Temperature of the newborn child varies from 98° to 99° F. It should be taken morning and evening, or oftener, if complications are suspected.
The temperature often goes up on the third or fourth day, and may stay up for several days. This phenomenon is called by some a starvation or inanition fever. The temperature may go to 106° F. and the rise is generally associated with a hot dry skin, dry lips, weak pulse, restlessness, and great prostration. The fontanelle may be sunken and the cry sinks to a fretful, feeble whine.
It is important that the fever should be recognized and treated, since the condition may terminate fatally. The etiology is obscure. The fever should not be confounded with pyogenic infections, for these rarely begin before the fifth or sixth day.
The treatment is simple. Give water regularly every two hours by mouth, and rectal flushings of normal saline twice daily. The symptoms rapidly subside if the child is properly nourished. Hence the breasts should be inspected and the child weighed before and after feeding. Usually the milk is poor and scanty. If the temperature does not soon fall the child should be put to another breast or artificial feedings should be instituted.
CHAPTER XIX
THE CARE OF THE CHILD (Cont’d)
Heart.—The heart tones while in the uterus may vary between 138 and 150 per minute, but when higher than 160 or lower than 120, danger is near. After delivery, the heart runs from 130 to 140, and during the first year gradually drops to 115, approximately.
Asphyxia neonatorum is a condition, wherein, for some reason, the child fails to breathe after delivery. Out of every one hundred babies born, about six will die at birth or within the first ten days, and a large proportion of them from asphyxia in some form.
Asphyxia is found in two degrees: asphyxia livida (blue) and asphyxia pallida (white).
In the first, the child is deeply cyanosed. This may be due to patency of the foramen ovale, and yet it is a question whether this cyanosis is not really a normal process. The child does not undertake its first respiration because it needs oxygen, but because an excess of carbon dioxide (CO2) in the blood acts as a stimulant to the respiratory center, which is thus set to work, with the result that oxygen is taken in. The blue asphyxias, therefore, may be only the first step in the physiological process of respiration. In these cases, the pulse is strong and full, and the muscular tone is preserved, as well as the sensibility of the skin.
In the second degree, the condition is quite different. The face is pale though the lips may be blue. The heart is irregular and many times can not be felt. The cord is soft and flaccid, with its vessels nearly empty. The reflexes are abolished, the skin and extremities cold. A few convulsive efforts at breathing may occur, but they soon cease.