When should a feverish child be taken to a doctor?

Cigdem Yavrucu / Child Health and Diseases Specialist

The general approach of the parents is that they go to the doctor in a hurry when the fever occurs. Whereas, first of all, you should be calm and the situation of going to the doctor should be evaluated after taking a fever measurement. Here are the situations that require you to go to the doctor if your child has a fever ...

In the neonatal period (First 1 month): Since the immune system is not sufficiently developed in infants in this period, they cannot respond adequately and reliably to infections. Even a fever that is not too high can be a sign of meningitis and pneumonia. In general, babies who have a fever and no other symptoms have a 7 percent risk of serious bacterial infection. For this reason, it should be taken to the doctor without delay, and examination and treatment should be done. Doctor must be visited in every fever of 38 degrees and above. If the child is in an overclothed and too thickly covered condition, it may cause the fever to be high as a mistake. The child's clothes are removed, the top is thinned, waited for 30 minutes and the fever is measured again. If the fever is measured normally, the child is considered without fever.

In infants 1-3 months: This period is the most common period of viral infections. In this period, babies should be taken to the hospital because their immune system is not developed enough and cannot provide an effective response. Sick babies with sick appearance (toxic / rejection of feeding, excessive restlessness) should be hospitalized, examined and the necessary treatments should be started without wasting time.

Between 3 months and 3 years: If the fever is between 38-38.9 degrees from the breech, it lasts longer than 3 days, if the child refuses to feed, if it is excessively restless, accompanied by findings such as respiratory distress and diarrhea, it should be left without waiting for 3 days. If the fever is 39 degrees and above and the fever does not fall; The child should be taken to the hospital, regardless of any circumstances.

• When should antipyretics be used?

The fever limit for the use of antipyretic drugs should be 39-39.5 degrees. It is absolutely not true to reduce the child's fever quickly, it disrupts thermoregulation (mechanisms that control body temperature).

Paracetamol: It is used orally or rectally in the form of suppositories. It has pain-relieving and antipyretic effects, can be given every 4-6 hours with the knowledge of the doctor and at the dosage recommended by the doctor. (10 mg per kilo)

Ibuprofen: It is antipyretic and painkiller, it also has anti-inflammatory effect. That is, it heals inflammatory reactions. (5 mg per kilo)

In cases of high fever, these drugs can be given alternately. Since paracetamol is excreted from the liver and ibuprofen from the kidney, medicine weight is divided into two instead of constantly tiring one organ. One thing to be aware of is that doses are very important, high doses can have toxic effects.

Aspirin: Never give aspirin! Administration of aspirin in viral diseases in children (REYE SYNDROME) can lead to a dangerous complication that can lead to liver failure. In addition, aspirin can cause side effects such as discomfort in the stomach and gastrointestinal bleeding.

• Should antibiotics be used in febrile conditions?

When the child is fever, antibiotics should not be started unless the doctor deems necessary. In particular, the onset of diseases such as meningitis and pneumonia can be similar with simple colds, and oral antibiotics can delay diagnosis. However, if the cause of the fever is bacterial infection, antibiotics can be started at the dose approved by the doctor.

• If the fever does not decrease as a result of antibiotic treatment…

Considering that there is a bacterial infection by the doctor, if the patient has started antibiotics and no response has been obtained, the doctor should be consulted again. Blood and urine tests should be performed and if necessary, hospitalization and treatment should be continued.

Editor's note: Be sure to read our columnist's other column about fire.