High and low body temperature in a newborn baby: what to do

The temperature of a newborn baby is one of the indicators of the normal condition 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, monitoring body temperature in the first month of a child's life is very important as an indicator of his general condition.

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Epidemiology

Statistics on the spread of the problem of elevated body temperature indicate that this is the most common symptom that makes parents seek help. Regardless of the figures for the increase in temperature, this causes concern in parents. More than 87% of parents consider any increase in body temperature to be pathological, and only in 65% of cases is elevated temperature a sign of infection. This indicates insufficient diagnostics and preventive work with parents regarding the problem of body temperature in a child.

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Causes fever in a newborn baby

First of all, you need to understand what body temperature means and when it rises. Temperature norms for newborns range from 36.5 to 37.4. It must be said that a child's temperature in the first month of 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 a child and may indicate illness.

Speaking about a decrease in temperature, it is important to know that this can happen very often in small children during a walk outside, when bathing. Most often, the reason for such a decrease in body temperature is the cooling of the child. After all, during this period, the thermoregulation center in the baby's brain has not yet fully matured, so any temperature fluctuations are very critically perceived by the body. Therefore, if the child is poorly dressed during a walk or if he cools down while bathing, then the body temperature can decrease. Even in the maternity hospital, immediately after birth, the baby's body temperature can decrease under the influence of hypoglycemia. When the child is poorly fed or sleeps for more than three hours without feeding, this can cause a decrease in body temperature. This is a protective reaction of the baby's body in response to a decrease in blood glucose levels.

There can be many more reasons for a child's body temperature to rise, and it does not always indicate illness. Most often, a child's body temperature of 36.8 - 37.4 can be due to simple overheating. This happens in summer or winter if the child is not dressed for the weather. It can also happen at home, when the body temperature is too high in a room without ventilation. It is important 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 in the first month of life can cause ordinary colic. This is not very typical for such a problem, but given the immaturity of the thermoregulation center, this can be considered normal. Also, if the baby has constipation or diarrhea, this can cause a slight increase in body temperature.

If we talk about an increase in body temperature as a sign of a disease, we can say that depending on the pathogen, there are different indicators. The cause of an increase in body temperature in a newborn can be a viral infection. This can be a simple runny nose or pharyngitis. In this case, there can be an increase in body temperature to 38-38.5 degrees, which is typical for a 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 most often the cause is pneumonia, bronchitis or urinary tract infection.

Pathologically high body temperature may be due to a congenital or acquired pathology of the central nervous system. These may be transient fluctuations in body temperature after a birth injury to the brain. Then there may be fluctuations that pass after some time. If the child was born in hypoxia or there were problems during childbirth, this may 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 an infection is the work of the thermoregulation center. This center is located in the medulla oblongata and is responsible for controlling body temperature. When a mild viral agent enters the child's body, the body temperature increases in order to destroy this virus. After all, this virus can normally live and reproduce only at a temperature of up to 36.8. Thus, a protective reaction is activated. If the cause is a bacterial agent, then to destroy it, the body temperature must be slightly higher than with a bacterial infection. Therefore, when bacteria enter the body, the inflammatory factors that are released into the blood increase the activity of the thermoregulation center and the body temperature increases.

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Risk factors

The following risk factors can be identified for a decrease in body temperature:

• 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 increased body temperature in a newborn:

• overheating of the child or incorrect temperature conditions in the room;
• hypoxia or asphyxia after birth;
• viral and bacterial diseases;
• the presence of chronic foci of infection or other pathologies;
• associated bowel disturbances or colic.

These factors can, under certain conditions, cause serious pathology, so they need to be corrected in a timely manner.

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Symptoms fever in a newborn baby

Symptoms of fever 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 increase:

1. subfebrile - 37-37.9 ° C
2. febrile 38-38.9 ° C
3. pyretic 39-39.9 ° C
4. hyperpyretic ≥ 40 ° C.

If the temperature of a newborn baby rises to 37.5 degrees and there are no other symptoms, then most likely this indicates that the baby is simply overheated. If there is no such reason, then this may simply be a feature due to the imperfection of the thermoregulation center. In this case, it will pass by itself by the end of the first month of life.

If there are other symptoms, this indicates a disease. Subfebrile body temperature in a newborn can be due to a viral infection. As a rule, a cold usually begins with general malaise, sneezing, sore throat, nasal congestion or runny nose, which are well expressed on the 2-3 day of the disease. Often, ARVI is accompanied by fever, a feeling of aches in the whole body, muscles, joints, headache, chills. Sometimes a cough, hoarseness or change in the timbre of the voice, congestion in the ears joins in. In children, due to impaired nasal breathing and a harsh dry cough, sleep may be disturbed. When a baby cannot sleep at night, he may snore, cough, eat poorly. All these signs can be with simple rhinitis caused by a viral infection. If the inflammatory process spreads to the throat, then this can be combined with pharyngitis. In this case, symptoms of coughing, a feeling of pain or scratching in the throat appear. But the baby cannot complain about this, so with a simple sore throat he eats poorly and is capricious. It is these viral infections that are most often accompanied by a subfebrile body temperature.

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 of the respiratory tract, urinary tract 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 can be dry, but then it becomes deep and wet, especially after sleep. Along with these symptoms, signs of shortness of breath appear. Pneumonia is characterized by the first or second degree of shortness of breath. In newborns, this is manifested by pale skin and cyanosis around the mouth, which appears when the child is restless. In addition, additional muscles participate in the act of breathing - you can notice the child's nasal wings flaring, the supraclavicular areas retracting. If there is at least 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 thermoregulation center that it can react incorrectly. Therefore, the absence of body temperature against the background of symptoms of respiratory failure or cough does not exclude pneumonia.

Urinary tract infection in newborns has few symptoms, since it is difficult to monitor the baby's urination at this age. But any increase in body temperature without signs from the respiratory system can be regarded as a possible urinary tract infection. The only symptom that a mother can notice is a violation of the urination process. The child may urinate less or, on the contrary, more often, and the color of the urine may be cloudy. But this is difficult to diagnose if the baby wears 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 ascending etiology is more likely than other pathologies. Then, against the background of an increase in body temperature, there may be drops of blood in the urine or vaginal discharge.

A newborn baby's temperature of 38 without symptoms may be a transient condition that occurs when a baby is overheated. But sometimes it may be the first sign of a pathology that has not yet matured to manifest itself, and then you need to wait for other symptoms to appear today or tomorrow.

It is necessary to know about another complex condition that can cause a significant increase in body temperature in a newborn baby. 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 often children are discharged home and their umbilical wound has not yet healed, or the navel has not fallen off at all. This can be a gateway for infection, which spreads very quickly here. Clinically, against the background of an increase in body temperature, you can see that fluid begins to come out of the navel or it turns red. If it begins to fester, then this already threatens 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 approaches to treatment. White fever is characterized by an increase in the child's body temperature and spasm of peripheral vessels. Clinically, this is manifested by the fact that against the background of temperature and a hot forehead, the child has pale and cold arms and legs. This type of fever requires an immediate decrease in body temperature. With red fever, on the contrary, peripheral vessels expand and therefore the child is all hot and red. This contributes to the fact that the temperature decreases faster than with narrowed vessels. Therefore, this 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 despite being in perfect health, you need to make sure that he is not cold and hungry. Then, after eating and dressing, everything may return to normal.

Complications and consequences

The consequences of elevated body temperature in newborns can be very serious. Hyperpyretic fever (> 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, vascular spasm occurs, and centralization of blood circulation occurs. Myocardial hypoxia with decreased contractility, brain hypoxia with its edema, and convulsions occur.

The most common complication of high temperature can be seizures. Since the child's neural connections in the brain are not yet fully mature, then too high a jump in body temperature can lead to increased activity of the cerebral cortex and the development of seizures. These can be just simple muscle twitches or they can spread to the entire body. As a rule, this does not cause any complications, parents are just very scared. Therefore, reducing high body temperature is necessary for a newborn.

As for complications of pathologies that cause an increase in body temperature, other infectious complications can very often occur. Pyelonephritis or cystitis at such an early age can be complicated by the development of kidney abscesses, bladder dysfunction 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 source of infection. Therefore, any inflammation of the navel with an elevated temperature is very dangerous and requires immediate treatment.

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Diagnostics fever in a newborn baby

Diagnosis of temperature in a newborn baby should begin with correct measurement. It often happens that there are no reasons for the decrease or increase in body temperature, but the thermometer shows the opposite. Then you need to make sure of two things: that the measurement process is correct and that the thermometer itself also shows correctly.

How to measure the temperature of a newborn baby? To answer this question, you first need to understand what thermometers there are. Most often, a mercury thermometer is used, which is considered 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. This mechanism provides an almost ideal temperature measurement, but with the correct technique. To measure with a mercury thermometer, the child must not move and fix the handle with the thermometer as much as possible. The duration of the measurement should be at least ten minutes. With such a 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. You can also measure the temperature in the rectum with such a thermometer. But you need to be very careful when doing this, since the child can twist and turn and it is easy to cause damage. It should be remembered that the temperature on the mucous membranes is 1 degree higher than on the skin. This should also be taken into account when measuring the temperature in the oral cavity.

Electronic thermometers are now gaining more and more popularity due to the simplicity of measurement. Such a thermometer can be held for only a minute and it will show the result. But it is very important that after the sound signal, the thermometer remains in place for at least 10 seconds. This is a very important rule, which is not always observed, but which greatly affects the result. There is also one disadvantage of such thermometers - they often give an error, so they need to be calibrated after some time after use. Therefore, it is better to re-measure with a regular mercury thermometer and be sure of the result.

The fastest and most accurate is considered to be an infrared thermometer. This device is capable of detecting infrared radiation from the skin or mucous membranes, which increases with an increase in the child's body temperature. It can be simply applied to the skin or to the eardrum area, then you can immediately see the result in a few seconds. But the cost of such a device does not allow every family to buy 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 elevated, then it is necessary to conduct further diagnostics and look for the cause. The doctor should carefully examine the child and listen, because more often the cause can be a pathological process in the bronchi or lungs. If there is pneumonia, then during auscultation you can hear crepitations and asymmetrical moist rales in the lungs. Percussion notes dullness of sound. In severe pneumonia, oxygen saturation may decrease. If there are auscultatory signs, then it is imperative to conduct further examination. Blood and urine tests must be taken at the beginning of the disease before 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 diagnostics in confirming pneumonia is the main method. For this, an X-ray of the chest organs is performed 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 reason for the increase in body temperature may be pyelonephritis or cystitis. Therefore, the main diagnostic method here is urine analysis. Now there are special containers for collecting urine for newborns. They have a convenient clasp and are sterile for accurate analysis. Therefore, it is better to collect urine in this container. A general urine analysis for urinary tract infection can determine the following changes: cloudy color, mucus, increased number of leukocytes, bacteria, and you can also determine a specific pathogen. This allows you to suspect a problem with inflammation of the urinary tract, and for confirmation, instrumental diagnostics are carried out. For this purpose, an ultrasound examination of the kidneys and bladder is used. If there is an expansion of the renal pelvis, this indicates pyelonephritis. Curl or additional inclusions in the bladder indicate cystitis.

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Differential diagnosis

Differential diagnostics of temperature should first of all be carried out between two types - "red" and "white" fever. This is necessary to determine the tactics of temperature reduction. Then it is necessary to differentiate the cause that caused such an increase. It is very important to decide on additional research methods in time to tell about pathology.

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Treatment fever in a newborn baby

If the temperature of a newborn baby rises above 38.5 degrees, it must be brought down to prevent the development of convulsions. Here it is important to determine the type of fever - red or white. Medicines to reduce the temperature are given for both types, but then the treatment tactics are slightly different.

To understand the medications and how to give them, you need to know the main principles of increasing body temperature. There are successive stages of reducing temperature:

1. the stage of increasing body temperature is the period when the temperature increases;
2. the plateau stage is the stage when the temperature reaches its maximum values. It is at this stage that you need to give drugs to reduce body temperature, because if the value is above 38.5 degrees, the temperature cannot decrease on its own.
3. temperature reduction stage – this can happen on its own if it is below 38.5. Therefore, subfebrile temperature reduction is not used, since this process is controlled by the body itself.

Antipyretic drugs come in the following dosage forms:

1. Tablets - but not all patients can swallow, slow effect, irritation of the gastrointestinal tract, allergy from ballast substances.
2. Fast dissolving - effervescent tablets.
3. Capsules with microgranules.
4. Syrups/suspensions.
5. Candles / suppositories.

Antipyretics are usually used when the body temperature rises above 38°C. Children under 3 years of age are prescribed antipyretics at 38°C if they have previously had convulsions. For infants, it is more acceptable to use medications in the form of suppositories, but suppositories are not used if there is diarrhea. Before inserting a suppository, it is necessary to cleanse the intestines with an enema.

The drugs that can be used to reduce body temperature in children are limited.

1. 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 the inhibition of prostaglandin synthesis. These substances potentiate the inflammatory response due to the synthesis of inflammatory substances. The drug blocks the release of these substances and reduces temperature and other symptoms of inflammation. In addition to reducing body temperature, paracetamol has an analgesic effect. For newborns, the best way to use is in the form of syrup. The dosage is 10-15 milligrams per kilogram of body weight per dose. The dose can be repeated no less than 4 hours after the last time. The syrup is available in a dose of 120 milligrams in five milliliters, which is then calculated based on 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.
2. Ibuprofen is the second antipyretic drug that can be used in pediatrics. The antipyretic effect of ibuprofen is detected only in fevers, the drug does not affect normal body temperature. Just like any drug from this group, ibuprofen has analgesic properties. The dosage of the drug is 5-10 milligrams per kilogram of the child's body weight. It is available in 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 pathology.
3. To treat rhinitis, which may be accompanied by subfebrile temperature, it is very important to properly care for the child, then medications to reduce body temperature may not be needed. A mandatory procedure for treating rhinitis in children is rinsing the nasal passages with saline solutions or infusions (decoctions) of medicinal herbs. The use of decongestants 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 to introduce oil solutions into the nasal passages of newborn babies, since if they enter the lungs, this can lead to the development of pneumonia.

Nazol-baby is a drug that constricts blood vessels in the nasal cavity. The active ingredient of the drug is oxymetazoline. For newborn babies, 0.01% oxymetazoline nasal drops are used. Dosage - one drop no more than three times a day, and it is better to use this drug only at night. Side effects - addiction and mucosal atrophy are possible with prolonged use.

4. Antiviral drugs can be used to treat a viral infection even if the temperature is subfebrile, then the course of the disease will be milder.

Immunoflazid is an antiviral agent, the main active ingredient of which is proteflazid. This is a substance obtained from extracts of the grasses of tufted hair grass and reed grass. The drug has a direct antiviral property and an immunomodulatory one. The method of application is in the form of a syrup, and the dosage is 0.5 milliliters for newborns twice a day. Side effects are headache, allergic reactions.

Vitamins can be used after the child has recovered to prevent respiratory and other diseases.

Traditional treatment of fever

Traditional methods of treating high temperature in adults are used very widely, but it should be remembered that in children such methods are very limited.

When a child is sick, it is necessary to follow a full-fledged diet for the mother if she is breastfeeding. It is very important to follow sanitary standards (twice a day - wet cleaning, constant ventilation).

1. If the child has a "red" type of fever, then at the height of the temperature you need to uncover the child or wipe him with water at room temperature. This will help reduce the temperature until it comes to medication.
2. In case of "white" fever, on the contrary, the child's hands should be rubbed with your hands until they become warmer. This will help improve blood flow in the peripheral vessels of the skin. Such actions should be carried out even when giving medications.
3. When a child has a fever, you need to give him a lot to drink. For a newborn, this can be special children's chamomile tea or baby water. It should be given from a teaspoon every twenty to thirty minutes during the acute period.

Herbal treatment can be used in the acute period when the body temperature rises, as well as in infectious diseases. Herbal medicines can be taken by a child or a mother if she is breastfeeding.

1. Linden is a well-known tree that has antiseptic and antitoxic properties, so it can be used for colds, bronchitis or pneumonia. To prepare the tincture, take 20 grams of dry leaves with inflorescences per glass of hot water. After infusion, you can give the child a teaspoon to drink several times a day.
2. Chamomile tea should be drunk when you have a cold, rhinitis or pharyngitis. It has antiseptic properties, due to which it can kill viruses in the oral cavity. To prepare tea for a child, it is better to take children's chamomile tea and dilute it with boiled water. You need to give half a teaspoon every half hour.
3. 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, take 50 grams of the herb and add 250 grams of boiled water. After the solution has been infused for two hours, the mother can take a teaspoon in the morning and evening if she is breastfeeding. Exceeding the dose can 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.

1. Aflubin is a complex antiviral drug that contains aconite extract, 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 is 1 drop seven to eight times a day. Side effects - dizziness, drowsiness.
2. Vokara is a complex homeopathic preparation that can be used in small children with pharyngitis with pronounced hyperemia of the back wall of the pharynx. Dosage - one drop three times a day. Side effects are very rare, there may be increased salivation.
3. Viburkol is a complex homeopathic suppository with pronounced antiviral activity. The drug is used to treat acute pathologies and prevent their complications. Dosage - one suppository twice a day, and when eliminating acute symptoms can be used once a day.
4. Influcid is a complex six-component homeopathic preparation with antiviral activity. It is used in the acute period to treat colds, and also reduces body temperature due to the 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 for newborns only on the recommendation of a doctor.

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Prevention

Prevention of increased body temperature in a child includes all preventive measures aimed at a healthy lifestyle for mother and baby. It is very important to properly accustom the child to the thermal regime and the weather immediately after birth, not to overheat it and not to provoke hypothermia. It is necessary to avoid contact with sick people and carry out all vaccinations to prevent infectious diseases.

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Forecast

The prognosis for elevated body temperature is favorable, with the correct tactics for its reduction and control throughout the disease. As for convulsions: if a child had an episode of convulsions against the background of temperature, then the probability is 95% that such convulsions will not recur and can pass absolutely without consequences.

The temperature of a newborn baby is an indicator that parents should monitor and not allow it to decrease or increase. Of course, an increase in body temperature may indicate that the child is ill, but this is not always the case. Therefore, you should always take into account all the symptoms and consult a doctor.

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