We are publishing part of Dr. Andreeva's presentation at the webinar for parents "He alth of the little child - approaches and solutions".
Maternal antibodies protect the baby until the sixth month, after which it begins to form its own antibodies. At the end of the first year after birth, the levels of immunoglobulins are not yet in sufficient quantity. IgM is 70% of this immunoglobulin in adults, and the levels of IgA, which is found in mucous membranes, is only 20%.
This means very low levels of immune protection in the mucous membranes of small children. Therefore, they often suffer from respiratory and intestinal infections. In practice, local protection is missing, there is nothing to protect them from runny noses, coughs, diarrheal stools. At the age of 6-7, children already get sick less because their immune system stabilizes. After the age of 12, the immunity is already almost built up. Maturation of the immune system in children continues until puberty.
Children have violent reactions to viral infections, so they raise their temperature very sharply. Every time they get sick, they suddenly develop a high fever. And this is extremely worrying for parents.
However, they should know that a temperature of 37 - 37.2 degrees for a small child is normal due to his increased physical activity. "Don't worry at all about such a temperature if the child jumps, runs and eats. But if at the same temperature it is depressed, sleepy, does not want to play and eat, this is already a signal that some disease is starting. I recommend that you measure the temperature again after 15 minutes
With a subfebrile temperature of 37 to 37.9 degrees, we must undress the child, ventilate the room, give him a lot of fluids, because a lot of water is lost with an elevated temperature, and measure the temperature again after 15 minutes. If the child has not yet had a febrile seizure, there is no need to give him antipyretics. Just monitor the temperature every 15 minutes.
Many parents explain to me how their child was at 37.1 degrees and only after an hour and a half it was already 40 degrees. Therefore, measure the temperature every 15 minutes, so you will react adequately. If after 15 minutes the child's temperature rises, give an antipyretic medicine. If it persists or starts to drop, measure again in an hour or two," explained the pediatrician.
She added that at a temperature between 38 and 39 degrees, you should not wait too long, but give a temperature-lowering agent. If the temperature persists, give an antipyretic again and monitor the temperature every 15 minutes.
“Keep in mind that all products that contain paracetamol, including suppositories, are given no more than four times a day, over six hours. A syrup should not be given and after two hours - a suppository, because we duplicate the active ingredient of the medicine and thus give an overdose of paracetamol, which is not suitable for the child's weight.
Since there is a huge variety of antipyretics on the market with different trade names, look for what the given medicine contains. Medicines containing ibuprofen are given a maximum of three times a day, every 8 hours. Analgin can only be given twice a day, and it is not recommended for children either.
If we have given medicine with paracetamol and the temperature does not go down, after an hour we can give medicine with ibuprofen or analgin. But we cannot shorten the time of taking the same medicinal product", said the doctor.
When the child's temperature is over 39 degrees, analgin brings it down very well and works great in small children. Cold wet towels are placed only where the large blood vessels pass, and towels soaked only with water that is not too cold. Relatively cold compresses can be placed under the armpits and on the inguinal folds - there the large blood vessels pass.
This will lower the temperature. You can even bathe the child, but with water whose temperature is one degree lower than that of the child. We shouldn't put him in an ice bath because it will shock him. It is also inadmissible to put vinegar towels on the child's head, because rashes may occur. Vinegar is an acid, and children's skin is very delicate and sensitive to the effects of acid.
Febrile seizure scares parents a lot. In fact, this is not such a terrible condition, because febrile seizures are benign and have no consequences. 2 to 5% of children have febrile seizures, and in familial cases, when the mother or father had them as children, 10% of children have seizures. This happens most often between three months and five years of age, but seizures usually occur between 11 and 12 months of age
Febrile seizures are due to the immaturity of the nervous system and occur when the temperature rises above 38 degrees. In this case, parents should keep calm and follow a few basic rules.
First, the child is placed on a safe surface, not, say, on the edge of the sofa, with the risk of falling off it. We turn the child on his side, slightly lifting his chin up - this way the airways are freed. In a safe place, we could see if the seizure was symmetrical, that is, the twitches happened in all four limbs at the same time, and how long they lasted.
Children come out of a febrile seizure in a minute, five minutes at most. It is good for parents to observe all these things, because this is how a febrile seizure, which is symmetrical, can be distinguished from epileptic conditions, in which there is lateralization - twitching on only one side of the body and different types of convulsions.
“It is very important during the spasm not to try to "take out the tongue" of the child who is in spasm. If we have placed the child on his side and lifted his chin up, there is no danger of the root of the tongue blocking his throat. This can only happen if the child is on their back.
The parent should remain calm and wait for the seizure to end. There is no point in calling 911, because the emergency medics will only state that the seizure is over. An ambulance must be called if the seizure lasts more than five minutes or if a second seizure occurs within half an hour or an hour. This already makes the febrile convulsion complicated and the child must go to the hospital for observation.
If the seizure was symmetrical, lasted about 2 minutes and the child got out of it on his own, it is good to consult a neurologist and have an electroencephalogram only after a month. This is to reassure the parents that their child does not have epilepsy," the doctor summarized.