often thought that a high fever can trigger seizures, but this is not the case. "The fever has nothing to do with the onset of convulsions which instead represent a particular response of subjects predisposed from a genetic point of view to the presence of an infection" explains Maurizio de Martino. In other words it is the cause of the fever itself - that is, the infection - that also causes the convulsions.
The first time they occur, you need to carry the baby at the emergency room. "This is because - affirms De Martino - if it is true that usually the cause is the one just described, in rare cases it could be a manifestation of meningitis or encephalitis".
If it is "only" benign convulsions, nothing special needs to be done. At the most, after a first episode it can be useful to keep gods in the house micro-enemas of diazepam, to be administered in the event of subsequent seizures, if these do not resolve on their own within two to three minutes.
Alarm bells
In some cases it is better not to wait and see your doctor immediately. For example if the child shows himself particularly suffering - is whiny, cannot get out of bed, completely refuses food - or introduces other symptoms such as a continuous, persistent and sleep-disturbing cough, a possible sign of bronchitis or pneumonia, or vomiting and diarrhea, usually signs of gastroenteritis. Fever, vomiting, and other symptoms such as headache, confusion, stiff neck, and light discomfort could signal meningitis, a dangerous but thankfully very rare disease. "In any case, better prevent it with vaccinationi "underlines Marseille.
The pediatrician should be heard even in the absence of particular symptoms, if after 3 or 4 days the fever does not pass not even with drugs: rarer or more persistent infections or inflammatory or autoimmune diseases, such as rheumatic diseases, could be involved. Sometimes, even after the first tests, the fever remains without an identified cause: we then speak of fever of unknown origin. This does not mean that you will never know what it is, but that to find out it is necessary to follow a diagnostic path a little longer.
To the doctor with a fever
The child with a fever you can safely go to the clinic: not only does his condition not worsen because of this, but in the office the doctor has any tools available for an initial diagnosis (throat swab, urine test, micro blood sampling). Only if the fever exceeds 39 ° C, does not respond to drugs and the general conditions are such that it does not allow moving (for example due to very frequent vomiting or diarrhea) can a home visit be useful.
Sponging no, honey yes
Sponging with warm water or rubbing with alcohol: do old fever-lowering remedies really work? There are not many scientific data available on the effectiveness of these practices, but they seem to indicate that they are of little or no use, and that moreover they can annoy the child. According to the SIP guidelines, they should be avoided, unless it is a fever but a hyperthermia (heat stroke): in this case they are useful.
If sponging is not needed, however, there is another grandmother's remedy that can help: the classic glass of hot milk and honey. "It is excellent and some studies underline the effectiveness of honey in alleviating some respiratory symptoms" confirms De Martino. "But be careful: afterwards you have to remind the child of Brush your teeth, because honey causes tooth decay ".
Updated on 04.10.2022
TAG:- fever
- influence
- meningitis
- pneumonia
- hospital
- infections children
