Hypothermia in Children: When to Seek Medical Attention

Hypothermia

On December 16, the child bumped their head while getting off the bed.
On December 19, a follow-up visit indicated that everything was fine, but the child was still observed to have shaking during sleep.
On December 31, the child had a fever, and on January 1, they visited a pediatric clinic.
By January 3, the fever had completely resolved, but the child continued to experience increased frequency of shaking during sleep.
On January 7, they went to the emergency room, where the doctor said everything was okay, but the child's body temperature remained between 35.4°C and 35.9°C, occasionally exceeding 36°C.
Should medical attention be sought in this case? What are the effects of low body temperature on children?

Elaine, 30~39 year old female. Ask Date: 2019/01/09

Dr. Xiao Kaiwen reply Pediatrics

During sleep at night, peripheral blood vessels constrict, which can sometimes lead to a decrease in peripheral temperature.
While ear thermometers or axillary temperature measurements are convenient, they can often have significant inaccuracies.
I believe that measuring the true core body temperature is the standard.
Rectal temperature measurements are closer to the actual core body temperature.

Measurement method: Apply a small amount of petroleum jelly or other lubricant to the tip of the thermometer.
For infants, it is advisable to place them in a prone position (face down) on an adult's lap or on a bed.
One hand should support the lower back above the infant's buttocks, while the other hand gently inserts the thermometer about 1.5 to 2.5 centimeters into the rectum, without going too deep.
The electronic thermometer should be held in place for about one minute until it beeps, indicating that the reading can be taken.
The normal rectal temperature range is 37 to 38.1°C.

Reply Date: 2019/01/09

More Info

Hypothermia in children is a condition that occurs when the body loses heat faster than it can produce it, leading to an abnormally low body temperature. In children, hypothermia can be particularly concerning due to their smaller body size and higher surface area-to-volume ratio, which makes them more susceptible to temperature fluctuations. Understanding when to seek medical attention for hypothermia is crucial for ensuring the safety and health of your child.

In your case, it appears that your child experienced a head injury followed by episodes of shivering during sleep and a persistent low body temperature ranging from 35.4°C to 35.9°C (95.7°F to 96.6°F). While a normal body temperature typically ranges from 36.1°C to 37.2°C (97°F to 99°F), a temperature below 35°C (95°F) is considered hypothermic and requires immediate medical attention.

The symptoms you describe, including shivering and low body temperature, can be indicative of hypothermia. Shivering is the body's natural response to generate heat, but if the body temperature continues to drop, shivering may cease, which is a sign of severe hypothermia and can be life-threatening. Additionally, the history of a head injury raises concerns about potential complications, such as a concussion or other neurological issues, which could also contribute to abnormal temperature regulation.

Given that your child has had a series of concerning symptoms, including persistent low body temperature and shivering, it is advisable to seek medical attention. A healthcare professional can perform a thorough evaluation, including a physical examination and possibly imaging studies, to rule out any underlying issues related to the head injury or other medical conditions that could be affecting your child's ability to maintain a normal body temperature.

Low body temperature in children can have several effects, including:
1. Metabolic Slowdown: Hypothermia can slow down the metabolic processes in the body, leading to lethargy, confusion, and decreased responsiveness.

2. Cardiovascular Effects: Prolonged low body temperature can lead to bradycardia (slow heart rate) and can affect blood pressure, potentially leading to shock in severe cases.

3. Respiratory Issues: Hypothermia can impair respiratory function, leading to shallow breathing and decreased oxygen levels in the blood.

4. Neurological Effects: Low body temperature can affect brain function, leading to confusion, disorientation, and in severe cases, loss of consciousness.

5. Increased Risk of Infection: Hypothermia can compromise the immune system, making children more susceptible to infections.

In summary, given the symptoms your child is experiencing, including low body temperature, shivering, and a history of head trauma, it is crucial to seek medical attention promptly. A healthcare provider can assess your child's condition, provide appropriate treatment, and ensure that there are no serious underlying issues that need to be addressed. Always err on the side of caution when it comes to your child's health, especially in cases involving potential hypothermia or head injuries.

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