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Subject:
From:
"Maryelle G. Vonlanthen" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 12 Jul 1998 00:57:42 -0500
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Hi lactnetters.
I am still alive even though I have not been keeping up as regularly as I
used to. Since I have been part time (january) have been spending more
time with the kids and much less time on the computer in my office.

Anyway, about the temps in slightly dehydrated poorly breastfeeding
babies.  I dont think one can ignore any temp.  Our cut off at Arkansas
children's is 100.5.  Any baby with more gets worked up.  How would you
know that the poor feeding is due to an illness or just poor technique or
bott?  I have a lot of respect for Group B strep infections in infants.
This would be, along with gram negatives such as E coli, your main source
of infection in the first week of life. Gr B strep can present as
fulminant sepsis and begin in such a benign way as just a little fever in
a baby not eating too well.  If not worked up and treated promptly, that
baby could be dead the next day.
So my approche is to work up all the temperatures.  Better to work up
babies for nothing than to loose one to a treatable disease.
Just 3 weeks ago a MD friend of mine who breastfed her very healthy
looking baby noticed that the baby was not eating as well as in the first
24 hours.  Withing 1 day and with no fever  the baby developped
congestive heart failure and was in intensive care with, you guessed, Gr B
strep.  Luckily, the baby did fine and is now cured.
But  you see Gr B strep is very sneaky and can fool you. By the way there
are several articles in the litterature documenting that regardless of the
experience of the MD or of the parents one cannot predict whether a baby
less that 2 months has a bacterial sepsis or just a benign fever. So there
is plenty of evidence supporting to work up all babies with fever.

Hope this helps.
Glad to occasionally contribute.
Thanks to those of you who contacted me directly with questions. I may not
yet have answered some of you. I am about 600 messages behind!

Maryelle

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