Fever in infants younger than 1 month (4 weeks)

Fever in infants younger than 1 month (4 weeks)

Fever (defined as body temperature above 100.4 degrees Fahrenheit or 38 degrees Celsius), is a common symptom in children. However, fever in infants younger than 1 month (4 weeks) is different from fever in any other age group because of two main reasons:

a. A high prevalence of serious bacterial infections in infants in their first few weeks of life.
b. Physician’s limited clinical tools and capability to differentiate between a baby with simple viral infection and a baby with a serious bacterial infection who needs immediate care and antibiotic treatment.

This is why such young babies must be referred to the emergency room for further evaluation.

What does emergancy room fever evaluation in these babies include?

Besides a thorough history taking and physical examination, these babies will usually undergo blood tests (including blood culture), urine test (including urine culture) and in most of the cases also lumbar puncture in order to get spinal fluid from the outer spinal fluid to rule out meningitis.

In most of the cases the baby will be hospitalized in order to receive antibiotics pending cultures (takes about 2 days) and for observation.

How do babies get infected with common viruses?

The source of these viral infection is usually a sick grownup (with mild common cold symptoms for example) or an older sibling attending a day care.
These viruses are transmitted by touch, wet kisses, runny noses or hands that haven’t been washed properly after touching saliva or a runny nose.

Can we avoid infections and fever in infants younger than 1 month?

Since older siblings should enjoy and bond with the new baby, it is almost impossible to make a full separation. However, I think it is best to make sure that the older siblings don’t kiss the new baby around the mouth and cheeks (kissing on the head is ok) and that they washed their hands and face before touching the baby.

In conclusion, try to keep babies younger than 1 month from getting infected, because apart from the unpleasant experience of being sick, it will cause a great deal of discomfort associated with the essential evaluation, treatment and hospitalization. And most of these infections are preventable with simple measures.

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