WWYD, newborn with a high fever? - Page 2

[workjw]

Originally Posted by Marylizah

Sorry to serial post.

workjw, thanks so much for the information. I'm bummed to know that there's a chance we'll be back in the hospital if DS has a reflux problem. I know that the u/s was to check for structural abnormalities and to see how far the infection had progressed. So they never told me they'd be able to totally rule out reflux.

The VCUG sounds pretty horrible, but hey, if we end up having to do it, we'll survive.

Does your daughter still struggle with this issue? Can it be outgrown? Ugh. What a horrible thing.

I hope I didn't scare you, that certainly wasn't my intention. Reflux is actually pretty common (1-3% of kids have it) and 80% of kids outgrow it by about age 6, depending on the severity. So even if he does have it, odds are that he will outgrow it but yeah, it can be a bummer. Hopefully your guy just happened to get a UTI and doesn't have reflux at all. I just think it's important to be very aware of signs for UTI if there is a past history mostly b/c treating it quickly is really important. For example ds (no reflux) can run a 103 fever for days without me batting an eye. On the other hand, if dd has a 101 fever for more than 24 hours with no visible signs of illness, we have her urine tested just to be sure that it is not a UTI. For a child with reflux, treating the infection before it has a chance to move into the kidneys is the key to keeping them healthy.

The VCUG is definitely not a lot of fun, but it's not as awful as it sounds. DD has had 2, one at 7 wks, and then one at 10 mos and she did really well with both.

We do still deal with reflux, and probably will for years, but dd is an extremely rare case. She has grade 5 reflux in both ureters, and also has 2 extra ureters both with low grade reflux, along with some other unique urinary and renal issues. She's what you might call a one of kind!

[Marylizah]

Thanks for the additional information. So sorry to hear your daughter has these unique issues! I will be super-vigilant about temperatures with DS2. This is just all so new for me-- DS1 didn't have a fever until he was, I dunno, 23 months old, or something like that! But it is good news that most kids will outgrow the problem.

We're lucky we caught it before the infection had reached the kidneys. And to think, I was half-tempted to let the baby sleep and "see what happened"...

[claddaghmom]

Originally Posted by workjw

I'm not sure I understand what you mean? Are you saying UTI's are not something to fear? (also not trying to debate, just don't know what you mean) ftr, we are selectively, delayed vax, but still not sure what that has to do with UTIs

No, I mean in the context of vaccinating culture...we routinely vaccinate when incidence is low, symptoms are clear and treatments are varied (for most vaccine related illnesses). Meanwhile, a UTI has a quick onset, no other symptoms and is very dangerous and require immediate medical intervention.

I mean, seriously? Why aren't we scared of UTIs? Other than this thread I've never heard of UTIs and newborns and the dangers of them, etc. I don't see it in baby magazines or on TV, or on hospital walls, or in pamphlets from the mayor, etc.

E.g. if I had a newborn with a fever, I would be concerned and ask for advice, but the first thing in my head would never have been "UTI! Hospital!"

Sorry if I was confusing, my short post was just a reference more to our cultural conditioning/focus.

[KatWrangler]

My DD1 has a Neurogenic Bladder. She has had lots of UTI's. Most of the time there is no real symptom except smelly, cloudy or dark pee. She doesn't normal present with a fever. Crabbyness, yes.

[workjw]

Originally Posted by claddaghmom

No, I mean in the context of vaccinating culture...we routinely vaccinate when incidence is low, symptoms are clear and treatments are varied (for most vaccine related illnesses). Meanwhile, a UTI has a quick onset, no other symptoms and is very dangerous and require immediate medical intervention.

I mean, seriously? Why aren't we scared of UTIs? Other than this thread I've never heard of UTIs and newborns and the dangers of them, etc. I don't see it in baby magazines or on TV, or on hospital walls, or in pamphlets from the mayor, etc.

E.g. if I had a newborn with a fever, I would be concerned and ask for advice, but the first thing in my head would never have been "UTI! Hospital!"

Sorry if I was confusing, my short post was just a reference more to our cultural conditioning/focus.

Thanks for clarifying I completely agree with you. I guess the reasoning is that UTIs themselves are not that dangerous except in infants or kids with kidney reflux, so it's not a priority? We had certainly never heard of the dangers of UTI (or fever for that matter) in a newborn when dd got sick. I guess maybe it doesn't happen that often, but I talk to parents all the time that have been through the exact same thing, so it can't be that uncommon either.

fwiw we started a website to raise awareness for kidney reflux and the dangers of UTI, so at least we're doing our part!

[workjw]

Originally Posted by Marylizah

Thanks for the additional information. So sorry to hear your daughter has these unique issues! I will be super-vigilant about temperatures with DS2. This is just all so new for me-- DS1 didn't have a fever until he was, I dunno, 23 months old, or something like that! But it is good news that most kids will outgrow the problem.

We're lucky we caught it before the infection had reached the kidneys. And to think, I was half-tempted to let the baby sleep and "see what happened"...

Yeah, it doesn't feel "natural" to be worried about a fever, but sometimes it is better to be safe than sorry. Like KatWrangler mentioned, you also want to watch for strange or smelly pee and sometimes ftt can also indicate UTI. Good luck! I hope everything works out well for you and you don't have to deal with this again!

[momofmine]

Originally Posted by Marylizah

Ceinwen, just out of curiosity, at what point would you consider a baby old enough to wait it out? Three months? Six? I'm also planning to ask the ped at our monthly check-up on Saturday at what point fevers are no longer a serious emergency...

I like Dr. Sears' fever guidelines, he also gives age ranges:

http://www.askdrsears.com/html/8/t082100.asp

Glad your LO is better.

[Marylizah]

Originally Posted by workjw

Yeah, it doesn't feel "natural" to be worried about a fever, but sometimes it is better to be safe than sorry. Like KatWrangler mentioned, you also want to watch for strange or smelly pee and sometimes ftt can also indicate UTI. Good luck! I hope everything works out well for you and you don't have to deal with this again!

I will keep an eye out for smelly pee. As for FTT, baby is up six pounds since birth (and he was a big baby, at 10 lbs) and is wearing size 6 months already! So no clues there, lol.

Originally Posted by momofmine

I like Dr. Sears' fever guidelines, he also gives age ranges:

http://www.askdrsears.com/html/8/t082100.asp

Glad your LO is better.

Thanks for the link, that's very helpful.

I feel like a first-time mom with this stuff, since DS1 was such a healthy baby. I think his first real illness was at 17 months, and his first fever wasn't until much later. I just never had to think about this kind of thing!

[jensb]

DD1 came down with a sore throat and fever when DD2 was 4 days old. Five days later, DD2 had a fever in the middle of the night. Despite being sure it was the same viral illness, we followed ped's advice and headed for the ER. There, they did blood cultures, urine cultures, and a spinal tap (very hard to watch on a 9-day-old), then started her on IV antibiotics and kept her in the hospital for 2 days. Fortunately, everything came back negative and her fever was down 2 days later, so we could go home. At the time, I regretted taking her to the hospital, because it certainly didn't help our already difficult time BFing, and the abx gave her diarrhea. However, I've thought about it a lot since then, and I would probably do the same thing again in a similar situation. She could just as easily been sick with a serious bacterial infection.

I'm glad everything turned out OK with yours.

[EviesMom]

I've done that, only the newborn was 9 days old. I called the dr and while waiting for the callback, put cool cloths on him. She sent us to the ER, and they did the whole spinal tap thing because the cath was fine, no UTI. Like JensB, it was probably a random virus, DH and DD were sick around the same time. I too would do it again if need be though, although I might not consent to a spinal tap again since they start IV antibiotics anyway. I might wait for a spinal tap with the regular doctor the next day rather than the ER resident with the "I-get-to-practice-spinal-taps!!!" attitude.

The guideline the hospital gave me was that if they're under 2 months old, then definitely bring them in. Between 2-3 months, it can be trickier, because if they've had a very recent vax and the temp isn't super high it might just be a common vax reaction. So at that age, call the dr. and they might say "oh you just got the polio vax, come to my office tomorrow if not sick in any other way").

I've always wondered what that means for newborns who get a Hep B vax at birth, but I delay that one, and my dr. starts the series at 2 months for her regular schedule anyway. It can cause fevers, so how would you know for a newborn?

[Rosehip]

ER @ the children's hospital