Life With Nine Kids

Thursday, June 27, 2013

Newborn With a Fever

Our newborn had a fever. She seemed different too. I described her as “not well” which when it comes to a newborn that means we need to think about going to the Dr. or hospital. Thankfully the not well look wore off quickly and she started acting better within an hour or so. We soon noticed she had gas for a bit and that's what seemed to make her act "not well." She never cried or screamed, but she moaned and fussed. Once the gas was out she settled down and we took her to bed thinking we might be at the ER by morning because of the low grade fever. By morning she seemed comfortable but the fever had spiked to 101.7, we think. We weren't sure the thermometer we were using was correct. She also hadn't nursed in 5 hours. I cried and we started packing hospital bags, diapers, cell phones, laptops. Over the course of that time she finally ate and looked very well and happy. She opened her eyes a lot, followed us with her eyes, watched us and just overall looked happy. I realized at that moment how well I knew her in just 11 days. I knew what was normal for her, I knew what she liked, I knew how she wanted to be held, how often she ate and wet, what her poop looked like, what facial expressions are normal for her, how and what time of day she wanted swaddled. I knew how to lay her down so she was comfy and I knew how to burp her best. When other people see my newborn they see a small sweet infant that needs cared for, I see a baby who I've bonded with and who I know with my soul. She just did not seem sick enough for an ER visit. The thought of handing her over was agonizing and it seemed extreme. We couldn't fathom our healthy, breastfed, alert baby going through those tests needlessly. Her temp slipped down a little again; it still in the "go to ER range" but not very high... we waited. 
Aunt Sharon and Grandma came and got the other kids so that we could go to the hospital immediately if needed. We were so thankful for the peace and quiet during such a stressful situation. They thought the baby looked great too and even Grandma, a former nurse, supported our decision to wait it out a bit longer.
Ricky went to the store three different times over the day: to buy a rectal thermometer, an ear thermometer and then finally a breast pump. (I wanted to pump off some foremilk in case too much was making her gassy, it seemed to help.) Ear thermometers aren't thought to be reliable with infants but we found it was. Rectal temp has a higher reading than other means of temp taking but is considered best for newborns. We took those things into consideration when deciding how high her fever was. We poured over webpages of medical advice about fever, meningitis, ER visits with newborns, and personal testimony from parents. Of course for as many stories that said ‘we took our baby in, and she had meningitis’ there were just as many stories saying it was horrible ‘they put our baby through hell and back with invasive testing and never found anything wrong.’ Better safe than sorry is a great rule of thumb when it comes to your kids, but common sense and instinct are also tools we use. So we had big decisions to make.

We have long known a newborn with a temp of 100.4 or higher is cause for concern and generally warrants an automatic ER visit. Taking her to our family Dr. would yield the same recommendation; take her to the ER because if she has a fever certain things are ruled out by testing --but she’s probably okay. We know that once in the ER nearly all babies under 3 months old and all babies (neonates) under 28 days old are automatically given a spinal tap, complete blood work up and a urine test (usually by a catheter). This is then followed by a standard 72 hour hospital stay and antibiotics. If we went in we knew we had to be ready for all of that.

It’s so hard to be an educated, involved, clear thinking, decision making parent in a sea of uneducated parents and a one size fits all health care model. Parents like us are sometimes bullied into things and threatened with social services for going against medical advice. We’ve always been very fortunate and had good professional health care givers, but you never know. So we sat at home counting every wet diaper, each time she nursed, every sound she made, every poop and every coo. We even counted how many hours she slept, all very diligently. There wasn’t a noise or movement she made that we weren’t hearing and seeing. Our bags were packed just in case.

Her fever kept going down all day. It spiked back up once or twice but not too bad. I’d get upset and scared when she wouldn’t wake to nurse, but within minutes of my tears and self-doubt starting up she’d latch on, wake up, eat, pass gas while briefly fussy, look around at us for a while, wet a diaper and then we’d do it all over again.

I noticed over hours of searching that I could not find anything online reassuring about staying home and observing a young baby before heading to the hospital. I didn’t find hardly any parents talking about fever, newborns, or medical choices, let alone very many questions regarding the invasiveness of routine “mandatory” procedures.

Her fever finally stayed steady between 100.3 and 100.5. She was doing great and it climbed down from there. Ricky and I collapsed into bed relieved. We looked at her so peaceful and healthy looking. Ricky mentioned how sick she'd look if she was hooked up to wires in the hospital and crying. We were so relieved we hadn't gone in yet.

Overnight her low fever left and she was eating and waking every 2-3 hours again, instead of every 3-4 hours. She’s been fine since.

 Worth mentioning in case other parents are stumbling across my blog looking for illness information:
The degree of fever is not always a good indicator on how sick someone is. In the case of meningitis it is just something to go off of. It’s a warning sign. That is why they say to go to the hospital, so they can monitor the child and get tests running. Meningitis is rare but there’s a lot at stake and babies can go downhill quickly. The absence of these serious symptoms: stiff neck, bulging soft spot, screaming/crying, not wanting to be held made us very confident about staying home but the “what if” thoughts did keep coming. Generally it's hard to tell how a newborn is -especially if they are sleeping. Our baby was waking and alert every 4 hours and wanting to be held and talked to so we luckily had that to go off of. In addition breastfeeding gives babies a huge advantage over illness so if she wasn't getting antibodies and gut protection via colostrum and breast milk we would have been a lot more worried as well. But we were still plennnnnty worried! We find new experiences, new scares, new joys, and new challenges with every new child we have!

Links added later:
When a trip to the hospital brings a visit from CPS

Spinal Taps Carry Higher Risks For Infants And Elderly, Study Shows   
An X-ray-guided spinal tap procedure fails more than half of the time in young infants and should be used sparingly, if at all, for those patients, according to a new study. 


Kimberly Jennery said...

OMG how SCARY Shauna!!! And what a boon you've done by putting at least ONE positive story about careful observation and educated waiting.

I find that I observe my neonatal foster kittens similarly. There is often a primary indicator or two (weight gain/loss and food intake) but that you also VERY much have to look at behavior, too! I often have kittens who aren't eating nearly as much as they *should* and aren't gaining for a day or two, but who are otherwise behaving perfectly like kittens. Those are the ones I watch like a hawk, but don't intervene... yet.

Phew! I'm SO glad she's fine, and didn't have to go in for all those awful hospital experiences! I'm glad it's available if needed, but YAY that she didn't need it, and has parents who can tell the difference! You must have been just sick with worry! ((hugs))

Mom of a bunch of great kids... said...

Thanks Kim!