Fever is a friend for my baby: Fever facts & myths

What is fever?
Any temperature above the maximum normal value is called fever. The human body temperature varies from 98 to 99 F, average 98.6 F (37 C). Practically any temperature measured above 99 F may be considered to be fever.
How is fever measured?
Mercury thermometers are still one of the best ways to measure temperature. Not only are they inexpensive, but also reliable. Newer techniques include digital thermometers (good), ear thermometers (good, but need practice, also expensive) & skin thermometers (not recommended).
What are the areas used for placing the thermometer?
Armpits, groin in small babies, & below the tongue in older children (5-7 years onwards). Special rectal thermometers give the most accurate readings. You should inform the doctor as to the site from where you have checked the temperature. As a rule of thumb you may add 1 degree to the temperature measured at the armpits for detecting fever.
My child has fever. When do I need to show a doctor?
The smaller the baby, the more is the likelihood of serious problems. In any child below 3 months, definitely consult a doctor. In case the baby is unduly lethargic, refusing to feed, vomiting or has a high grade fever, any child of 1 to 2 year needs to be shown to a child specialist. In an older child or adult any fever lasting more than a week definitely merits a medical consultation.
What are the causes of fever?
It may be a common cold, or even cancer! This means that a lot of conditions including infections, inflammations (swellings) & other rare diseases like cancers etc. may cause fever. Only a detailed history, examination & relevant investigations if needed may point to the exact cause.
What are the investigations needed?
These will depend on the exact cause suspected. Remember in young children more tests may be needed because we need to rule out serious illnesses more aggressively. A general set of tests may include Blood counts (TLC, DLC), ESR, Widal (typhoid), Malarial parasite, urine routine & culture (especially in girls), and many others like chest x ray, abdominal USG, Blood culture, ECHO as per the history & examination findings.
What is the treatment?
Recent studies indicate that both Ibuprofen (Brufen, Ibugesic) & are equally safe & effective in treating high fever. Nimesulide is not recommended for children less than 1 year.
The safest & probably most effective treatment would be sponging with tepid water (not too hot & definitely not cold).
Fever Facts & Myths
All fever need treatment. FALSE
Most fever are viral in origin and will get better with time, do not use medicines to treat temperature if it is below 101 F (~ 38 C), especially if the child is active and playful.
Untreated fever will keep on getting higher. FALSE
In fever the body’s thermostat has changed & set to higher level. In a vast majority of cases the fever will settle at a slightly higher level even without treatment. The primary purpose of fever medicines is to make the child (& parent) more comfortable.
We should try to bring the temperature back to normal with treatment. FALSE
FEVER IS A FRIEND. There is no need to bring the temperature to normal as fever helps the body fight infections better. It helps in increasing the body’s defense mechanisms like hormones, infection controlling cells, enzymes, chemical reactions within the body to counter inflammation effectively.
Certainly no bodily harm is likely to come to a child by a fever of even 103-105 F!
High fever in children leads to seizures. PARTLY TRUE
Actually it is not the height of fever but the rapidity of fever rise that determines whether a child prone to febrile seizures will actually have a fit or not. In a child with definite febrile seizures nothing bad is likely to happen even if he has recurrent seizures, he will likely outgrow them by the time he is 5-6 years old.
For more information of febrile seizures click here

Monsoon Hungama: My child & the rain

Monsoon is the time of getting drenched in puddles & rivulets of water, tea , pakoras, and maybe a few holidays from school!
What fun, but it is also a time when a few common diseases strike children.
Dirty water can be a big risk for children, leading to diarrhoea, vomiting & dehydration. Treatment would involve adequate fluids like ORS, neembu paani, salty Lassi (Buttermilk), light juices, curd, bananas etc. Antibiotics should not be taken without a doctor's consent.
Poor quality of water can also lead to Typhoid & hepatitis A, prevention lies in using a filter or boiling the water. Please ensure that your child has taken vaccination for both these vaccine preventable diseases. Remember Typhoid vaccine is needed every 3 years. Hepatitis A vaccine is not the same as Hepatitis B vaccine and needs to be given separately. Avoid eating cut fruits, chaat or drinking juice from roadside vendors.
Foods To Eat: The monsoon brings with it the magnificence of mangoes, the aroma of roasted corn and the sweet tasting jamuns, enjoy them.
Small boils & pustules are very common in rainy seasons, prevent them by regular baths especially after playing in th rains. Treatment with antiseptic creams usually suffices, though a doctor's opinion should be taken in case of no improvement.
Malaria is another side-effect of the abundance of stagnant water during the monsoons. Avoid having stagnant water in your house. Empty the water coolers, the unused flower pots etc. Use a mosquito repellant & a Mosquito net if possible. Some of the other diseases you will prevent by these measures include brain fever (viral encepahlitis like JE), and Dengue fever.Any high grade fever should prompt a visit to your Pediatrician.
So enjoy this season with tea, bhuttas, hot snacks & by following some of these common precautions.

Cough Syrups: The PLACEBO effect

In case you are wondering about the title; a Placebo is a medicine that has no active ingredient, but is prescribed by doctors to encourage the patient's expectation to get well.
Also it also plays an important role in drug trials to find out if a particular medicine is more effective/ has more side-effects than if no medicine was given.
As pediatricians most of us are aware that the innumerable cough syrups available in the market are not very effective in reducing children's cough. In the July issue of 'Pediatrics' Medical Journal, an interesting study has shown that two of the most commonly used medicines in cough mixtures, namely dextromethorphan & diphenhydramine, are no better than sugar syrups (placebo, right!) in treating cough caused by common cold.
So what should a parent do?
Confirm with a child specialist that your child has an upper respiratory infection; try using home made "daadi maa ke nuskhe" (grandmother's recipes) like Ginger & honey (adrak, shahad) based concoctions, or try hareera (traditional cough mixture).
Common Cough tips:
Avoid ice, extremely cold drinks;
Try to rest the throat by not shouting;
Warm saline gargles if possible,
Saline nasal drops;
Plenty of fluids to maintain hydration
Humidification of air;
Avoid dust & smoke,
No antibiotics without the pediatricians consent, and try not to 'pressurize' him into writing an antibiotic prescription ! :-)
What is the best way to heal a cough?
Give it TIME to heal. In case it does not go within a week reconsult the doctor.