Hives on Baby: What You Need to Know

Hives are common symptoms of viral infections such as cold or flu. They occur when your body’s immune system attacks its own tissues, causing redness, swelling and pain. Viral infections usually begin with a virus that infects the respiratory tract (nasopharynx) or skin (skin lesions). After they have infected the lungs or other organs, viruses often spread through the air from person to person via coughing or sneezing.

The symptoms of viral infections vary widely among children. Some may experience fever, chills, cough and runny nose. Others may not feel sick at all and even become well. Symptoms typically last one day to two days but some children might be contagious for longer periods of time if they have been exposed to others who are showing signs of illness. Most children recover completely without any treatment needed.

Viral infections can cause serious complications including pneumonia, meningitis, encephalitis (brain damage), sepsis (blood poisoning) and death. If left untreated, these illnesses can lead to permanent disability.

How do I know if my child has a viral infection?

Most viral infections are mild and will resolve themselves within 24 hours. However, there are times when your child may develop severe symptoms such as high fever, headache, muscle aches or seizures.

Your child may also experience difficulty breathing, dry cough, wheezing, fast and difficult breathing or swallowing for long periods of time.

If your child shows any of the symptoms listed above, call your doctor immediately and do not wait until regular office hours. If your child has a fever over 100.4 degrees Fahrenheit or a severe headache that comes on suddenly, these may be signs of meningitis. In some cases, hives may develop red patches on the skin. These patches may be itchy and should be checked by a medical professional immediately.

Most viral infections are not serious and will go away by themselves. Your child may develop hives with no known cause.

You child may have hives that come and go for weeks or even months. The skin may itch and become swollen, but their general condition is good. They have no fever and do not display any other symptoms of illness.

Most children with hives can be treated at home. Your child’s doctor may also prescribe an allergen-reducing medicine, such as a steroid, if the hives are severe or spreading. If it is not known what is causing your child’s hives, your doctor may also want to see your child every few weeks until the reason for the hives is clear. Your doctor may also want to have immediate access to your child’s medical records.

If the rash spreads or gets worse after home treatment, you should see a doctor immediately. This can be a sign of anaphylaxis, which can cause difficulty in breathing and swallowing and can lead to death if not treated quickly.

HIVES (URTICARIA)

Hives are itchy red welts that usually appear on the arms, legs or trunk of the body. They may occur suddenly and spread rapidly. They tend to last for a period of days and then resolve over a period of weeks. While hives can be caused by a severe allergic reaction, most cases are caused by an irritation, such as poison ivy, insect bites or heat rash. Hives are not contagious and most cases resolve without any treatment at all.

FEVER WITHOUT A FUNGUS

If your child develops a fever with no apparent cause, he or she doesn’t have a fungal infection. The fever may be due to a virus or sometimes even stress. Viral infections tend to last a few days while fungal infections tend to last weeks or months. Viral infections can be spread from person to person. Viruses can’t live for very long outside the body.

While most fungal infections are spread through contact with infected soil or contaminated objects, a few fungi can be spread from person to person. Fungal infections tend to be more serious because they tend to invade more deeply into the skin and into body tissues.

If your child has a fever without any other symptoms, he or she may have viral syndrome. Viral syndrome causes a fever and other symptoms that come and go on their own. In most cases, there is no treatment necessary. Your doctor may want to see your child so that he or she can rule out any other conditions such as meningitis or an ear infection.

Your doctor may also suggest that your child take acetaminophen (e.g. Tylenol) or ibuprofen (e.g. Motrin) to help reduce the fever.

Be sure to follow the dosing instructions provided by your doctor. Be sure to contact your doctor if your child’s symptoms get worse.

If your child has a fever and other fungal symptoms, such as red patches or swelling, your child may have a fungal infection. Fungal infections can be contagious and often require treatment with prescription antifungal medication. Your doctor may want to see your child right away. In some cases, your child may have a fever with no other symptoms.

FEVER

Your child’s normal body temperature is around 98.6 degrees Fahrenheit (37 degrees Celsius). A fever is considered anything over 100 degrees Fahrenheit and can be caused by viruses or bacteria. Viral infections tend to last a few days while bacterial infections are longer and can be serious.

Fever, however, does not cause brain damage even if the fever does not go away or gets higher.

TYPES OF FEVER

In order to know how to treat a fever, you need to know what is causing it.

Bacterial infection: This is the most common cause of fever. Some of the symptoms include diarrhea, vomiting, coughing and difficulty breathing. If your child has these symptoms they may have a serious infection that needs medical treatment.

Insect bite fever: This type of fever can be caused by mosquito or tick bites. Some of the symptoms include headache, fever, and a red bump on the area where you were bitten. See your doctor immediately if you think this is what is causing your child’s fever.

Drug fever: This type of fever can be caused by some prescription medication. If your child has been taking any new medication in the last three days, it could be causing the fever. Other symptoms may also be present along with the fever.

Viral infection: Viral infections can also cause a fever along with other symptoms such as a cough or diarrhea. The good news is that this type of fever should go away on its own in a few days and does not usually need any type of medical treatment.

Fever from other causes: There are several other conditions that may cause a fever, including an allergic reaction to medication or food, sunburn, heat stroke and even stress. If you child has been under a lot of stress lately or has had an allergic reaction to a new food or medicine in the past three days, then these may be the source of the fever.

WHAT TO DO IF YOUR CHILD HAS A FEVER

Even though fevers are often caused by viruses, it is still important to take your child’s temperature. A fever can sometimes indicate a more serious medical problem such as meningitis or an ear infection.

Try to keep your child comfortable and hydrated during a fever. It is normal for temperatures to spike up as high as 104 degrees Fahrenheit (40 degrees Celsius) and stay there for several hours before coming down. A fever should never be treated with medicine without speaking to your child’s physician first, even over-the-counter medications can cause serious side effects if used improperly.

It is important that your child stays well hydrated because dehydration can make their symptoms worse and, in severe cases, can be life-threatening. Offer your child small sips of water throughout the day, every hour if they can keep it down. If water is not well-tolerated, alternate with juice and soft drinks. The sugar and electrolytes in these can help if your child is vomiting or has diarrhea. Offer popsicles or ice to suck on if your child complains of a sore throat or mouth.

Exercise and bathing should be kept to a minimum since the movement can make the symptoms worse. If your child is unable to sleep due to the fever, it is okay for them to get out of bed and rest on the couch or a chair as long as they remain bundled up.

If your child’s fever lasts more than three days, begin taking their temperature twice a day. If the morning temperature is 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, or the evening temperature is 102 degrees Fahrenheit (39 degrees Celsius) or higher, call your doctor immediately. Do not give your child any more over-the-counter medications.

WHEN TO CALL THE DOCTOR

Most of the time, a fever will run its course and your child will feel better in a few days. Call your doctor if:

The fever lasts for more than three days.

Your child has other symptoms in addition to the fever, such as a cough or diarrhea.

Your child is less interested in playing or engaging in regular activities.

Your child starts running a fever in the middle of the night and does not feel like playing or interacting.

You feel that your child is suffering and needs something to make them more comfortable.

You feel your child’s life is in danger for any reason.

BEFORE YOU GO

Before you leave for the doctor’s office, call ahead and let them know that you are on your way and your child’s symptoms and what medications, if any, you have given so far. While you may be worried about making your child even sicker, many illnesses, especially fevers, can cause dehydration and loss of nutrients such as potassium. If your child has not eaten or had anything to drink in a long time, they may need a shot of these nutrients before seeing the doctor.

It is important to be truthful about your child’s symptoms and when you noticed them because the health care provider needs as much information as possible to diagnose any underlying conditions or illnesses. If your child does not have health insurance, inform the receptionist before you make the appointment. Many doctors have a sliding fee scale to make their services more affordable.

EMERGENCY VS. NON-EMERGENCY

When your child is feeling ill, it can be difficult to know if your child needs to see a doctor right away or if a visit to the doctor can wait until you get back from your vacation. Here are some guidelines:

If your child:

Is under 3 months old and has a fever.

Has difficulty breathing.

Has diarrhea for more than 24 hours or the diarrhea is green or contains blood.

Has been drooling excessively, seems confused or has decreased awareness.

Is less than one year old and has a fever of over 100 degrees Fahrenheit (38 degrees Celsius) in the soft spot on the top of their head.

Has a rash, redness or swelling in or around the eye(s).

Is unwilling to drink fluids.

Has a severe headache, stiff neck or pain in the jaw.

Has had any kind of head trauma within the past 24 hours.

Then go to an emergency room immediately or call 911.

If your child:

Is less than one year old and has a fever above 102 degrees Fahrenheit (39 degrees Celsius) in the soft spot on the top of their head.

Has trouble breathing or you are having a hard time listening to the lungs or they seem to be struggling to breath.

Has blurry vision, a rash all over their body or has difficulties seeing.

Has a severe sore throat.

Feels weak, dizzy or is vomiting.

Has uncontrollable shivering or feels like their skin is burning up.

Then call your doctor immediately or if it is after hours, call your doctor’s answering service and they can tell you what to do. If you are not near a phone or cannot get through, then take your child to the nearest emergency room.

EMERGENCY KIT

A good way to be prepared is to put together a portable first-aid kit that you can grab on your way out the door. For infants, keep the items in the car and for toddlers, keep the items in every room of the house. Check your kit at least once a year to make sure the medication has not expired or been damaged. Here are some suggested items:

A backpack or bag that is easy to carry. You may have to carry your child out of the house.

Extra key for your car, house and mailbox.

Portable car seat. If you need to leave your child while you go get help, put them in the car seat and keep them in sight at all times.

Infant care items such as diapers, rash cream, formula or bottle, extra clothing, blanket.

Children’s care items such as bandaids, antibiotic ointment for cuts and burns, antihistamine (for insect bites), acetaminophen, children’s pain reliever.

Tweezers, alcohol wipes.

Flashlight.

Seat belt cutter or knife. In the event of a crash, you may need to quickly free yourself or your child from a locked car.

Whistle. In the event of a crash, you may be unable to yell for help but can blow the whistle to draw attention to yourself or your child.

Duct tape. Can be used as a tourniquet, slung over a broken arm or to mark a path out of danger.

Emergency contact information. Keep phone numbers for: doctor, pediatrician, dentist, local clinic, poison control center, police and fire departments.

CPR instruction card.

Q: What is the best way to keep my toddler safe in our yard?

A: One of the greatest dangers that your toddler may encounter is in your own backyard. The following are suggestions on how to make your backyard safer for your toddler.

Keep your yard well-lit. Install outdoor lighting with sensors so the lights only come on when it’s dark outside. Place lighting around pathways, steps and driveways.

Trim brush and trees around the yard so you can easily see into the yard from the windows of your house.

Keep furniture, barbecue grills, and tools out of a child’s reach.

Put mesh or fencing over open pits, such as those that contain pools, spas, or hot tubs. Fence or cover all walls of these structures as well.

Cover unused electrical outlets. Buy plates that cover the outlet or push-locks that require a tool to open them.

Fence your pool area so that a child cannot access it. Pool fences should be at least 4 feet tall and have a self-latching gate.

Keep the ground around the pool free of anything that could cause someone to trip, such as toys or chairs.

Buy a pool alarm to put by the deepest part of the pool. The alarm will alert you if a person (or large object) enters the water.

Do not leave a child alone in a hot tub, even if it is fenced.

Outfit your doorbell with a light that only comes on when someone is at the door. This way your toddler will not be able to access the doorbell and can’t be tempted to answer the door.

Q: I just found out that my toddler is creeping into our room at night to sleep with us. It scares me to think what might happen if he stopped breathing or rolled over in his sleep and was smothered in the bed.

Is this my fault? What can I do?

A: It’s not your fault at all. While it’s true that children are safer when sleeping in their own beds, there is no reason to feel guilty about your child wanting (or needing) to sleep with you.

Children naturally feel more secure when sleeping with a parental figure. There is nothing wrong with that as long as the child is safe and not in danger of being smothered or hurt in some other way. The trick is to keep them safe while still allowing them to get the reassurance they need.

Follow these tips to help keep your toddler safe while still allowing them to sleep with you:

Move your child’s crib into your bedroom. This will make it easier for you to monitor your child and reassure him if he starts to wake up in the middle of the night. Make sure you have a fitted sheet that is tight enough that the baby won’t be able to get loose, but not so tight that he can’t move around at all.

Use a pillow or other object to create a “barrier” between your child and other parts of the bed. This will allow you to still be near your child if he wakes up in the middle of the night or if you need to tend to him during the night, but it will also keep him from rolling off of the bed or getting into trouble.

Buy a portable bed rail. These are devices that you can put at the side of the bed (or next to your body if you’re in the middle) that will act as a barrier without actually obstructing your own movements.

Q: I just read on the internet about leaving my toddler home alone. What are your thoughts on this?

Sources & references used in this article:

A Note on the Origin and Meaning of Bold Hives in the American South by A Cavender – Southern Folklore, 1996 – search.proquest.com

Adrenergic urticaria: a new form of stress-induced hives by WB Shelley, ED Shelley – The Lancet, 1985 – Elsevier

Knowledge swarms and experiential hives: knowledge transfer by CP Weiner, K Rope – 2013 – Macmillan

The Stepforth Hives by P Marsh – Civil Engineering= Siviele Ingenieurswese, 1982 – journals.co.za

Lupus Q&A: Everything You Need to Know by D Strischek – RMA JOURNAL, 2004 – cms.rmau.org

The Ultimate Guide for Gay Dads: Everything You Need to Know about LGBTQ Parenting But are (mostly) Afraid to Ask by RG Lahita, RH Phillips – 2004 – books.google.com

When It’s Time to Clean Out the Medicine Cabinet: Tell your patients that leftover drugs are rarely safe. by E Rosswood – 2017 – books.google.com