Patient's question:
My little one is just 7 months old and has been exclusively breastfed with appropriate complementary foods. Three days ago, at noon, he suddenly had two bowel movements in a row, especially the second one was loose and quite large in volume. In the evening, he started fevering, with a high of 38.5°C. When I took him to the hospital, they couldn’t find anything specific but said it might be a cold or a chill. At home, we used physical cooling methods, gave him more boiled water, and after sweating, his temperature gradually returned to 37°C. The next day, he was quite normal during the daytime and didn’t have a bowel movement. However, at 6 p.m. that evening, he started fevering again, reaching a high of 39.7°C. When we went back to the hospital, they gave him a fever reducer called "Tianqian." After drinking 2.5ml, less than an hour later...Doctor's answer:
A child has a fever, but parents must not get carried away by the heat. Stay calm, don't panic, and don't handle things randomly. Follow these steps in order:1. Analyze the cause of the fever: Most fevers are caused by infections, with viruses being the most common, such as colds, influenza, measles, roseola, and epidemic mumps. Bacterial infections are the next most common, such as tonsillitis, scarlet fever, and meningitis. Parasitic infections can also cause fever, such as malaria and kala-azar, but they are less common. Non-infectious causes include heatstroke, dehydration, leukemia, tumors, trauma, or post-surgical conditions. There are also diseases that impair heat dissipation, such as generalized ichthyosis and hypohidrosis. Of course, it may not always be easy to distinguish, but once the situation is clear, it can provide the doctor with valuable information.
2. Observe the type of fever: Use a household thermometer to accurately measure the axillary temperature and keep a record. Below 37°C is normal, below 38°C is a low-grade fever, between 38°C and 39°C is a moderate fever, and above 39°C is a high fever. Also, note the duration of the fever and any accompanying symptoms.
3. Avoid overusing antibiotics: Many households keep antibiotics on hand, and children are often given them immediately upon fever. This is not appropriate. First, most antibiotics are ineffective against viruses and can even suppress the body's immune function. Second, fever itself is a normal response of the body to fight off pathogens. Using medication to kill bacteria and viruses will affect the proliferation of phagocytes and the production of antibodies, weakening the body's ability to fight the disease. Therefore, antibiotics should not be used too early.
4. Use antipyretics cautiously: Low-grade or moderate fevers generally do not require antipyretics, as early cooling can also affect the development of the immune system. Moreover, drug-induced fever reduction often leads to excessive sweating and dehydration. Even for high fevers, medication should be used cautiously, with the minimum effective dose to control the fever. Do not take it continuously, and be especially careful with infants under six months old.
5. Promote physical cooling: Physical cooling is much safer than chemical cooling. You can apply a cool towel to the forehead or use an ice pack on the head and neck. Alternatively, you can bathe the child's head, chest, limbs, and palms with alcohol. If alcohol is not available, 54° liquor can be used as a substitute, as it also helps to dissipate heat and reduce fever.
6. Prevent high-temperature convulsions: When a child has a fever above 39°C, some infants may experience convulsions, characterized by loss of consciousness, facial drooping, stiffness in the neck, muscle twitching in the face and limbs, holding their breath, and bluish skin. This is due to the immature and unstable central nervous system regulation in infants under three years old, with a high stress response. Recent studies have shown that when a child's fever reaches 38°C, diazepam can be given at a dose of 0.2 mg per kilogram of body weight. If the fever does not subside after 8 hours, a second dose can be administered. This has a good preventive effect on high-temperature convulsions, and a third dose is generally not needed. For children with a history of high-temperature convulsions or those with low calcium or epilepsy, diazepam should be given promptly to prevent convulsions.
7. Other measures: Children with fever should be given plenty of fluids and a light, easily digestible diet. Oral hygiene should be maintained, and the room temperature, humidity, and air circulation should be kept comfortable. If the above measures do not lower the child's temperature or if the fever returns after subsiding, medical attention should be sought. After a clear diagnosis, treatment should follow the doctor's advice.