Temperature - protection of the body from disease

2024 Author: Seth Attwood | [email protected]. Last modified: 2023-12-16 15:55

Medical professionals - doctors and nurses - have led them to believe that high fever is always dangerous. Moreover, they also increased the effect of fear, spreading the misconception that the severity of a child's condition is determined by his body temperature. That is why, for 30 percent of patients, the reason for contacting a pediatrician is fever.

When you call a doctor to report a child's illness, the first question he almost always asks is, "Have you measured the temperature?" And further, regardless of what data you tell him - 38 or 40 degrees, he advises giving the child aspirin and bringing him to an appointment. This has become a ritual of almost all pediatricians. I suspect that many of them speak memorized phrases, even if they hear about a temperature of 43 degrees. My concern is that children's doctors are asking the wrong questions and giving the wrong advice.

Doctors see a rise in temperature as something extremely dangerous, otherwise why is it their first concern? And from their advice to give the child aspirin, parents inevitably conclude that treatment should be medication and aimed at lowering the temperature.

By measuring body temperature and recording its indicators in a medical record, an appointment begins in most children's clinics. There is nothing wrong. Fever is indeed an important diagnostic symptom in the context of a follow-up examination. The problem is that it gets a lot more value than it should. When a doctor sees a nurse's record in the chart about a temperature of, say, 39.5 degrees, he invariably says with a gloomy face: "Wow! We must do something!"

His concern about temperature is nonsense, and misleading nonsense! Nothing needs to be done about the rise in temperature by itself. In the absence of additional symptoms, such as unusual behavior, extreme weakness, difficulty breathing, or others that suggest serious illnesses such as diphtheria and meningitis, the doctor should tell the parents that there is nothing to worry about and send them home with the child.

Taking into account the exaggerated attention of doctors to fever, it is not surprising that most parents, according to opinion polls, have a huge fear of it. Moreover, this fear grows in proportion to the readings of the thermometer, while it is most often groundless.

Here are twelve facts about body temperature that can help you avoid a lot of anxiety, and your children - unnecessary and dangerous tests, x-rays and medications. These facts should be taken into account by every doctor, but many of the pediatricians prefer to ignore them and do not consider it necessary to introduce them to their parents.

Fact number 1. Temperature of 37 degrees is not "normal" for everyone, as we have been told all our lives. This is simply not true. The established "norm" is very conditional, since the indicator of 37 degrees is an average value. Many people have a normal temperature higher or lower. This is especially true for children. Studies have shown that the body temperature of the majority of perfectly healthy children is 35, 9-37, 5 degrees, and only a few have exactly 37 degrees.

Fluctuations in the child's body temperature during the day can be significant: in the evening it is a whole degree higher than in the morning. If you find a slightly elevated temperature in a child in the afternoon, do not be alarmed. This is normal for this time of day.

Fact number 2. Temperatures can rise for reasons unrelated to any medical condition, such as the digestion of heavy and heavy meals, or at the time of ovulation in adolescent girls during puberty. Sometimes a rise in temperature is a side effect of medications prescribed by your doctor - antihistamines and others.

Fact # 3. Temperatures to be wary of usually have an obvious cause. In most cases, an increase in temperature, which can pose a threat to health, occurs either as a result of poisoning with toxic substances or as a result of overheating (so-called heatstroke). Classic examples of overheating are a soldier passing out in a parade, or a marathon runner falling out of range and exhausted in the sun. In such cases, the temperature can rise to 41.5 degrees or higher, which is fraught with harmful consequences for the body. A similar effect can be achieved by overheating in excess in a bath or in a jacuzzi.

If you suspect that your child has swallowed a poison, call the Poisoning Center immediately. When this is not possible, without waiting for trouble, urgently take the child to the hospital and, if possible, grab a package from the swallowed drug - this will help you quickly find an antidote. As a rule, substances swallowed by children are relatively harmless, but timely seeking help is very important.

Immediate treatment is also necessary if the child loses consciousness, even if for a short time, after outdoor games in the heat or after a bath or jacuzzi. A call to the doctor in this situation is not enough. Take your child to the hospital as soon as possible. External influences are potentially dangerous. They are able to suppress the body's defenses, which, under normal conditions, do not allow the temperature to rise to a dangerous level. Preceding events and accompanying symptoms help to recognize these conditions. Let me emphasize: loss of consciousness means that the child is in danger.

Fact No. 4. Readings of body temperature depend on the way it is measured. Rectal (in the rectum) temperature in children is usually a degree higher than the oral (in the mouth) temperature, axillary - a degree lower. However, in infants, the difference between the temperature values measured by these methods is not so great, so it is better for them to measure the temperature in the armpit. I do not recommend using a rectal thermometer: when it is introduced, perforation of the rectum is possible, and it is fatal in half the cases. Why take risks when you don't need to? Finally, do not assume that a baby's body temperature can be determined by touching the forehead or chest. This will not be possible for either the medical staff or you.

Fact number 5. You should not knock down body temperature. The only exceptions are newborns suffering from infections, which are often caused by obstetric interventions in childbirth, intrauterine and hereditary diseases. Acute infectious disease can also result from certain procedures. For example, an abscess under the scalp can develop in an infant from the sensors of the device during intrauterine observation, and aspiration pneumonia - due to amniotic fluid that has entered the lungs as a result of the administration of drugs by the mother during childbirth. Infection is also possible during the circumcision procedure: there are legions of pathogens in hospitals (this is just one of the reasons why my grandchildren were born at home).

If a baby has a high fever in the first months of life, it is simply necessary to show it to the doctor.

Fact # 6. Fever can rise from excessive wrapping. Children are very sensitive to overheating. Parents, especially firstborns, are often overly concerned about whether their children are cold. They wrap the baby in many clothes and blankets, forgetting that if he gets hot, he will not be able to get rid of warm clothes on his own. If your baby has a high fever, be sure to check to see if he is overly dressed.

If a child with a fever, especially accompanied by chills, is wrapped tightly in thick blankets, this will provoke her to rise even more. A simple rule that I recommend to the parents of my patients: let the child have as many layers of clothing as they themselves.

Fact number 7. Most cases of fever are associated with viral and bacterial infections, which the body's defenses cope with without any help. Colds and flu are the most common causes of fever in children of all ages. The temperature can rise to 40.5 degrees, but even in this case there is no cause for concern. The only danger is the risk of dehydration from the accompanying processes of sweating, rapid pulse and breathing, coughing, vomiting and diarrhea. It can be avoided by giving the baby plenty of fluids. It would be nice if the child drank a glass of liquid every hour, preferably nutritious. This can be fruit juice, lemonade, tea, and anything that the child will not refuse.

In most cases, viral and bacterial infections are easy to recognize by the accompanying fever symptoms: mild cough, runny nose, watery eyes, and so on. With these diseases, you do not need the help of a doctor or any medication. The doctor will not be able to "prescribe" anything more effective than the body's defenses. Medicines that alleviate the general condition only interfere with the action of the vital forces. I'll talk about this in more detail in one of the next chapters. Antibiotics are not needed either: although they can shorten the duration of the bacterial infection, the risk associated with them is very high.

Fact # 8. There is no clear relationship between the temperature of a child's body and the severity of the disease. A common misconception about this is not substantiated. In addition, there is no consensus among parents or even among doctors about what constitutes "high fever". The parents of my patients, and I had a lot of them, had diametrically opposed views on this matter. Studies have shown that more than half of the parents surveyed consider the temperature to be "high" from 37.7 to 38.8 degrees, and almost all of them call the temperature 39.5 degrees "very high". In addition, all respondents were convinced that a high temperature indicates the severity of the disease.

It's not like that at all. More precisely, by the clock, the measured temperature does not say anything about the severity of the disease if it is caused by a viral or bacterial infection. Once you understand that infection is the cause of your fever, stop taking your fever hourly. Tracking its increase in such an illness will not help; moreover, it will only increase your fears and tire the child.

Some common, benign illnesses, such as measles a day, sometimes cause very high fevers in children, while others, more serious ones, can go on without them. If there are no additional symptoms such as vomiting or breathing difficulties, remain calm. Even if the temperature rises to 40.5 degrees.

It is important to consider the child's general condition, behavior and appearance to determine whether a fever is caused by a mild illness like a cold or a serious illness like meningitis. You will appreciate all these points much better than a doctor. You know much better how your child usually looks and how he behaves. Call your doctor if you experience unusual lethargy, confusion, or other warning signs that last a day or two. If the child is active, has not changed his behavior, there is no reason to fear that he is seriously ill.

From time to time, pediatric journals come across articles about "fever-phobia" - about the unjustified parental fear of fever in children. Doctors specially invented this term - a typical for people of my profession tactic "blame the victim": doctors never make mistakes, and if mistakes occur, the patients are to blame. In my opinion, "temporophobia" is a disease of pediatricians, not of parents. And it is the doctors who are to blame for the fact that the parents become her victims.

Fact number 9. The temperature caused by a viral or bacterial infection, if not brought down, will not rise above 41 degrees. Pediatricians are doing a disservice by prescribing antipyretics. As a result of their appointments, the parents' anxiety that the temperature may rise to an extreme limit, if not taken care of, is reinforced and intensified. Doctors do not say that knocking down the temperature does not affect the healing process, just as the fact that the human body has a mechanism (not yet fully explained) that does not allow the temperature to overcome the 41-degree barrier.

Only with heatstroke, poisoning and other external influences, this natural mechanism may not work. It is in such cases that the temperature rises above 41 degrees. Doctors know about this, but most of them pretend not to know. I believe that their behavior is motivated by a desire to demonstrate their help to the child. In addition, there is a common desire for doctors to intervene in any situation and a reluctance to admit that there are conditions that they are not able to treat effectively. Apart from cases of fatal, incurable diseases, what doctor would dare to tell a patient, "I can't do anything"?

Fact No. 10. Measures to reduce the temperature, whether it be the use of antipyretics or rubbing with water, are not only unnecessary, but also harmful. If a child is infected, then the increase in temperature that accompanies the course of the disease, the parents should not perceive as a curse, but as a blessing. The temperature rises as a result of the spontaneous production of pyrogens, the substances that cause fever. This is the body's natural defense against disease. An increase in temperature indicates that the body's healing system has turned on and is working.

The process develops as follows: the child's body reacts to an infectious disease by producing additional white blood cells - leukocytes. They kill bacteria and viruses and cleanse the body of damaged tissues and waste products. At the same time, the activity of leukocytes increases, they quickly move to the focus of infection. This part of the process, the so-called leukotaxis, is stimulated by the production of pyrogens, which increase the body temperature. The increased temperature indicates that the healing process is accelerating. One should not be afraid of this, one should rejoice at this.

But that's not all. Iron, which feeds many bacteria, is removed from the blood and stored in the liver.

This reduces the rate at which bacteria multiply and increases the effectiveness of interferon, which the body makes to fight disease.

This process has been demonstrated by scientists in laboratory experiments on infected animals. With an artificial increase in temperature, the mortality of experimental animals from infection decreased, and with a decrease, it increased. Artificial increase in body temperature has long been used in cases when the body of patients lost their natural ability to do so in diseases.

If your child's temperature rises as a result of an infection, resist the urge to knock it down with medication or rubdown. Let the temperature do its thing. Well, if your compassion requires you to alleviate the patient's condition, give the child paracetamol at an age-appropriate dosage or wipe the body with warm water. This is quite enough. A doctor is needed only when the temperature lasts for more than three days, other symptoms appear, or the child becomes completely ill.

I emphasize that by lowering the temperature to relieve the child's condition, you interfere with the natural healing process. The only reason that forces me to talk about ways to lower the temperature is the knowledge that some parents are unable to resist it. If you cannot keep the temperature down, wiping with water is preferable to taking aspirin and paracetamol because of their danger. Despite their popularity, these funds are far from harmless. Aspirin poisons possibly more children every year than any other poison. This is the same form of salicylic acid that is used as the anticoagulant base in rat poisons - rats die of internal bleeding when they eat it.

Aspirin can cause a number of side effects in children and adults. One of them is intestinal bleeding. If children get this drug while they have the flu or chickenpox, they can also develop Reye's syndrome, a common cause of infant death, mainly due to effects on the brain and liver. This is partly why many doctors switched from aspirin to paracetamol (acetaminophen, panadol, calpol, and others).

Reception of this remedy is also not a way out. There is evidence that high doses of this drug are toxic to the liver and kidneys. I would also like to draw your attention to the fact that babies whose mothers took aspirin during childbirth often suffer from cephalohematoma, a condition in which fluid-filled bumps appear on the head.

If you do decide to lower your baby's body temperature by rubbing, use only warm water. A decrease in body temperature is achieved by evaporation of water from the skin and does not depend on the temperature of the water. This is why water that is too cold has no benefit. Alcohol is also not suitable for rubdown: its vapors are toxic to the baby.

Fact No. 11. High temperature caused by a viral or bacterial infection does not lead to brain damage and does not cause other negative consequences. The fear of high fever stems largely from the widespread belief that it can lead to irreversible damage to the brain or other organs. If this were the case, the parents' panic when the temperature rises would be justified. But, as I said, this statement is false.

For those who are familiar with this fear, I advise you to forget about everything that sowed it, and never take on faith the words about such a threat of high fever, no matter who they come from - from other parents, the elderly or a doctor friend who is friendly giving advice for a cup of coffee. And even if such advice was given by an omniscient grandmother. She is right, alas, not always. Colds, flu, and any other infection will not raise a child's body temperature above 41 degrees, and temperatures below that level will not cause long-term harm.

There is no need to expose yourself every time to the fear of possible brain damage in a child when his temperature rises: the body's defenses will not allow the temperature to rise above 41 degrees. I don’t think even pediatricians who have been practicing for decades have seen more than one or two cases of high fever. The rise in temperature above 41 degrees is not caused by infection, but by poisoning or overheating. I have treated tens of thousands of children and only once observed a temperature of my patient above 41 degrees. No wonder. Studies have shown that in 95 percent of cases of fever in children, it did not rise above 40.5 degrees.

Fact # 12. High fever does not cause seizures. They are caused by a sharp rise in temperature. Many parents are afraid of high fever in their children, because they notice that it is accompanied by seizures. They believe that the "too high" temperature is causing the cramps. I understand these parents well: a child in convulsions is an unbearable sight. Those who have observed this may find it difficult to believe that the condition is generally not serious. In addition, it is relatively rare - only 4 percent of children with high fever have seizures, and there is no evidence that they have serious consequences. A study of 1,706 children who experienced febrile seizures found no motor impairment or deaths. There is also no conclusive evidence that such seizures subsequently increase the risk of epilepsy.

Moreover, measures to prevent febrile seizures - taking antipyretic drugs and rubbing - are almost always carried out too late and, therefore, in vain: by the time a high temperature is detected in a child, most often, the seizure threshold has already been passed. As I said, seizures do not depend on the level of temperature, but on the rate at which it rises to a high level. If the temperature rises sharply, the convulsions have either already occurred, or the danger has passed, that is, it is almost impossible to prevent them.

Children under five years of age are usually prone to febrile seizures. Children who experience such seizures at this age rarely suffer from them later.

Many doctors give children long-term treatment with phenobarbital and other anticonvulsants to prevent recurrence of seizures at high temperatures. If these drugs are prescribed for your child, ask the doctor about the risks associated with them and what changes in the child's behavior they lead to.

In general, there is no unanimity among doctors on the issue of long-term treatment of febrile seizures. The drugs that are commonly used in this case cause liver damage and even, as shown in animal experiments, negatively affect the brain. One of the authorities on this issue once remarked: "Sometimes it is more useful for a patient to live a normal life between episodes of seizures than to live on drugs without seizures, but in a constant state of drowsiness and confusion …".

I was taught to prescribe phenobarbital to children with febrile seizures (to prevent recurrence), and today's medical students are taught the same. I had doubts about the correctness of the appointment of this drug when I noticed that during treatment with it, convulsions in some patients were repeated. This, of course, made me wonder: did phenobarbital stop them in the rest of the patients? My suspicions intensified after complaints from some mothers that the drug overexcited or inhibits children to such an extent that, usually active and sociable, they suddenly turn into a half-zombie. Since the seizures are episodic and do not leave long-term consequences, I stopped prescribing this medicine to my little patients.

If a child with febrile seizures is prescribed long-term treatment, the parents will have to decide whether or not to agree to it. I understand that it is not easy to openly express doubts about doctor's prescriptions. I also know that a doctor can dismiss questions or not give intelligible answers. If this happens, there is no point in starting an argument. It is necessary to take a prescription from a doctor and, before buying a medicine, seek advice from another doctor.

If your child has fever-related cramps, try not to panic. Of course, giving advice is much easier than following it. The sight of a child with seizures is really scary. Still: Remind yourself that seizures are not life threatening or irreversible, and take simple steps to ensure that your child does not get hurt during a seizure.

The first step is to turn the baby to one side so that he does not choke on the saliva. Then, make sure that there are no hard or sharp objects near his head that could hurt him during an attack. After making sure that nothing is blocking your baby's breathing, place a hard, but not sharp object between his teeth - for example, a clean folded leather glove or wallet (not a finger!) So that he does not accidentally bite his tongue. After that, for your own reassurance, you can call the doctor and tell about what happened.

For the most part, seizures last for a few minutes. If they drag on, call your doctor's advice. If the child does not fall asleep after a seizure attack, you cannot give him food or drink for an hour. Due to extreme drowsiness, he may choke.

A quick guide to body temperature

Fever is a common symptom in children that is not associated with serious illness (in the absence of other alarming symptoms such as unusual appearance and behavior, difficulty breathing, and loss of consciousness). It is not an indicator of the severity of the disease. The temperature that rises as a result of infection does not reach values at which irreversible damage to the child's organs is possible.

An elevated temperature does not require medical intervention beyond what is recommended below. The temperature does not need to be knocked down. It is the body's natural defenses against infection and helps speedy healing.

1. If the child's body temperature rises above 37.7 degrees before two months, see a doctor. This may be a symptom of an infection, whether intrauterine or due to obstruction of the birth process. Fever in children of this age is so unusual that it is prudent to play it safe and rather calm down if the alarm turns out to be false.
2. For children over two months old, a doctor is not needed when the temperature rises, unless the temperature lasts for more than three days or is accompanied by serious symptoms - vomiting, shortness of breath, severe coughing for several days and others not typical for a cold. Talk to a doctor if your child is unusually lethargic, irritable, absent-minded, or looks seriously ill.
3. See a doctor, regardless of the thermometer reading, if the child has difficulty breathing, indomitable vomiting, if the temperature is accompanied by involuntary muscle twitching or other strange movements, or if something else bothers the child's behavior or appearance.
4. If the rise in temperature is accompanied by chills, do not try to cope with this sensation of the child with a blanket. This will lead to an even more dramatic rise in temperature. Chills are not dangerous - this is a normal reaction of the body, a mechanism of adaptation to a higher temperature. It does not mean that the child is cold.
5. Try to put a feverish child to bed, but do not overdo it. There is no need to tie your child to bed and keep him at home unless the weather is too bad. Fresh air and moderate activity will improve your baby's mood without worsening their condition and make your life easier. However, too intense loads and sports should not be encouraged.
6. If there is reason to suspect that the cause of the high temperature is not an infection, but other circumstances - overheating or poisoning, take the child to the hospital immediately. If your area does not have an ambulance department, use whatever medical care is available.
7. Do not try, according to folk tradition, "to starve the fever." Nutrition is essential for recovery from any illness. If the child is unresponsive, feed both colds and fevers. Both those and others burn the reserves of proteins, fats and carbohydrates in the body, and they need to be replaced. If your child refuses to eat, give them nutritious fluids such as fruit juice. And don't forget that chicken soup is good for everyone.

A high fever and its usually accompanying symptoms result in significant fluid loss and dehydration. It can be avoided by giving the child a lot to drink, preferably fruit juices, but if he does not want them, any liquid will do, preferably one glass every hour.

Chapter from the book "How to raise a healthy child in spite of doctors"