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Fever & Your New Baby

by Sue Hubbard, M.D.

I have recently seen many babies coming in to the office for their first post hospital newborn check. The lovely thing about summer is that the office is not quite as busy as there just aren’t as many sick children.

Despite the decrease in sickness throughout the country during the summer, I still explain to new parents that it is important to try and limit their newborn’s exposure to illness. This is best accomplished by avoiding crowds.  This is especially important for the first 6–8 weeks of a baby’s life.

We pediatricians get especially concerned if a newborn develops a fever during these first weeks. One of the first precepts of pediatrics is,” an infant under 8 weeks of age with a fever, is admitted to the hospital for a presumed bacterial infection until proven otherwise”.  This means a spinal tap, urine culture, and blood culture are performed and IV antibiotics are routinely started. In most cases the fever is secondary to a viral infection, but until all tests are negative, the baby spends 2-3 days in the hospital. Traumatic for everyone.

But with the summer months here, many families are planning on travelling to the beach or mountains, or to go visit the grandparents etc. The travel issue came up as I had a patient that just had her 3rd baby (via C-section no less), and she came in with her precious newborn. While I was examining the baby, the mother casually mentioned that she was planning on going to Washington, DC in the next few weeks (baby would be about 3 ½ weeks old), for a family trip and sightseeing.  Her husband wanted the older children to see DC and they then planned to drive up to the battlefields in PA. UGH!

I grew up in DC and there really is not a better place to take children for a combination of fun and learning.  But, the thought of travelling with a newborn, standing in lines to get through security at the airport (another post), and flying for over 3 hours only to stand in more lines to enjoy the sights of Washington with the older children, made me cringe.  Not just for the huge undertaking of travel, but because of this newborn’s possible exposure to infection.  Think of all of the germs that this newborn might come in contact with!!

Now, you know I am not a “germaphobe” but I am wary of a newborn being exposed to this many people. Every time you stand next to someone who coughs or sneezes, they may unknowingly pass a virus on to you.  Many of the viral infections we so often discuss are airborne and enter our own eyes or noses via aerosolized droplets. Mother’s and father’s hands also touch many surfaces, and even with hand sanitizers there is no way to be sure that those travelling hands have not come into contact with germs that then may be spread to the newborn.

No one wants to get a tiny baby sick, but there are a gazillion people out at airport check in counters, or in security lines, or sitting next to you on a plane that may be ill.  You don’t get to pick who you are with. Same thing goes for standing in a museum or shopping mall or hotel lobby.  So, that precious newborn may develop a fever from all of this exposure and they will end up in the hospital, wherever you are.

So, if possible (I realize there are emergencies) stick close to home and plan that trip with your baby after they are 8 weeks of age. It will make it much easier on parent, infant and the pediatrician who hates to have to hospitalize a newborn.

That’s your daily dose for today.  We’ll chat again tomorrow.

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