Fevers in newborns under two months of age need to be monitored. Fever phobia is common among parents but most times these fears are unfounded. That all being said; very young infants ARE at high risk for serious infections, so quick care and medical evaluation can be necessary. The following are a few tips parents should know about fevers in newborns so they know how to react…
What Body Temperature Should Cause Concern
We all learned in elementary school that 98.6 Fahrenheit is a normal body temperature. The body’s temperature is constantly fluctuating within a degree or two. Any temperature from 97.0 to 100.3 is normal. Any temperature of 100.4 or higher is a fever. Low temperatures can also be a problem so bring those to the attention of your doctor as well. Many parents fear that fevers will cause brain damage, but really that is not the case. Fevers caused by illnesses are not dangerous, they are simply a sign that something is going on. That something may or may not be concerning, so it is really the cause of the fever and not the fever itself that matters.
When to Check a Baby’s Temperature
Do not bother purchasing a 24-hour temperature monitor. Hospitals do not even track temperature that closely. Checking the baby’s temperature should not be part of your baby’s routine. If your baby is happy, feeding well, and not feeling warm, you do not need to check a temperature. If you feel your baby might be sick, it is a good idea to tell the doctor his temperature.
How to Take a Baby’s Temperature
For newborns when accurate measurements are really important, you should use a rectal thermometer. To take a rectal temperature, place your infant on their back, remove their diaper and pull their legs up towards their chest. Use a dedicated digital thermometer dipped in Vaseline. Turn the thermometer on and insert it gently about ½ to 1 inch into the rectum. Hold the thermometer in place until it beeps and then read the temperature on the display. Wash the thermometer with soap and water, or wipe it off and clean it with rubbing alcohol.
Why Fevers Are Important With Newborns
Fevers in newborns can be a early sign of a life-threatening infection. Babies get sick fast, so it is important to catch infections early as possible. This is one of the reasons we do not routinely give Tylenol to infant under 2 months, there is nothing harmful about it but it can mask a fever and delay the recognition of a serious illness. A few of the things we worry about are things like bacteria in the bloodstream, meningitis, urinary tract infections and pneumonia. Being a parent is terrifying at times but the good news is that 85% of infants with fevers have mild infections like colds or stomach viruses that resolve in a few days. And the other good news is that even the more serious infections are treatable!
Treatment for Newborns With Potentially Serious Infections
The exact plan will vary based on the doctor’s judgment, as well as, the baby’s appearance, rick factors, and age. Typically the plan will involve taking blood and urine samples, and often collecting spinal fluid with a procedure called a lumbar puncture. The procedure sounds horrible but it is relatively straightforward and complications in babies are rare. A chest x-ray may be ordered for infants with symptoms that suggest pneumonia. Infants suspected to have a serious infection will often be admitted to the hospital and be started on at least one antibiotic. These treatments are typically continued for 24 to 48 hours while waiting for the results of the tests. Some of the test come back quickly and will give an idea of the infant’s risk for severe illness. The better tests are cultures, which involve trying to grow bacteria from the body fluids. These require several days for a final result. We all like answers, it is important to remember that the things we are looking for aren’t things you’d want us to find. Parents are frequently disappointed to leave the hospital without answers, instead of relieved that we’ve ruled out the scary stuff. But in this case, no answer is both the most likely outcome and the best. There will be follow up exams, maybe more tests, and maybe more antibiotics depending on how the child is does after leaving the hospital.
It is important to remember that a plan depends heavily on the doctor’s judgment, the baby’s appearance, and a variety of other factors. Fever is almost never a big deal but infants under 2 months are sometimes an important exception. If you find yourself in this situation, call your doctor right away or go to the nearest emergency room. Most likely the whole event will fade into a memory that you can talk about at your baby’s next birthday party.
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About Pediatrics of Florence
We believe that children are more than just “little adults.” They have unique personalities, challenges, and life circumstances and we have made every effort to make our offices and care as “kid friendly” as possible. We have an aquatic theme in the waiting rooms (separated for sick and well children) as well as themed examination rooms. All of our physicians are Board Certified Pediatricians and members of the American Academy of Pediatrics and our nurse practitioners are all licensed Pediatric Nurse Practitioners and are available to see both well and sick children.
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