Fever And Febrilw Seizures

Many times, infections among children are accompanied by a fever. One of the ways the body fights the infection is to raise the body’s temperature as a protective mechanism against these infectious bodies (bacteria and viruses). A high fever is not necessarily indicative of a dangerous disease, though many parents tend to worry more about the fever than they do about what might be the cause of the fever. Fever is a symptom, not a disease. Many parents are also concerned about febrile seizures, which are also relatively harmless and only occur to a small percentage of children.

Treating a Fever
Making sure your child feels better is more important than lowering his fever therefore, if your child feels okay, there is no reason to give him medications just to lower the fever. Lowering a fever can be done with other methods.

To lower a fever:

  • Medication – make sure you give the correct dosage based on the instructions or the recommendation of your doctor. The most common medications for lowering a fever are Acamol and Dexamol (pills or syrup). The recommended time between doses is four hours. Other pain relievers that can help lower a fever are ibuprofen (advil, nurofen), which should be taken every 8 hours. An excessive dose can be harmful to the liver (and in extreme cases, an excessive dose can be fatal). If the fever lasts longer than 24 hours, see your doctor.
  • Lukewarm bath – the bath should be between 10 minutes to ½ hour. Despite the fact that your child is most likely feeling hot, the bath should not be outright cold.
  • Hydration
  • Airing out the room – you can open windows or doors to let fresh air circulate
  • Light clothing

The fever may not go down completely, despite all of your efforts. Even lowering the fever by one degree is enough to help your child feel better.

Infant Fever
Fever generally indicates the presence of an infectious agent in the body. With infants (up to a month) it is hard to know the source of the infection. Anytime a newborn’s temperature spikes, the newborn should be brought to the hospital for antibiotic treatment. Infections are extremely dangerous for newborns as their immune system is still not fully developed.

Tests for Newborns – these tests help determine the source of the infection:

  • Blood Tests
  • Urine Samples: a urine sample is taken directly from the newborn’s bladder
  • LP: a long needle is inserted into the spinal cord of the baby to extract a few drops of spinal fluid (in order to rule out meningitis).
  • Chest X-Ray: if the baby is exhibiting signs of breathing difficulty, the doctors will order a chest x-ray to rule out pneumonia. The initial test results will be done within a few hours and cultures can take between 48-72 hours.

Treating a Newborn with Fever
Antibiotic treatment: there are two types of antibiotics used to destroy the common types of bacteria which may be responsible for the infection. Antibiotics are generally administered four times a day intravenously for 48-72 hours (until the culture results are in). If there is no evidence of an infection, and your child is feeling better, you will be discharged without further treatment under the assumption that the fever was viral. In 95% of cases, there is no evidence in the blood tests of a bacterial infection. In the event that there is evidence of a bacterial infection, the antibiotic treatment will last for 7-10 days.

Symptomatic Treatment: if your newborn has a fever, you can help lower it by administering acamol and giving your baby a lukewarm bath.

Why aren’t pain relievers enough for my baby?
Five percent of newborns suffering from fevers have bacterial infections – meningitis or vasculitis to name a few. These infections are extremely dangerous, can cause irreparable damage, or even death. Pain relievers do not affect or fight the infection in any way, making antibiotic treatment necessary.

What should I look out for during my baby's hospitalization?
If the baby is eating normally, nurse or feed him like you always would. Pay attention and tell the nurse if you notice any changes in his behavior (loss of appetite, fever, inability to suck or over-tiredness). Make sure to report if you notice any swelling, redness or fluids around the IV area.

Nursing Mothers: if you have an overabundance of milk the department has a breast pump. We recommend that you continue pumping milk and storing it, and you can give it to your baby when his appetite returns.

Febrile Seizures
A febrile seizure is a sudden change in the normal brain activity due to a high fever, causing temporary changes to the behavior and function of the body. Febrile seizures are quite common during childhood – occurring mostly between the ages of 6 months to 3 years. It is less common among 6-8 years and past 8 it is rare. It is more common among boys and there is a genetic factor which causes the seizures. Febrile seizures are caused from a sudden spike in the child’s temperature, which causes a stimulus to the brain and results in a seizure. Children’s temperature-regulating mechanism is less developed than adults so temperature spikes can easily lead to seizures. A seizure will generally appear during the first stages of the fever, and usually lasts no longer than 5 minutes. Though it may look scary, the seizure does not cause any brain damage. Children who have had a febrile seizure are likely to have one again.

Signs and symptoms of the seizure include losing touch with reality, inability to recognize parents and other family members, eye rolling, staring, rigid body and shaky limbs. Children older than two may leak urine or stool and may vomit. The symptoms disappear when the seizure is over.

Remember! In many cases, the seizure is accompanied by cyanosis or paleness. Cyanosis is not necessarily a sign that your child stopped breathing it may be the result of your child’s rib cage contracting, which affects the type of breathing. His breathing will return to normal after the seizure is over.

What treatment will my child get in the hospital?
The child will be admitted for observation, and to determine the source of the fever. If your child’s temperature is higher than 100.4 degrees F (38 degrees C) notify the nurse, who will administer medication to lower the temperature. The child will be examined by a doctor to determine that the fever is lowered and to rule out any complications or any other possible reasons behind the seizure. The doctor will conduct a physical examination and take blood and urine samples. To rule out meningitis, the doctor may also take spinal cord fluid. In most cases, the fever is the result of a virus and there is no need for further treatment.

Can I help my child prevent future seizures?
Since the seizure is caused from a spike in the child’s temperature, it is hard to predict when or if it will happen again. However, if you notice that your child is not feeling well or has a low-grade fever you can help prevent a seizure by making sure the fever stays down.

At home, you child can return to his normal activities once he’s feeling better. Make sure to notify your general practitioner, the teacher or kindergarten teacher about the seizure. Make sure the teacher also knows what medication (and doses) your child needs in the event it happens again. If you notice a change in your child’s behavior – loss of appetite, restlessness, crying – take his temperature and treat him accordingly.

What can you do during a febrile seizure?

  • Remove sharp objects that may harm your child and surround him with pillows and blankets. Try to lay him on a mattress.
  • Document the seizure – what body parts were involved?
  • Lay your child on his side with his mouth open, but do not put a finger in his mouth or grab his tongue
  • Make sure he is not wearing clothing that restricts his movements; wrap him in a wet towel or sheet to cool his body faster – do not use cold water.
  • Do not try to make him drink during the seizure
  • After the seizure, take his temperature and give him acamol. Take him to the hospital. Every child must receive medical care after a febrile seizure, even if he feels fine afterwards.
  • If the seizure lasts longer than 10 minutes or your child turns blue, call for help immediately.