Infant Fever

[yhtking]

Does anyone out there has any experience with fever in infants three months and younger?? DD turned 11 weeks yesterday. She is two weeks away from turning three months old. She was running a fever last night. My toddler DS did have a running nose and a caugh this week. Of course the pediatrician on call told us to go to the ER since their office is closed. WE had a horrible experience our DS when he was five weeks old with a fever. They send infants under six weeks old to the ER automatically if they are running a temperature. He had all sorts of things done to him there, spinal taps, etc. WE hate to subject our DD to the ER environment. They wouldn't even tell me how long the wait was. Anyway, we treated her with infant Tylenol and her temperature is coming down today. And she seems to be eating normal again today. She wasn't eating as much yesterday which should have been a red flag to me. Anyway, I was just wondering if anyone out there had any similar experience that they would share with us. I would really appreciate it.

Mommy to baby Hailey (6-4-5) and Tyler (6-4-3)

[barbarhow]

When Anna was 7 weeks she had a low grade temp and some wheezing-she caught a cold from her big brother. I did not take her to the ER but talked to our DR about it and he reassured me that he thought it was just a cold.
Babies this age do not have established immune systems which is why your 5 week old got a million dollar work up. I worked pdiatric ER for many years-our standard was to do the full sepsis workup on any baby under 6 weeks who presented with fever. I was a wreck with my own kids until after that 6 week mark because I never wanted to subject them to the big workup. That being said-infants can get sick very fast and if there is no source for a fever-ie they don't have a cold or didn't recently get immunizations-I would never not get my infant evaluated for a fever. Septic shock can be really devastating to an infant. Your baby is older and therefore should have a better established immune system. If she has not had fever today, is eating and peeing normally and is happy and playful-I probably would not go to the ER. However if she still had a fever or isn't eating-I would want her evaluated. As much a pain as the ER is-I would not chance it. Hope I was clear without scaring you. It sounds like she is doing better. Hope she continues to do great.
Barbara-mom to Jack 3/27/03, a Red Sox fan
and Anna 5/12/05, my little Yankee fan!

[yhtking]

Thank you for your reply. She had her first round of immunization shots two weeks ago and she did have a fever afterwards but went away in 24 hours.

This morning Haily had a temperature of 101.5. She eats every three hours and seems to be eatting okay today so far. We gave her a half drop of infant Tylenol after her 10:00 feeding just to make her comfortable. I felt her forehead a while ago just to make sure she is okay. She feels cool to the touch. She has been sleeping since after 11:00 this morning. I'm getting ready to wake her up for her next feeding.

How high of a temperature should I start thinking about taking her to the ER? What would they do to her? The full work? Or, urine test to rule out kidney infection?

thanks.

[yhtking]

Barbara,
I just sent you an email with few more questions. Thanks so mcuh for your reply. DH just took Hailey's temperature. It was 99.4. We will continue to monitor her temperature throughout the day. Thanks again.

[barbarhow]

At this age I would expect them to do a urine culture and a blood culture and a cbc. This only requires a small amount of blood. In our ER a spinal tap was not "routine" for an infant with fever of this age-unless the infant was lethargic.
Do you normally have to wake her to feed? 101.5 is pretty high for this age. I, personally, would err on the side of safety and have her evaluated.
Either way please keep us posted on how she is doing.
Barbara-mom to Jack 3/27/03, a Red Sox fan
and Anna 5/12/05, my little Yankee fan!

[lisa56308]

Do you have a nurse line (through your insurance) that you can call? We have BCBS and the nurse line has been a great help. I hope she's feeling better. My toddler has been running a 102-103 temp for almost 3 days. It's so hard when they can't tell you what's wrong.
Lisa
Jacob 6/95
Tyler 10/03

[yhtking]

Barbara,
Thanks again. Hope your first day back at work went well.

We will monitor her temperature today. She was sleeping in the swing. I turned off the swing and she woke up just like that. I don't think she is lethargic. Hopefully it's just a viral infection.

Now, do you think I should call the ped office tomorow when they open just to be safe. Can the ped office draw the blood and run the culture and cbc work? If we end up going to the ER tonight, would they admit her at this age? I'm just not very fond of the ER, she will probably catch something there.

Thanks again,
Mommy to Baby Hailey (6-4-5) and Tyler (6-6-3)

[aasmey]

I agree, an 11 week old with a fever over 101 who doesn't have any findings on physical exam (sores in the mouth, etc) that would account for the fever should at a minimum get blood and urine checked, but if she otherwise looks well (not lethargic, taking fluids, etc) she is not a child I would automatically admit to the hospital. Most pediatricians do this workup routinely in the office setting, and can even give injected antibiotics on an outpatient basis if there is anything concerning about the bloodwork but the baby otherwise looks ok.
All of this said, if it *were* a major infection of the worrisome kind, waiting on getting her evaluated would not be a good idea. We tend to take fevers more seriously until they're a little older and their immune systems are more developed. So if she is running a high fever and she can't get the bloodwork/urine test done somehow through an urgent care or office today, then she *should* be seen in the ER.

[ykc]

Just wanted to chime in because I've noticed a lot of posts about illness recently, and the winter months are coming.... Not meant as medical advice, and I hope I don't sound too lecture-y or obnoxious, but I thought this info might be helpful to some.

Fever is defined as a temperature of over 100.4 degrees (obviously, a somewhat arbitrary cut-off; it's basically a couple standard deviations above "normal"). Fever is one of the body's ways of fighting infection, as some organisms die more easily in warmer temperatures. Fever in and of itself is usually not a problem. It's virtually unheard of for a fever due to illness to cause permanent damage or problems for a child, no matter how high it is. Children tend to run higher temperatures when ill than adults do, and they tolerate it better, but most kids still feel like crud when their temp is up. The reason why fever is routinely treated is because of the discomfort.

However.... Fever, especially in babies, is sometimes the only sign of a serious bacterial infection. Most of the time, the illness is viral or something a child's immune system is able to fight off, but in some situations, there is no way to tell until a child gets sicker instead of better. So, with babies, the approach towards fever is very cautious. Standard of care is to do a full sepsis work-up (blood, urine, spinal tap; possible 48 hour admission to the hospital for IV antibiotics) on all children under 1 month, most children under 2 months, many children under 3 months, and very much depending on the circumstances on all older children. I know it seems horrible and cruel, and it's definitely stressful, worrying and a hassle, but truly, it's meant to protect the child. There are some situations when your doctor will choose to do something different, but he or she should probably tell you why.

When in doubt, call your doctor. If you're not comfortable with your doctor, then you need to find another doctor.

Here's hoping that no one gets sick this winter. :)

[yhtking]

Barbara,

DD's fever has gone down to the 99 range (99.4, 99.6, 99.0 and 99.2). Did you use the miracle blanket with Anna when she had her low grade fever? We decided not to wrap her tonight. We didn't wrap her last night either. She has been eating well and napping good today. DH gave her a bath tonight and she was content with that. She definitely not lethargic. But, I will call the ped office tomorrow and see what they think. They will probably tell me not to come in since her temperature has dropped. We will see. I will keep everyone posted.

Thanks again.

Mommy to Tyler (6-6-3) and baby Hailey (6-4-5)

[chlobo]

Do they take a different course of action if they can reduce the fever with meds? That is, if you give motrin & the fever comes down is that a sign that the illness is less serious? If it were something serious would the fever not come down with meds? Do the docs really need to know what the "untreated" temp is in order the evaluate the severity?

[ykc]

Doctors need to know the "untreated" temp to know that there really was a fever. And it gives an idea of how badly a person is feeling. Otherwise, a fever is a fever, no matter the temperature. The height of the temperature and the severity of the illness are not usually related.

If you give medicine and the fever comes down, it does not necessarily mean that the illness is less serious, but it is reassuring. If a child perks up (though probably not acting normally still) when the fever is down, then the listlessness is probably due to discomfort associated with fever and not overwhelming infection.

But again, fever is just a symptom of illness, and not really an indication of how serious the illness is. The severity of an illness really depends on what it is, and how well the body is coping with all of the problems caused by the illness.

[yhtking]

First, I want to thank everyone who replied to my message and shared their experience with me, especially you Barbara.

I took Hailey to see our ped this morning. She had a 97.7 normal temperature after her first feeding. Anyway, the ped said it was most likely a viral thing since she was really not very lethargic and that she is a bit older now, and also that my son had a running nose and a cough. He sent us for a blood screening to be sure and to put my mind at ease. Well, the white blood count was normal and some other count was higher than average which indicates a viral infection. Whew.....

I'm going back to work next week. Hopefully she'll stay healthy. I can only hope! :-) Thanks to all.


Mommy to Tyler (6-6-3) and baby Hailey (6-4-5)