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 state of the baby in the first month after birth. Increase or decrease in body temperature in this period in the child can cause pathology. Therefore, monitoring the body temperature in the first month of life of a child is very important, as an indicator of its general state.

[1], [2], [3]

Epidemiology

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

[4], [5], [6], [7], [8], [9], [10], [11],

Causes of the temperature in a newborn baby

First of all you need to understand what the body temperature means and when it rises. The temperature norms for newborns range from 36.5 to 37.4. It must be said that the temperature of the child in the first month of his life is very labile and can change under the influence of many factors. Reducing body temperature, like raising it, is dangerous for the child and may indicate a disease.

Talking about the drop in temperature, you need to know that in small children this can be very often while walking on the street, when swimming. Most often, the reason for this decrease in body temperature is the cooling of the baby. After all, during this period the center of thermoregulation in the brain of the baby is not yet fully ripe, therefore, any temperature fluctuations are very critically perceived by the body. Therefore, if during a walk a child is poorly dressed or if he has cooled down while bathing, the body temperature may drop. Even in the hospital immediately after birth, the baby can decrease body temperature under the influence of hypoglycemia. When a child is poorly fed or he sleeps more than three hours without feeding, this can cause a drop in body temperature. This is a protective reaction of the baby's body in response to a decrease in blood glucose levels.

The reasons for raising the body temperature in a child can be much greater, and this does not always signal a disease. The most common increase in body temperature in a child in the area of 36.8 - 37.4 can be with simple overheating. It happens in summer or in 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 airing. It must be remembered that being in the street under direct sunlight for a child is harmful and dangerous, since it can cause not only a rise in body temperature, but also a sunstroke.

The increase in body temperature to subfebrile digits in a baby of the first month of life can cause ordinary colic. This is not very typical for such a problem, but considering the immaturity of the thermoregulation center, it can be considered normal. Also, a constipation or diarrhea has accumulated in the baby, this can cause a slight rise in body temperature.

If we talk about the increase in body temperature as a sign of the disease, then 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. It can be a simple runny nose or pharyngitis. In this case, there may 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 it is worth urgently to contact the doctor, because often this indicates a bacterial infection. The localization of the inflammation can be different, but more often the cause is pneumonia, bronchitis or urinary tract infection.

Pathologically high body temperature can be with the pathology of the central nervous system of an innate or acquired character. This can be transient fluctuations in body temperature after a child's traumatic brain injury. Then there may be oscillations that go away after a while. If a child was born in hypoxia or had problems during childbirth, it can also be a factor in such a transient rise in temperature against a background of normal well-being.

The pathogenesis of an increase in body temperature during infection is the work of the thermoregulatory center. This center is in the medulla oblongata and is responsible for controlling body temperature. When a light viral agent enters the body of a child, in order to destroy this virus, the body temperature rises. After all, this virus can normally live and multiply only at temperatures up to 36.8. Thus, a protective reaction is activated. If the cause is a bacterial agent, then to destroy it, you need to have a body temperature slightly higher than with a bacterial infection. Therefore, when a bacterium enters the body, the inflammatory factors that are released into the bloodstream increase the activity of the thermoregulatory center and increase the body temperature.

[12], [13]

Risk factors

The risk factors for lowering body temperature can be identified as follows:

• low temperature in the room where the newborn baby is located;
• hypoglycemia or large intervals between feedings;
• congenital or acquired pathologies of the central nervous system with a violation of thermoregulation.

Risk factors for fever in a newborn:

• overheating of the child or the wrong temperature in the room;
• hypoxia or asphyxia after birth;
• viral and bacterial diseases;
• presence of chronic foci of infection or other pathologies;
• associated stool or colic disorders.

These factors can under certain conditions become the cause of a serious pathology, so you need to correct them in time.

[14], [15], [16]

Symptoms of the temperature in a newborn baby

Symptoms of temperature in a newborn baby can be combined with other symptoms or it may be the only symptom. There are several types of hyperthermia.

Types of temperature increase:

1. low-grade - 37-37,9 ° С
2. febrile 38-38,9 ° С
3. pyretic 39-39,9 ° С
4. Hyperpyretic ≥ 40 ° C.

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

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

The high temperature of 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 impaired sputum outflow 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, there is a cough. At the beginning of the disease, it can be dry, but then it becomes deep and wet, especially after sleep. Along with these symptoms, there are signs of shortness of breath. For pneumonia, the first-second degree of dyspnea is characteristic. In newborns, this is manifested by the pallor of the 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 swelling of the wings of the nose, retraction of the supraclavicular areas. If there is at least one of the symptoms of dyspnoea or cough that combine with a high body temperature, then a very high probability of pneumonia.

The wheezing in a newborn baby without a temperature can also talk about pneumonia, because it is because of the incomplete development of the thermoregulatory center that it can react incorrectly. Therefore, the absence of body temperature against the background of symptoms of respiratory failure or coughing does not exclude pneumonia.

Urinary tract infection in newborns has few symptoms, because it is difficult at this age to follow the urination of the baby. But any increase in body temperature without signs on the part of the respiratory system can be regarded as a possible infection of the urinary tract. The only symptom that mom can notice is a violation of the process of urination. A child may be less or more likely to urinate, and the color of urine may be cloudy. But it's 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 it is a question of the girl, development of a cystitis of a rising etiology is possible with more probability, than other pathology. Then, against the background of an increase in body temperature, there may be droplets of blood in the urine or vaginal discharge.

The temperature of a newborn child 38 without symptoms can be either a transient state, which happens when the child overheats. But sometimes this may be the first sign of a pathology that has not yet been sung to manifest and then one must wait for the appearance of other symptoms today or tomorrow.

It is necessary to know about another complex condition that a newborn child can cause a significant increase in body temperature. To this state is omphalitis. It is an inflammation of the skin and fiber around the navel caused by the bacterial flora. For newborns, this is a particularly dangerous condition, since children are often discharged home and the umbilical cord 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, on the background of a rise in body temperature, one can see that a liquid starts to appear from the navel or that it turns red. If already he starts to get bogged down, then it already threatens with sepsis. Therefore, when the body temperature rises, attention should be paid 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 body temperature of the child and spasm of peripheral vessels. Clinically, this is manifested by the fact that against the background of temperature and hot forehead, the child has pale and cold hands and feet. This type of fever requires an immediate drop in body temperature. With red fever, the peripheral vessels on the contrary expand and so the baby 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 form of fever.

Low temperature in a newborn baby may indicate hypothermia or hypoglycemia. If a child sharply against a background of complete health reduces body temperature, then you need to make sure that he is not cold and he is 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 (> 41 ° C) - increases the tone of the sympathetic nervous system, respiratory center, the need for organs in oxygen, sodium, chlorine and water are delayed, edema develops, vascular spasm arises, and blood circulation centralizes. There is hypoxia of the myocardium with a decrease in contractility, hypoxia of the brain with its edema, convulsions.

The most common complication of fever may be seizures. Since the child has not yet mature neural connections in the brain, a too high jump in body temperature can lead to increased activity of the cerebral cortex and development of seizures. It can only be a simple twitching of the muscles or they can spread to the whole body. As a rule, it does not cause any complications, just parents are very frightened. 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 other infectious complications can occur. Pyelonephritis or cystitis at such an early age can be complicated by the development of kidney abscesses, a violation of the bladder function in the future. Pneumonia can cause lung abscess or pleurisy. The most frequent complications of omphalitis are sepsis, because from this source of infection bacteria spread very quickly. Therefore, any inflammation of the navel with fever is very dangerous and requires immediate treatment. 

[17], [18], [19], [20]

Diagnostics of the temperature in a newborn baby

Diagnosis of temperature in a newborn child should begin with the right measurement. It often happens that there is no reason to reduce or raise the body temperature, but the thermometer shows the opposite. Then you just need to make sure of two things: that the measurement process is correct and that the thermometer itself also shows correctly.

How correctly to measure temperature to the newborn child? To answer this question, you first need to figure out what thermometers are. The most commonly used mercury thermometer, which is considered the most accurate. The main mechanism of its action is an increase in the concentration of mercury vapor with an increase in body temperature, which is determined by the gradient of the values. Such a mechanism provides an almost ideal temperature measurement, but with the right technique. To measure a mercury thermometer, it is necessary that the child does not move and fixes the pen 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 area of the armpits, you can measure the temperature of newborns in the groin. To do this, you also need to fix the foot for at least ten minutes. Such a thermometer can measure the temperature in the rectum. But you need to do this very carefully, because the child can spin and easily be damaged. It should be remembered that the temperature on mucous membranes is 1 degree higher than on the skin. This should be taken into account when measuring the temperature in the oral cavity.

Electronic thermometers are gaining popularity because of the simplicity of the measurement. Such a thermometer can only be held for 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 respected, but which strongly affects the result. Also there is one minus of such thermometers - they often give an error, so they need to be calibrated some time after use. Therefore, it is better to measure with a conventional mercury thermometer and be sure of the result.

The fastest and most accurate is the infrared thermometer. This device is capable of catching infrared radiation from the skin or mucous membranes, which is intensified when the child's body temperature rises. It can be simply applied to the skin or to the region of the tympanic membrane, then you can see the result in a few seconds. But the cost of such a device does not allow it to be purchased by every family. 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 accurately known that the temperature is raised, then you need to further diagnose 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 you can hear at auscultation crepitation and asymmetric wet wheezing in the lungs. Percussion notes blunting sound. In severe pneumonia, the oxygen saturation can decrease. If there are auscultative signs, then it is necessary to conduct further examination. The analysis of blood and urine must necessarily be given at the beginning of the disease before treatment. With pneumonia, there may be changes in the analysis of blood - an increase in the number of leukocytes in the dynamics and an increase in rods, an increase in ESR. Instrumental diagnosis in confirming pneumonia is the main method. To do this, X-rays of the chest cavity are performed and inflammatory foci in the lungs can be seen in the form of infiltrative shadows.

If there are no symptoms on the part of the respiratory system, then another cause of fever may be pyelonephritis or cystitis. Therefore, the main method of diagnosis here is the analysis of urine. Now for newborns there are special containers for collecting urine. They have a convenient clasp and are sterile for accurate analysis. Therefore, it is better to collect the urine in this container. A general urine test for urinary tract infection can determine the following changes: murky color, mucus, increased number of leukocytes, bacteria, and also a specific pathogen can be identified. This allows you to suspect a problem with inflammation of the urinary tract, and to confirm the instrumental diagnosis. 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. Depending on or additional inclusions in the bladder, they speak of cystitis.

[21], [22], [23], [24]

Differential diagnosis

Differential diagnosis of temperature should primarily be conducted between two species - "red" and "white" fever. This is necessary to determine the tactics of lowering the temperature. Next, we need to differentiate the reason that caused this increase. It is very important to determine in time with additional methods of research to say about pathology.

[25], [26], [27], [28], [29], [30]

Treatment of the temperature in a newborn baby

If the temperature of a newborn child has risen above 38.5 degrees, then it must be knocked down to prevent the development of seizures. It is important to determine the type of fever - red or white. Medicines for lowering the temperature are given both at that type and at another, but further the tactics of treatment are slightly different.

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

1. the stage of increase in body temperature is the period when the temperature rises;
2. 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 above 38.5 degrees, the temperature can not decrease by itself.
3. the temperature reduction stage - this can occur on its own if it is below 38.5. Therefore, the decrease in subfebrile temperature is not used, since this process is controlled by the body on its own.

Antipyretics are in such medicinal forms:

1. Tablets - but not all patients can swallow, a slow effect, irritation of the sistile GIT, an allergy from ballast substances.
2. Instant - effervescent tablets.
3. Capsules with microgranules.
4. Syrups / suspensions.
5. Suppositories / suppositories.

Usually the use of antipyretics begins with an increase in body temperature above 38 ° C. Children of the first 3 years are prescribed antipyretics at 38 ° C if they have seen cramps earlier. For infants, the use of drugs in the form of suppositories is more acceptable, but in the presence of diarrhea, suppositories are not used. Before the introduction of the suppository it is necessary to clean the intestines with an enema.

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

1. Paracetamol  is a drug that belongs to analgesics-antipyretics from a group of non-hormonal anti-inflammatory drugs. The main mechanism of action of paracetamol is oppression of the synthesis of prostaglandins. These substances potentiate the inflammatory reaction due to the synthesis of inflammatory substances. The drug blocks the release of these substances and reduces the temperature and other symptoms of inflammation. In addition to lowering body temperature, paracetamol has an analgesic effect. For the newborn, the best way to use it is in the form of a syrup. Dosage of 10-15 milligrams per kilogram of body weight at one time. You can repeat the reception at least 4 hours after the last time. The syrup is released in a dose of 120 milligrams in five milliliters, which is already calculated on the body weight. Side effects - from the side of 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. Antipyretic effect of ibuprofen is detected only with fevers, the drug does not affect normal body temperature. As well as any of this group of drugs, ibuprofen has analgesic properties. Dosage of the drug is 5-10 milligrams per kilogram of the child's body weight. It is produced in syrup for 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. For the treatment of rhinitis, which can be accompanied by low-grade fever, it is very important to take care of the baby properly, then medications for lowering body temperature may not be needed. Obligatory procedure for the treatment of rhinitis in children is the washing of the nasal passages with 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 at a concentration appropriate to the age of the child. Newborn babies are not recommended to inject oily solutions into the nasal passage, as this can lead to the development of pneumonia as a result of getting into the lungs.

Nazol-baby  is a drug that narrows the vessels in the nasal cavity. The active substance of the drug is oxymetazoline. For newborn babies, 0.01% solution is used in the nose of oxymetazoline. Dosage - one drop at most three times a day, and it is better to use this drug only for the night. Side effects - it is possible to develop addiction and mucosal atrophy with prolonged use.

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

Immunoflazid  is an antiviral agent whose main active ingredient is proteflazide. This substance, which is obtained from extracts of herbs of pike and turkey grass. The drug has a direct antiviral property and immunomodulatory. 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 manifestations.

Vitamins can be used after the child's recovery in order to prevent respiratory and other diseases.

Alternative temperature treatment

Alternative methods for treating elevated temperature in adults are used very widely, but it should be remembered that in children such methods are very limited.

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

1. If the child has a "red" type of fever, then at the height of the temperature you need to open the child or wipe it with water at room temperature. This will help reduce the temperature, while it comes to the drugs.
2. When the "white" fever handles the child on the contrary you need to grind your hands until they become warmer. This will help improve blood flow in the peripheral vessels of the skin. Such actions need to be carried out even when giving medicines.
3. At the temperature of the child should be given plenty to drink. For a newborn, this can be a special children's tea made from chamomile or a baby's water. It is necessary to give from a teaspoon every twenty to thirty minutes in an acute period.

Herbal treatment can be used in an acute period with an increase in body temperature, as well as in infectious diseases. Herbal medicines can be taken to a child or mother if she is breastfeeding.

1. Lime tree is a well-known tree that has antiseptic and antitoxic properties, therefore it can be used for colds, bronchitis or pneumonia. To make a tincture on 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 a few times a day.
2. Tea from chamomile should be drunk for colds, rhinitis or pharyngitis. It has antiseptic properties, due to which it can kill viruses in the oral cavity. To make tea for a child, it is better to take children's tea from chamomile and dilute with boiled water. Give you need half a teaspoon every half hour.
3. The infusion of the marigold grass also has antiseptic properties and promotes the normalization of local immunity in viral respiratory tract infections. 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, the mother can take a teaspoon in the morning and evening if she is breastfeeding. Excess dose may cause an allergy.

Homeopathy for the treatment of body temperature in the acute period is not used. It is possible to use antiviral and immunomodulating agents for viral infection.

1. Aflubin is a complex antiviral drug that contains an extract of aconite, bryonium and other substances. The drug has antiviral activity and immunomodulating. The method of application is in the form of drops. Dosage for children up to a 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 marked hyperemia of the posterior pharyngeal wall. 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 with the elimination of acute symptoms can be applied once a day.
4. Influcid is a complex six-component homeopathic preparation with antiviral activity. It is used in an acute period for the treatment of colds, and also reduces body temperature due to immunomodulatory action. Dosage of the drug - one tablet five times a day. Method of use - for children, it is better to grind the tablet into powder. Precautions - use newborns only on the advice of a doctor.

[31], [32], [33]

Prevention

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

[34], [35], [36], [37]

Forecast

The prognosis of elevated body temperature is favorable, with the correct tactics of its reduction and control throughout the course of the disease. With regard to convulsions: if the child had a seizure episode against the background of temperature, then the probability of 95% that such cramps do not repeat and can pass absolutely without consequences.

The temperature of a newborn baby is the indicator that parents should monitor and not allow to reduce or increase it. Undoubtedly, an increase in body temperature may indicate a child's illness, but this is not always the case. Therefore, you should always consider all the symptoms and consult a doctor. 

[38], [39]