Caring for a child with a temperature

In the first two years, you may spend more time fighting the temperature than with any other problems. Children are blazing, parents are panicking. Here's how to deal with both.

Facts about high temperature( fever)

What is high temperature? The normal temperature of the child's body is within 36 ° C -37.8 ° C.The average oral temperature( measured in the mouth) in small children is 37 ° C.The axillary temperature can be half a degree or one degree lower than the oral temperature, and the rectal temperature ( measured in the anus) may be half a degree or one degree higher than the oral temperature, but in these figures there is no magic. Each child has his own normal body temperature. During the day, body temperature can naturally deviate from normal up or down by one or one and a half degrees. A healthy child can have a body temperature of 36 ° C on waking in the early morning and 37.8 ° C at the end of the afternoon or after hysterics or active movement.

In general, an increased body temperature can be said if the rectal temperature( in this article only the rectal temperature is given, unless otherwise indicated) is:

• over 37.8 ° C in the early morning

• more than 38.3 ° C at the endthe second half of the day.

It's best to know your child's normal body temperature. When the child feels well, measure and record his rectal temperature on waking in the morning. Do the same at the end of the second half of the day, when the child is calm. This is the average temperature of your child's body. If the temperature rises above these indications, it indicates a fever.

Why is there a high temperature?

High temperature is a symptom of a disease, not a disease. The rise in temperature is a normal and healthy reaction of the body to infection. But we all have temperature-phobia: 50% of all phone calls to the doctor and 20% of all calls from the First Aid are due to panic because of the rising temperature. And many parents mistakenly think that the heat will hurt their child.

A rise in temperature usually means that your child is struggling. When pathogenic microorganisms and white blood cells fighting with them( otherwise called leukocytes) converge on the battlefield, these white blood cells produce substances called pyro genes and have the following effects on the body: first, they stimulate the body's defense system to fightwith microbes.

They then enter the hypothalamus, a tiny organ in the brain that performs the function of the thermostat in the body, maintaining a relatively constant body temperature and regulating the ratio of heat released by the body and produced by it. These pyrogens cause the hypothalamus to raise the preset level so that the body functions at a higher temperature. The body reacts by resorting to all available methods to get rid of excess heat: the blood vessels expand and thereby increase the heat release through the skin;hence the flaming cheeks. The heart beats faster to bring more blood to the skin. The child breathes faster to release hot air, as the dog does in the summer heat to cool down a bit;and the child sweats to give heat through evaporation, although sweating is more common in older children. So if the heat helps fight the infection, why struggle with the temperature?

Heat is both a friend and an enemy. Pyrogens, released with increasing temperature, slow down the multiplication of viruses and bacteria, increase the production of antibodies to these microbes and increase the number of white blood cells that fight infection. But high fever also causes anxiety in children, making them moody and irritable, in addition to discomfort from the disease itself. In addition, a rapid rise in temperature can cause convulsions, known as febrile convulsions.(Read more about this problem next.)

Kiss is better than any thermometer

Fever can show tricks. Usually when the temperature rises, the blood vessels in the skin widen, the skin turns red and when touched or kissed it feels hot. But sometimes the skin may seem only slightly warmer than usual, despite the fact that everything is burning inside. Hot spots in which you can determine the heat by touch are the forehead of the baby and the upper abdomen. Studies have shown that parents are right in 75% of cases when they decide that their child has a fever, feeling his forehead.(More precisely, than thermometers-plasters.) Remember, what your child is "normal".In addition to hot skin, pay attention to other signs of fever: glowing cheeks, palpitations, accelerated breathing and hot air on exhalation, as well as intense sweating.

Special note: Since recent studies have discovered that pyrogenic substances help fight infection, parents have become less willing to knock down their children's temperature, not wanting to reduce the effectiveness of the body's natural defenses. More recent studies, however, have shown that antipyretic drugs act directly on the body thermostat and lower the temperature without interfering with the protective system of the organism, which conducts its biological war even after taking antipyretics.

Temperature measurement

Temperature measurement technology develops as quickly as diapers change, and perhaps one day a glass thermometer will take its place in the antique museum next to the diaper pins. Electronic thermometers that display numbers on the screen are simple, easy to use, accurate and inexpensive. Thermometer-plaster( which is glued to the forehead) is easy to operate, but less accurate. But the glass thermometer, which was used by my grandmother, is still very reliable. Here's how to choose a thermometer and use it.

Thermometer selection

Glass thermometers come in two types: rectal and oral. The whole difference lies in the working tip. Rectal thermometers have a short, wide tip to inject them safely and simply;in oral thermometers, the tip is long, thin, in order to have more contact surface area contacting the tongue( they have the label "oral").Any type can be used to measure the temperature under the arm, but only the rectal type is safe for insertion into the rectum. Because a rectal thermometer can be used to measure temperature both under the arm and rectally, there is no need to buy an oral thermometer for babies. The oral thermometer is completely impractical for a wriggling one-year-old child, and very rarely children under four agree to keep the thermometer in their mouth. Measuring temperature in the rectum or under the arm is the most reliable;rectal temperature is the most accurate. Try to take off the thermometer readings before you buy it, because on some thermometers the readings are easier to see than on others.

Measuring rectal temperature

Some children aged one to two measure rectal temperature very upset because of discomfort. Respect the feelings of the child and never force the child to go through this procedure by force.

Preparing the child. If you try to enter a thermometer in the ass of a wriggling child, the temperature can rise in both of you. In addition, a crying child usually has a fever. If the child is given a breast, a pacifier, or a song to sing warmly before measuring the temperature, it usually helps to soothe him.

Preparation of thermometer. Hold the thermometer behind the top and, with a brush, shake it so that the mercury bar falls below 35.6 ° C.How to avoid unnecessary hassle: thermometers are slippery and easily fly out of nervous hands. Shake the thermometer over the bed or carpet. And keep in the medicine cabinet a spare thermometer in case you break one. Cover the round tip with a lubricant abundantly.

The position of the child's body. Place the baby on your knees with your butt up, so that his legs are slightly hanging to relax the buttocks. Or put the child on the floor or on the dressing table, both for changing the diaper, grabbing both ankles and bending the legs to the tummy. The target will be right in front of you. In the position on the knees with the belly down, it is easier to restrain the child's movements, but lying on the back provides face to face communication and a better introduction of the thermometer.

Temperature measurement. Spread the buttocks with one hand and the other carefully insert the round tip of the thermometer into the rectum by about 2.5 cm. Hold the thermometer between the index and middle fingers like a cigarette, holding the palm and all the fingers of the baby's buttocks. This position of the hand fixes the thermometer and prevents the child from turning. Never leave a child with a thermometer alone.

How many to keep. Glass thermometer try to hold for three minutes. If the child strongly protests, after one minute readings will differ from the true temperature within one degree. Electronic thermometers show accurate data in less than thirty seconds.

Temperature measurement under the arm

Although the measurement of temperature in the armpit is not as accurate as measuring the rectal temperature, it is easier to make a measurement here, and you get indications very close to the true temperature, which in most cases is quite enough. The readings taken under the arm may differ from the rectal temperature by as much as two degrees. Follow the rules below.

The position of the child's body. Place the child on your lap, in the corner of the couch or on the bed and firmly wrap your arm around one's shoulders with one hand. If the child is excited, you can easily insert a thermometer, attaching the baby to the chest in the "cradle" position or when he falls asleep.

Preparation of thermometer. Shake the thermometer as described above to measure rectal temperature.

Temperature Observation Table

Fill in the table, indicating the following information: time, temperature( rectal or measured under the armpit), treatment and response to treatment. For example:

Time Temperature Treatment Reaction

16:00 38.8 ° C( rectal) 1 complete pipettor The temperature of the

acetaminophen decreased to 37.8 C, and the child became less irritable

Temperature measurement. Dry the child's armpit dryly. Raise the child's hand and carefully insert the tip of the thermometer into the armpit. Press the child's hand against his chest, closing the armpit.

How much to hold .Keep at least three minutes to get an accurate axillary temperature.

When to worry, and when there is no

Here are the basic rules that will help you decide when a high temperature can be cause for concern.

How high the temperature has risen. It is not always true that the higher the temperature, the stronger the child is. In fact, some mild viral diseases give the highest temperature( 40-40.6 ° C).And every child responds to the temperature of the disease, accompanied by a rise in temperature, individually. At some children the temperature jumps very high at the most frivolous infections, others become only a little hot even at a serious disease. If the temperature does not reach 41.7 ° C( the rectal temperature is indicated, under the arm usually about two degrees below), the increase in temperature does not harm the children. It does not fry the brains. Your anxiety should not depend more on the number of degrees the thermometer has risen on, but on how painfully your child behaves.

How did the temperature rise? ( "An hour ago she felt so good, and now she's just burning.") A sudden increase in temperature usually occurs in viral diseases, especially if the child does not look very sick. If the temperature rises gradually, and the child feels worse and worse, this should be of great concern.

How the temperature behaves. If the mother says to me: "Whatever I do, I can not bring down the temperature, and it seems to him equally bad that before taking the medication, which is after it" - it causes me greater concern than if I hear such a remark: "The temperature rides with him by itself, I'm flying it or not."But one should not think that the only reason for concern is the reaction of temperature to antipyretics. Studies have shown that the response to antipyretics is an unreliable indicator of the severity of the disease.

How the child behaves. How your child behaves is much more important than how high his temperature has risen. "He has a temperature of 40 ° C, and he, as if nothing had happened, sits to himself and plays cheerfully" - this is not such a frightening situation, but if the child is lying, although the temperature is only 38.8 ° С, this is already alarming. Much will tell you and how your child behaves, in addition to increasing the temperature behavior."He feels just as bad, even when the temperature drops a little" - this is a worrying sign."It feels bad when the temperature is high, and much better when it falls off" - this means that you can worry less, but it does not guarantee that your child's illness is not serious.

What your intuition tells you

Your anxiety level is more important to your doctor than the level to which the temperature has risen. Be sure to let the doctor know that your inner feeling tells you that in your child, maybe, there is a serious illness. Your anxiety is perhaps all that a doctor needs to determine how quickly and intensively you respond to the temperature rise in your child.

Special note: The younger the child, the more worried. The high temperature of a three-month-old child is much more dangerous than that of a three-year-old child. In young children, the immune system is very weak, which protects them from pathogens. Any increase in temperature in a baby up to three months should be reported to the doctor.

When to report a doctor's temperature to

Your assessment of your child's health status for a doctor is more important than how high his temperature is. If only the child does not look visibly sick, it rarely makes sense to call the doctor immediately, barely taking his hand off the hot forehead. Before calling your doctor, apply the temperature reduction methods listed on the next few pages and fill out the temperature observation table above, as the doctor will ask what you have already done and how the child has responded to your treatment. After measuring, writing down and attempting to bring down the temperature, call the doctor in the following cases:

• If at least a slight increase in fever persists in a child under three months old for more than eight hours, tell the doctor immediately. At this age, if the child looks unhealthy( lethargy, uncontrollable vomiting, increased drowsiness, loss of appetite, pallor), you should contact the doctor immediately, regardless of the time of the day or night. If, however, the child does not seem so sick and the temperature goes down easily, it is simply to give the child plenty of fluids and to wrap it up, there is nothing wrong with waiting a few hours, fixing the development of the disease and temperature behavior, and then informing the entire doctor. Do not forget that the temperature increase in a child of up to three months should be treated with all seriousness.

• If your child becomes more drowsy, pale, apathetic and the methods of lowering the temperature do not give any result, call the doctor.

• If your child has obvious symptoms of bacterial infection, such as earache, severe cough, redness of the throat, or painful urination amid high fever, call the doctor.

Remember: It is necessary to decide whether to call a doctor or not, depending on the severity of your child's illness, and not on how high the temperature has risen.

How to tell your doctor about the temperature of your child

When talking to your doctor by phone or in his office, keep the following information ready:

• How did the temperature rise? Did the temperature rise very quickly, with the child feeling great before, or did it rise very slowly and get higher every day, as the child became worse?

• How the temperature was changing: show the doctor or read the temperature monitoring table.

• How does your child's state of health change: did he become worse, better, or his condition does not change?

• What are the other symptoms: does your child have any other symptoms, such as a painful cry, diarrhea, pain and redness in the throat, vomiting, etc.?

• How alarmed you are.

doctor's approach A scene with a glowing child and a panicking mother is played out in the doctor's life several times a day. Try to look at things because of the doctor's stethoscope and see the heat from his point of view. The heat is just a symptom that led you to his office. What is really important is to find the cause of the heat.

First, the doctor is trying to draw a general conclusion: is it dangerous or not? Is the disease easy, for example viral( such as baby roseola, also known as exanthemia, which will take place within two to three days without any measures other than antipyretics and time management)?Or is it a bacterial infection and is required to give antibiotics? And one more conclusion: if it is a bacterial infection, is it dangerous or not?

Then, when examining your glowing child, your doctor listens to your story and looks at your table - you took it with you, did not you? Then the doctor tries to find the child any indication of the cause of the fever. Sometimes the diagnosis is obvious after telling the mother or examining the child. In other cases, the diagnosis is more difficult, and this requires time and analysis. If your doctor suspects nothing but a virus, he can measure the temperature with you and send you home with a farewell message: "Be sure to call if the child becomes worse."Sometimes at the first examination the diagnosis is difficult to put, but every day the child has

all the new symptoms, as the disease progresses, such as undetectable stains in the throat or specific rashes. In general, viral diseases are not treated with antibiotics, but in some cases, an antibiotic can be prescribed to prevent a secondary bacterial infection.

If your doctor suspects a treatable bacterial infection, but it is not easy to locate it, the doctor can give you directions for laboratory tests, such as sowing( taking a material from the throat, blood or urine for culture), blood tests or urinalysis. To determine the type of infection and the severity of the disease is also helped by the study of white blood cells, which is called counting of leukocytes or leucoformula.