It is all too common for children to have headaches and fever. Especially in autumn and winter, the number of children with colds and fevers increases sharply. Every time a child has a fever, parents are always worried and at a loss. Aunt Bao invited Feng Bin, a pediatrician from the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, to answer your questions. Personal profile: Feng Bin, Ph.D., attending physician, the fifth batch of national heirs to the academic experience of traditional Chinese medicine, executive director of the Pediatric External Treatment Massage Society of the China Association for the Promotion of Traditional Chinese Medicine Research, director of the Pediatric Branch of the Chinese Society of Ethnographic Medicine, and Henan Anti-Epilepsy Society Youth member, member of Henan Province Stroke Society, and specialist member of Children\’s Health Management of Henan Province Health Management Society. He is mainly good at treating children\’s fever, cough, asthma, recurrent respiratory infections, tonsillitis, tonsil hypertrophy, food accumulation, anorexia, diarrhea, night sweats, etc. with traditional Chinese medicine. Common pediatric diseases, the main research direction is the diagnosis and treatment of short stature, neuromuscular diseases, epilepsy, multiple tics, cerebral palsy and other diseases using traditional Chinese and Western medicine. Keywords: Understanding fever Question 1: What exactly is fever? Feng Bin: The latest guidelines for reducing fever from the American Academy of Pediatrics have repeatedly emphasized that unless it is an extremely high fever, fever will not cause harm to children. On the contrary, it is beneficial. So how should we correctly understand fever? It can be said from several aspects: First, fever is a signal for the human immune system to launch a war against the viruses, bacteria or toxins that have invaded the body. This is the body\’s elimination of these invading viruses. And the best time for bacteria. The human immune system removes harmful substances from the body through warfare and further improves its own immune function. Secondly, fever can remove toxins trapped in the bones, prompt the body to speed up metabolism, and expel those toxins. If you rush to reduce the fever as soon as you see a child with a fever, it is equivalent to the body preventing the removal of toxins. In this way, viruses and bacteria will easily remain in the body, waiting for opportunities to cause trouble at any time, and the child will have repeated fevers. Of course, if it is life-threatening, first aid should be taken. Third, many parents will say that this is the first time their child has a fever and has never had such a high fever. From birth, a child\’s immune system gradually strengthens and becomes capable of attacking pathogens, so he or she will develop high fever. The fact that a child is less likely to have a fever does not mean that his body is in good health. It just means that his immune system is low and he is unable to develop a fever or detoxify. Question 2: I am always afraid that my child will have a fever. When does a child have a fever and need to go to the hospital? Feng Bin: The body temperature of a baby less than 3 months old exceeds 38°C; fever occurs repeatedly for no obvious reason and lasts for a long time; it is located on the top of the baby’s head. The fontanel bulges outward; the child complains of headache, earache or neck pain; the child continues to have diarrhea and/or vomiting, urinates rarely, has a dry mouth, and has few tears when crying; the child has a fever accompanied by frequent urination, urgency, and painful urination, which is suspicious Urinary system infection; the child\’s fever is accompanied by cough and sputum, which is suspicious for bronchopneumonia and asthma; the child\’s fever is accompanied by headache and vomiting, which is suspicious of febrile convulsions and encephalitis; the child\’s fever is accompanied by vomiting, weakness, and lack of energy, and it cannot be determined whether it is acute gastritis or myocarditis; the child has fever accompanied by lower limb movement disorders, such as lameness, pain during exercise. The following situations require a pediatric emergency: convulsions; obvious difficulty breathing; extreme excitement; extreme weakness, or even refusal to move (including crawling, walking, etc.); rash or purple pinhead-sized bleeding spots or ecchymoses; purple lips, tongue, or nail beds ; Neck stiffness, severe headache. Question 3: How should parents cool down their children when they have a fever? Feng Bin: Warm water scrub bath: You can use warm water scrub bath. The areas are skin folds, neck, armpits, elbows, and groin. Try not to rub the back of the neck. Head, chest, abdomen. Some people also recommend using ice compresses or ice packs, but I recommend not using them as much as possible. However, some experts believe that there is no need to use warm water bathing below 39°C. Above 39°C, antipyretics should be taken first. This method must be used only when the child cannot take antipyretics. . The latest version of the \”American Academy of Pediatrics Parenting Encyclopedia\” (6th edition) in the United States has deleted the content of physical fever reduction and no longer recommends physical cooling. However, in the clinical treatment of fever, I personally believe that warm water bathing can still relieve fever symptoms. Physical cooling: The physical cooling mentioned here mainly refers to antipyretic patches. None of the current fever guidelines mention that antipyretic patches are used to treat fever. However, children will feel discomfort in their heads when they have a fever. The antipyretic patch contains ingredients such as borneol, peppermint, and eucalyptus oil, and the evaporation of the water vapor contained in the hydrogel can take away heat. These things will indeed cause local skin damage. Feeling cool and relieving head discomfort symptoms in children. Western medicine: If the body temperature exceeds 38.5°C, Western medicine can be used for treatment. Commonly used Western medicines include acetaminophen and ibuprofen preparations. Currently, oral liquids and suppositories are commonly used in children. The interval between use is 4-6 hours, up to 4 times a day. , if there is no relief after taking the medicine for more than 3 days, you need to see a doctor in time. Chinese patent medicines: Bupleurum oral liquid, Chaigui oral liquid. If you have high fever, you can use Zixue powder; if you have a history of febrile convulsions or epilepsy, you can take antelope horn powder. Question 4: What are the wrong ways to deal with a fever at home? Feng Bin: Many parents feel sorry for their children. In addition, during the fever period, most children have a poor appetite, or when the fever gets better, parents quickly let their children drink some chicken soup, fish soup, or even use There are turtle stews, but this approach is wrong. During the fever period, you should drink plenty of water to replenish fluids, and eat mainly light meals. Try not to eat eggs, and avoid spicy and greasy foods. Many children have fevers at night, and some parents go straight to the emergency room with their children in their arms. This approach is wrong. The correct approach is to measure the child\’s body temperature first. If the body temperature does not exceed 38°C, no other treatment can be done temporarily. You should drink more warm water, and you can also take some Chinese patent medicines such as Bupleurum Oral Liquid at the same time. . If the body temperature exceeds 38.5°C, you can take antipyretic drugs orally before seeing a doctor. In addition, it is also wrong to wear more clothes and cover yourself with a quilt to sweat when you have a fever. This will hinder the dissipation of body heat and make it difficult for the body temperature to lower. The correct method is to let the child wear light and sweat-absorbent clothes, open doors and windows appropriately to allow air circulation, but do not let the cool breeze blow directly to the child. Children sweat a lot when they have a fever, so sweaty clothes and underwear should be changed frequently to keep them clean and dry. Question 5.Is it necessary to take antibiotics for fever? Feng Bin: We often encounter parents in the clinic who take antibiotics on their own initiative as soon as their children have a fever. They also say that the fever is not due to inflammation. There are many reasons for children to have fever, most of which are viruses, bacteria or mycoplasma, chlamydia infection, etc. Some fevers are non-infectious diseases, so blindly taking antibiotics may be ineffective. Taking the wrong antibiotics will be counterproductive. Not only can it not cure the disease, On the contrary, it may cause secondary harm to the child. Therefore, when you have a fever, you can go to the hospital to get a blood test to see the ratio of white blood cells and neutrophils to understand the cause. It can even detect mycoplasma at the same time to understand the cause of infection and provide targeted treatment. It’s important to know that antibiotics are not a panacea for treating fever. It only targets bacteria and certain mycoplasma, chlamydia and other germs, and cannot inhibit or kill viruses. Antibiotics are not effective against viral infections. Antibiotics themselves are chemicals, and improper use may cause unwanted side effects on children. Question 6: Can fever cause pneumonia? Feng Bin: Fever is only a symptom of the disease. If a child has a fever and respiratory symptoms, it means that the body already has an infection focus. Therefore, the body is infected first and then the fever appears. , regardless of respiratory, urinary system, or nervous system infections, fever symptoms can occur, which does not mean that the infection is caused by fever. There are also some upper respiratory tract infections. If the inflammation is not controlled in time, it can spread downward and involve the bronchi or alveoli, causing bronchitis or pneumonia. Parents mistakenly believe that pneumonia is caused by fever because the doctor did not treat the infection properly. In fact, many cases of pneumonia will manifest as upper respiratory tract infection in the early stages, even like lobar pneumonia. From beginning to end, they only present fever, no cough, or even cough symptoms, and there are many cases where there are no crackles in the lungs. Therefore, these diseases are caused by the lungs being infected with pathogens first, and then fever occurs. It is not that the fever burns the lungs. Question 7: Will fever burn out the brain? Feng Bin: I often see parents who are particularly worried when they encounter fever. Will repeated fevers burn out the child\’s brain? Will the fever burn out the child\’s brain? In fact, fever will burn out the child\’s brain. The brain is often not simply caused by fever itself. Most pediatric infections are common endogenous infections. The fever caused by it rarely exceeds 41°C. This type of fever will not cause damage to brain cells and lead to fever. Bad brain. As for fever that may affect the brain, it is more common in encephalitis, meningitis, sepsis, etc.; or ultra-high fever during heat stroke (body temperature is often close to 42°C), which causes irreversible high-temperature denaturation of brain cell proteins. However, high fever may cause brain dysfunction, and a small number of children may have febrile convulsions. Question 8: What is febrile convulsion? Feng Bin: Also known as febrile convulsion, it is the most common febrile convulsion in childhood. The prevalence varies between countries and regions: the incidence in Europe and North America is 2%-5 %, Japan is 7%, and China is 4.4%. The definition of febrile convulsions is: the first onset is between 3 months and 5 years old, and the convulsions occur suddenly when the body temperature is above 38°C, excluding intracranial infection and other organic and metabolic diseases that cause convulsions., if there is no history of febrile convulsions in the past, febrile convulsions can be diagnosed. Febrile convulsions are divided into simple types and complex types. The main differences are: simple type first onset age is 6 months to 5 years old, the body temperature during the convulsion is greater than 38 ℃, the form of convulsions is generalized, the number of convulsions is less than 1 within 24 hours, and convulsions are The duration was less than 15 minutes, there were no abnormal neurological signs after the convulsive attack, the electroencephalogram was normal when reviewed 2 weeks after the attack, and there were no neurological abnormalities before the onset. The age of onset of complex type is less than 6 months or more than 5 years old, the body temperature during convulsions is less than 38°C, the convulsions are in the form of focal or generalized attacks, the number of convulsions is at least 2 times within 24 hours, and the convulsions last more than 15 minutes. There are abnormal neurological signs or Todd\’s paralysis after the attack. The electroencephalogram is abnormal after 2 weeks of the attack. The nervous system is abnormal before the attack. Question 9: Will repeated fever and convulsions turn into epilepsy? Feng Bin: The vast majority of children with febrile convulsions have a good prognosis. Only 2%-10% of children will develop epilepsy in the future. Complex febrile convulsions are more likely to develop into epilepsy. The risk is higher than with simple febrile seizures. However, some children with early onset age and multiple features of complex febrile seizures should be alert to the possibility of Dravet syndrome (an epilepsy syndrome). Question 10: How can traditional Chinese medicine prevent febrile convulsions or repeated fevers? Feng Bin: Most children with febrile convulsions and repeated fevers have a thermal constitution, which is characterized by: frequent dry mouth, bad breath, and indigestion; they like to drink cold drinks or iced food; afraid of heat, sweating profusely, and often have a high body temperature; prone to acne rashes, blushing, and bloodshot eyes; often constipated, with less and yellow urine; prone to irritability and bad temper. These conditions can be treated through TCM syndrome differentiation and regulating the heat constitution.