This week Bobbi Conner talks with Dr. Ian Kane about the importance of seeking immediate medical care for newborn babies and infants younger than two months who develop a fever. Dr. Kane is an Associate Professor of Pediatrics and a pediatric emergency physician at MUSC Shawn Jenkins Children’s Hospital.
TRANSCRIPT:
Conner: I'm Bobbi Conner for South Carolina Public Radio with Health Focus here at the radio studio for the Medical University of South Carolina in Charleston. Infants younger than two months old who have a fever need immediate medical attention, even if they have no other signs of being ill. Doctor Ian Kane is here to provide important details about fever in infants and newborns. Doctor Kane is an Associate Professor of Pediatrics, and he's a pediatric emergency physician at MUSC Shawn Jenkins Children's Hospital. Doctor Kane, first, what is actually considered a fever in an infant or a newborn baby?
Dr. Kane: So, we define fever as any temperature of 100.4°F or greater, or a temperature of greater than or equal to 38°C. Now, it's also important to mention that rectal temperatures are how we measure fevers in infants and newborns. There are other methods of taking a temperature, such as forehead thermometers, oral, armpit, ear thermometers. But really, none of these methods are as reliable and should not be used at this young age.
Conner: What makes fever in infants and newborn babies different than other ages?
Dr. Kane: So, for infants less than two months of age, the biggest problem we have is that it's really difficult to tell the difference between an infant who has a fever that's caused by a serious illness, and one who has a fever from a virus. At this young age, newborns and infants just might not show very many other signs of serious illness. Newborns also have a weaker immune system, and since they don't get their first set of vaccines until they're two months old, they are also at more risk for serious infections.
Conner: And what typically does cause a fever in infants and newborns?
Dr. Kane: So most commonly, newborns and infants get the same things that older children get- viruses like the common cold, flu, RSV, and Covid. However, infants that are less than 1 to 2 months of age have an increased risk for bacterial infections, and urinary tract infections are by far the most common infection that we see at that age group. Infections of the blood or meningitis are possible, but are much less common.
Conner: When should a parent or a caregiver actually take their child's temperature? What are some of the signs or symptoms to look for?
Dr. Kane: Right. So we recommend checking your child's temperature only when you think there's something wrong. Signs to watch for would include an infant who's not feeding well, one who's especially irritable or who feels very warm or isn't waking up appropriately. It's also very concerning if your infant is making abnormal movements that look like a seizure.
Conner: When should a parent take their child to the E.R. (emergency room) or doctor related to concerns about a fever?
Dr. Kane: So, I recommend going to the E.R. if your baby has a fever and is less than one month of age, that's really the only place they'll be able to get the care they need to evaluate a fever at that age. However, if your infant's between 1 and 2 months of age, I recommend calling your pediatrician first. But it's likely in those cases they'll still want you to be seen in the emergency department. For infants older than two months, they can usually be seen in the pediatrician's office, unless you have serious concerns about how your child is acting. For example, if they're very difficult to wake up, if they haven't made any wet diapers in the last 8 to 12 hours, or if they're having difficulty breathing.
Conner: And Doctor Kane, what will happen in the way of an exam in the E.R. when an infant or newborn arrives with a fever?
Dr. Kane: For infants, less than one month of age will typically start with blood work, urine tests, virus tests and will likely need to do a lumbar puncture as well. A lumbar puncture is also called a spinal tap, and it's a common procedure that we do to test for meningitis. Infants between 1 and 2 months of age will have blood work, urine, and virus tests done, and we may need to do a lumbar puncture in certain cases.
Conner: Doctor Kane, thanks for this information about fever in infants and newborns.
Dr. Kane: Thank you very much Bobbi.
Conner: From the Radio studio for the Medical University of South Carolina in Charleston, I'm Bobbi Conner for South Carolina Public Radio.
Health Focus transcripts are intended to accurately represent the original audio version of the program; however, some discrepancies or inaccuracies may exist. The audio format serves as the official record of Health Focus programming.