Dr Bi­jal Shri­vas­tava answers all your child­care queries

Mother & Baby - - CONTENTS -

Fever as a symp­tom is an im­por­tant clue to reach to a di­ag­noses in any ill­ness. A five-year-old girl suf­fer­ing from a seven-day fever, who was un­der a course of dif­fer­ent feverre­duc­ing drugs at the reg­u­lar six-hour in­ter­val but with­out mea­sur­ing it, came in for a check-up. The med­i­ca­tions served to re­duce the fever and this led her par­ents to think that she was al­right, as there was no fever, fur­ther de­lay­ing their visit to the clinic. When she fi­nally came to us af­ter a week, the in­fec­tion had in­creased and she was di­ag­nosed with pneu­mo­nia. Need­less to say, she re­quired to be hos­pi­talised. I want to stress on the im­por­tance of mea­sur­ing the fever and main­tain­ing a fever chart. You’ll know when your child has a fever if the tem­per­a­ture reads above 100.4 de­gree F in rec­tal area; above 99 de­grees F when mea­sured in the armpit; and above 100 de­gree F when mea­sured orally. How­ever, body tem­per­a­ture should not be mea­sured orally in young chil­dren. Chil­dren do have fre­quent vi­ral in­fec­tions and fever is a very im­por­tant symp­tom. Fever is also a com­mon in­di­ca­tor of cer­tain chronic dis­eases. With in­fec­tions, a fever can guide us as to when we have to visit doc­tor, when we may need an­tibi­otics or when any fur­ther in­ter­ven­tion is needed. Cer­tain dos and don’ts: 1. Al­ways mea­sure fever be­fore giv­ing

your child any fever-re­duc­ing drugs. 2. In the case of a fever be­tween 101 to 102 de­grees that lasts for more than 48 hours, or if the ini­tial tem­per­a­ture is be­tween the 103 to 104 de­gree F-range, then your child may need med­i­cal at­ten­tion. 3. Do not over cover the child as it may in­crease the fever. In high grade fevers, start cool­ing the body with ei­ther spong­ing or by re­duc­ing the en­vi­ron­ment tem­per­a­ture. 4. Drugs such as parac­eta­mol or ac­etaminophen are very safe and should be the first line of fever re­duc­ing drugs. How­ever, th­ese can be re­peated to max­i­mum six times in a 24-hour pe­riod. In case of high fever, one can use ibupro­fen (not ibu­gesic plus or Comb­i­flam), but given a be max­i­mum of four times, and can also be al­ter­nated with parac­eta­mol. The third op­tion is mefe­namic acid which can be given a max­i­mum of three times in 24 hours. Ex­cept for parac­eta­mol, other med­i­ca­tions have a side ef­fect of acid­ity, rarely gas­troin­testi­nal bleed­ing, and chance of re­nal fail­ure. Bar­ring parac­eta­mol, other NSAIDs are to be avoided if the child has low platelets count or has bronchial spasm, or any un­der­ly­ing kid­ney is­sue. 5. Al­ways main­tain hy­dra­tion by

in­creased flu­ids and be sure of urine out­put. Do not stop any food or milk from the child if they are will­ingly hav­ing it. Keep the skin clean by bathing the child daily. In this man­ner, by mea­sur­ing fever and con­trol­ling it, you can avoid fre­quent vis­its to the doc­tor for nor­mal vi­ral in­fec­tions and, in ad­di­tion, a doc­tor will not be late in di­ag­nos­ing cer­tain se­ri­ous in­fec­tions or other con­di­tions.

Send in your queries to mbe­d­i­to­ with ‘Child­care’ in the sub­ject line

Dr Bi­jal Shri­vas­tava, MBBS and MD (Pae­di­atrics), is a neotol­o­gist at Dr LH Hi­ranan­dani Hos­pi­tal. She works full-time as a pe­di­atric con­sul­tant and has been a pe­di­atric prac­ti­tioner for the last 12 years.

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