Episode 22: Do all fevers in kids need bringing down? Science, exceptions and the myths of fever in children.
 
It’s one of the most common worries for parents — and one of the most misunderstood. We discuss fever myths and more providing clarity and discussion
In this episode of Cocooned Health, Dr Eliz Kilich & Dr Lydia Yarlott tackle the biggest fever myths in children:❓ Do all fevers need treating?❓ Will fevers keep rising to dangerous levels if left alone?❓ Does getting lots of colds mean a weak immune system?❓ Should you always give paracetamol after vaccines?❓ When should you given paracetamol / ibuprofen to children. What age is it not OK? Can you switch between the two?
As we discuss in the episode: Note children > 1 year can tolerate fevers much more than adults and thus the fever number itself becomes less concerning than other features. In adults the normal fever ranges tends to be 37.8 -39.4 (103°F) whereas in OLDER children (over one year) this is a little higher 38 - 39.8. Note this is not a hard and fast rule and the most important feature tends to be other symptoms.
KEY EXCEPTIONS where the NUMBER MATTERS:1. Children under or 3 months old - any fever needs URGENT same day medical review (>38°C (100.4°F))2. Children under or 6 months old > 39°C degrees3. Fever > 5 days. Should be improving in 2-3 days or with fever medication 4. Seek medical attention in an adult > 39.4. This episode does not specifically describe fevers in adults and is limited to a discussion around fever in children.
We unpack why other symptoms with fever tell you more than just the fever itself. 
💡 We’ll unpack what’s fact, what’s fiction, and what really matters when your child spikes a temperature.
🎧 Subscribe so as not to miss a new episode 
✨ Don’t miss this myth-busting chat that could save you a lot of late-night worry! Listen Now. And DM us on Instagram any queries and feedback
Disclaimer: Remember we are sharing our opinions and medical knowledge, and not associated with our affiliations. Note that knowledge evolves over time. Note that this is not direct medical advice as we are not your personal doctors however feel free to share any ideas expressed with your own healthcare professional as needed. This episode is unsponsored and received no financial incentive. 

Ep 21. "My child has a fever - What do I do?" From Newborn to Teenager. Expert Guest: Dr Seilesh Kadambari  
Today our episode is a crucial one for all parents - it is a focus on fever in children with a focus on how fever differs based on the AGE of your child - from newborn to teenager. 
At Cocooned Health we often focus on the advice around vaccines, food and immune health, how to protect against common and rare, but serious, infections and today we dive into the commonly asked question - my child has a fever - what should I do? As co-hosts Dr Lydia Yarlott and Dr Eliz Kilich we have great privilege to welcome our special guest: Dr Seilesh Kadambari who is a consultant in paediatric infectious diseases and an Honorary Associate Professor at UCL Great Ormond Street Institute of Child Health known as GOSH. We will discuss today: understanding fever in children of different ages, the myths, when to seek medical attention, the science behind a fever with vaccinations along with insight into how specialists think about fever in your child and the evidence that supports it. 

Part 2: Group B Streptococcus (GBS) What is the evidence for screening all pregnant women with a swab? 
One doctor would get the swab on the private system in the UK and another would not
Listen Now.
(June's Episode Re-released: Apologies we had a technical issue with this episode where it was unintentionally shortened in some apps - now resolved)
Dr Lydia Yarlott and Dr Eliz Kilich discuss the two sides of the coin: To get the screening swab for Group B Streptococcus (GBS) or not. The discussion revolves around why different countries have different policies. GBS is a bacteria carries by around 1 in 4 people and can cause sepsis, pneumonia and meningitis in babies when a mother who carries the bacteria (as part of her normal microflora) inadvertently transfers it to baby during delivery of her baby. It is however rare. We follow up on the previous episode with Professor Kirsty Le Doare, an expert in GBS and a leader in running the trials that will hopefully lead to a GBS vaccine for the public in the future. Thus the discussion follows:
1. What are the benefits of the swab as part of screening and if your country of residence does not offer it as routine, would the hosts consider getting it. Spoiler - one would, one wouldn't
2. What are the risk of the bacteria to the baby and what is the actual numerical risk. How many babies need to be delivered to a mum who carries the bacteria for one of the babies to actually get the disease? 
3. Are there any downsides to the antibiotics in labour for GBS given that there will be some people due to screening who get it that may not have needed it? If so is there actual proof? How to we weigh this up against the risk of severe illness to baby? 
4. What was the evidence that led to some of the differing recommendations and why can't we do a study now.
 
References:
Azad, M. B. et al. Impact of maternal intrapartum antibiotics, method of birth and breastfeeding on gut microbiota during the first year of life: a prospective cohort study. BJOG 123: 983-993. (2015)
Corvaglia. et al. Influence of intrapartum antibiotic prophylaxis for Group B Streptococcus on gut microbiota in the first month of life. JPGN 62: 304-308. (2016)
Gensollen, et al. How colonization by microbiota in early life shapes the immune system. Science 352(6285): 539-543. (2016)
Group B Streptococcus Incidence. Rates of GBS infection in Babies. Group B Strep Support Charity: https://gbss.org.uk/professional-resources/gbs-incidence/ Accessed June 2025
Le Doare, K. et al. Intrapartum antibiotic chemoprophylaxis policies for prevention of Group B Streptococcal disease worldwide: Systematic Review. Clin Infect Dis 65(S2): S143-S151. (2017)
Matorras et al.  Maternal colonization by group B streptococci and puerperal infection; analysis of intrapartum chemoprophylaxis. Eur J Obstet Gynecol Reprod Biol 38(3): 203-207. (1991)
Mazzola et al. Early gut microbiota perturbations following intrapartum antibiotic prophylaxis to prevent group B streptococcal disease. PLoS ONE 11(6): e015727. (2016)
Nanduri et al. Epidemiology of invasive early-onset and late-onset group B streptococcal disease in the United States, 2006 to 2015: Multistate laboratory and population-based surveillance. JAMA Pediatr 173(3): 224-233. (2019)
Ohlsson, A et al. Intrapartum antibiotics for known maternal group B streptococcal colonization. Cochrane Database Syst Rev 1: CD007467. (2013)
Puopolo, K. M. et al. American Academy of Pediatrics, Committee on Fetus and Newborn, Committee on Infectious Diseases et al. Management of infants at risk for Group B Streptococcal disease. Pediatrics 144 (2): e20191881. (2019)
Van Dyke, M. K. et al. Evaluation of universal antenatal screening for group B streptococcus. N Engl J Med 360(25): 2626-2636. (2009)Whilst no information is perfect, it changes, we have done our best to bring together information to the best of our knowledge. It is always important to discuss anything we talk about with your own healthcare provider. This is not direct personal medical advice as you are not our patients however, we want to give the public the information we already have, so you are more informed to make your own choices.

The Swab That Saved Their Baby - Talking about Group B Streptococcus, global screening programs differences and what options there are for pregnant women 
Welcome to Cocooned Health, the podcast where we discuss infections in pregnancy and newborns and beyond. Not only do we discuss the advice given, but talk about the reasons why such guidance exists. We help to answer questions the public have on these topics. Today, we are thrilled to be joined by Professor Kirsty Le Doare, a distinguished clinician-scientist specializing in paediatric infectious diseases. This episode will focus on the important vaginal swab or urine test results that is received for many before giving birth and the bug it is related to Group B Streptococcus.
Professor Le Doare joined St George’s, University of London (SGUL) in 2018, transitioning from Imperial College London, and brings a wealth of experience from her work in the UK, the Gambia, Uganda and South Africa.
Currently holding a Chair in Vaccinology and Immunology, Professor Le Doare is a Principal Scientist at Makerere University in Uganda. There, she leads groundbreaking research, including the development of maternal vaccine platforms and the surveillance of pregnancy outcomes in a large urban cohort. Her research focuses on age-related immune responses to infectious diseases in pregnant women and their babies, with a particular interest in how maternal antibodies in blood and breast milk protect newborns and how vaccination can enhance this natural defence.
Professor Le Doare’s work is shaping the future of maternal and neonatal health, with her team conducting clinical trials of investigative vaccines globally. She also holds a dual appointment with Public Health England as a Principal Scientist within the Pathogen Immunity Group at Porton Down. She is currently working as a consultant at the WHO on Group B Streptococcal vaccines.
Join us as we dive into her remarkable career, her cutting-edge research, and the global impact of her work in maternal and infant health. We will pay particular attention to one of her special interests GBS or Group B Streptococcus.
Disclaimer: Remember we are sharing our opinions and medical knowledge, and not associated with our affiliations. Note that knowledge evolves over time. Note that this is not direct medical advice as we are not your personal doctors however feel free to share any ideas expressed with your own healthcare professional as needed. This episode is unsponsored and received no financial incentive. 
 

Whats the impact of a western diet in pregnancy on child development? Expert Guests: Professor Morten Arendt Rasmussen and Dr David Horner
It is unclear what the impact of a western diet is like on the unborn child. Now, a large observational clinical study from the University of Copenhagen and the Copenhagen Prospective Studies on Asthma in Childhood at the Danish Paediatric Asthma Centre, Herlow and Gentofte Hospital, find a relationship between maternal diet during pregnancy and the presence of ADHD and autism in children. The more of a Western diet a woman has in pregnancy - e.g. high in fat, sugar, processed products while lower in fish, fresh vegetables, and fruit—the greater the risk appears to be for her child developing ADHD or autism. Today we are joined by Professor Morten Arendt Rasmussen and Dr David Horner University of Copenhagen who led on this research to tell us what this means for pregnant women. Thank you do being with us todayDisclaimer: Remember we are sharing our opinions and medical knowledge, and not associated with our affiliations. Note that knowledge evolves over time. Note that this is not direct medical advice as we are not your personal doctors however feel free to share any ideas expressed with your own healthcare professional as needed. This episode is unsponsored and received no financial incentive. 
 

Ep 17. Should I get the new RSV vaccine in pregnancy? When, and why?
 
RSV. Talking About Health Optimisation Part 2 -  How to protect against a disease that affects 90% of children under the age of 2 years. Around 90% of children are infected with Respiratory Syncytial Virus (RSV) by 2 years old. This episode discusses health consciousness and the desire to protect oneself. Discussions revolve around prevention medicine and how that coincides with other healthy lifestyle choices like organic food, exercise and mindfulness. We discuss how to balance the rare side effects with health optimisation. In this episode Dr Lydia Yarlott and Dr Eliz Kilich talk about how to balance the benefits and risks when thinking about vaccines. Disclaimer: Remember we are sharing our opinions and medical knowledge, and not associated with our affiliations. Note that knowledge evolves over time. Note that this is not direct medical advice as we are not your personal doctors however feel free to share any ideas expressed with your own healthcare professional as needed. This episode is unsponsored and received no financial incentive. 

Episode 16: Pregnancy RSV Vaccine Update. Expert Guest: Professor Paul Heath. Join us for an update on the respiratory syncytial virus (RSV) vaccine given during pregnancy. Hear what the latest evidence is. This vaccine protects babies against a common cause of bronchiolitis which can be severe in newborns. The UK has made a decision to prevent against RSV with Abrysvo™, the maternal vaccine, manufactured by Pfizer. Previously the UK had been considering the use of Nirsevimab instead. This is an RSV monoclonal antibody for newborns (Beyfortus™, manufactured by Sanofi Pasteur). Both the vaccine and the antibody were recommended as safe and effective options in 2023 by the JCVI. After a cost-effectiveness analysis and financial tender by the Department of Health, a decision was made to move to Abrysvo™.
The maternal vaccine success was revealed following a study involving over 7000 pregnant women, published in early 2023, the MATISSE trial. They showed that the Abrysvo™ maternal vaccine is highly effective at preventing severe infection in babies up to 180 days after birth. Vaccination is approved from 28 weeks of pregnancy in the UK. At the same time, the MELODY and HARMONIE trials showed the monoclonal antibody for babies Beyfortus™, currently unavailable in the UK, also effectively prevents RSV for up to 6 months after administration. This vaccine can be given to all babies anytime from birth. 
We now we hear about what the evidence is now that the UK has been giving the vaccine since September 2024.Tune in now. Disclaimer: Remember we are sharing our opinions and medical knowledge, and not associated with our affiliations. Note that knowledge evolves over time. Note that this is not direct medical advice as we are not your personal doctors however feel free to share any ideas expressed with your own healthcare professional as needed. This episode is unsponsored and received no financial incentive. 

Episode 15: Debrief: Cravings and Places: when your pregnancy craving lead you astray 
Dr Eliz Kilich and Dr Lydia Yarlott. In this follow-up to our insightful discussion with Dr. Matthew Gilmour in "Ep 14: Brie-ing Safe in Pregnancy – Christmas Special!", we delve deeper into the nuances of food safety during pregnancy.We summarise the main points in a shorter recap and highlight some of the areas that need further explanation. For instance here we talk about Listeria's rarity, the outbreaks, the food industry's role in protecting pregnant women, and practicalities. This episode offers practical advice on identifying actual risks, understanding potential consequences of consuming high-risk foods, and recognising the most hazardous items to avoid.We also examine the significant 2019 listeriosis outbreak in UK hospitals linked to pre-packaged sandwiches. Our discussion covers the events, the subsequent investigation by the UK Health Security Agency (UKHSA), and the lessons learned to enhance food safety protocols.assets.publishing.service.gov.uk
Resources:UKHSA's report on the 2019 listeriosis outbreak: https://assets.publishing.service.gov.uk/media/5fbd0f898fa8f559e9ea363e/2019-05-Listeria-CC8-Outbreak-Report.pdf
Tune in to gain valuable insights and join our debate on this critical topic. Please remember this is not direct medical advice, sharing knowledge and thoughts. Please do contact your own healthcare professional if seeking personal medical adviceDisclaimer: Remember we are sharing our opinions and medical knowledge, and not associated with our affiliations. Note that knowledge evolves over time. Note that this is not direct medical advice as we are not your personal doctors however feel free to share any ideas expressed with your own healthcare professional as needed. This episode is unsponsored and received no financial incentive. 

Ep 14. Brie-ing Safe In Pregnancy. Christmas Special Episode - Food Safety While Pregnant. Expert Guest: Dr Matthew GilmourWanted a bit more dialogue on trying to understand the food list of what to and what not to eat during pregnancy? In this episode of Cocooned Health, hosts Dr Eliz Kilich and Dr Lydia Yarlott unravel the complexity of avoiding infections in pregnancy with a special focus on food safety. This one is particularly important for little bubba. They take a deep dive into one of the most talked-about topics among expectant parents—cheese! But more surprisingly, beyond cheese! 
What You'll Learn:
Is it really dangerous to indulge in soft cheeses like brie, camembert, or stilton during pregnancy?
What is Listeria monocytogenes, and why does it make certain foods risky? 
What are those particularly risky foods? smoked salmon? ice cream?
What are the actual risks, and how can you protect yourself and your baby
Practical advice
Special Guest:
Dr. Matthew Gilmour, a global expert in foodborne pathogens, joins the conversation.Matthew is Co-director of the UK Food Safety Research Network and is a Group Leader in the ‘Microbes in the Food Chain’ programme at the Quadram Institute Bioscience and the University of East Anglia in Norwich, England.The UK Food Safety Research Network is hosted by the Quadram Institute and Dr Gilmour leads the Listeria research at the Quadram Institute. (Find out more here: https://quadram.ac.uk/). His experience as Co-Director of the UK Food Safety Research Network and former Scientific Director General of Canada’s National Microbiology Laboratory,
Tune in to hear science-backed insights and actionable advice that will help mums, dads, and mums-to-be navigate the dairy dilemma with confidence! Don't miss this episode—it’s about so much more than just cheese!Check out our new episodes monthly. 🎧 Cocooned Health Podcast: Brie-ing Safe During Pregnancy
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Ep 13. The DEBRIEF: Microbiome Baby & Me: This is a debrief episode discussing some of the topics brought up in episode 12 with Expert guest Dr Lindsay Hall. This includes probiotics in pregnancy and for newborns. The impact of breastfeeding. And the impact of C Section versus vaginal delivery on the microbiome of baby. Dr Eliz Kilich and Dr Lydia Yarlott give extra thoughts on the subject and what the evidence might mean for mums & bubs.

Ep12. Is it worth taking probiotics during pregnancy & are probiotics good for baby? Gut health against infection. Expert Guest: Professor Linsday HallToday we will be talking about the gut health of mum and baby and what the implications are for later life. This is quite a new area of research and so we are deeply privileged to have our special guest today expert Professor Lindsay Hall who is Chair of Microbiome Research at the University of Birmingham, who has really been one of the leaders in helping to get answers on this topic.  Her work explored how "friendly bacteria" like Bifidobacterium coincides with laying the foundation for baby's future health and vitality. She is Group Leader at Quadram since 2015. The Quadram Institute brings together researchers, academics and NHS clinicians to address global challenges in human health, food and disease.
Today we will touch on topics such as 
What the microbiome is and why it's interesting in pregnancy and for babies
the evidence for probiotics in pregnancy
Gut health of the baby after C Section versus vaginal delivery
The impact of breastfeeding 
We will also explore with Professor Hall, why from a scientific perspective it is quite challenging to research these questions. 
It’s important to note that the views we’ve expressed here are our own, and don’t represent those of any institution or other affiliated party and do not constitute medical advice. If you are looking for medical advice, please, as always, contact your own healthcare professional.  Please leave feedback via Instagram @Cocooned Health: And don't forget to subscribeDisclaimer: Remember we are sharing our opinions and medical knowledge, and not associated with our affiliations. Note that knowledge evolves over time. Note that this is not direct medical advice as we are not your personal doctors however feel free to share any ideas expressed with your own healthcare professional as needed. This episode is unsponsored and received no financial incentive. 

Ep11.  Chickenpox Vaccine - Juggling Vaccine Timings and Life -  Expert Guest: Professor Adam Finn
Chickenpox vaccines for babies: Can you get them on the NHS or state provided services? Or only via private healthcare? Why if so? Dr Lydia Yarlott and cohost Dr Eliz Kilich is joined by special guest Professor Adam Finn, who is a Professor of Paediatrics at the Universtiy of Bristol in the UK. We talk about Chickenpox vaccines for babies, their timings, different schedules across the world and why it is important.
Professors Finn's research interests include immunity to bacterial respiratory illnesses. He is also a senior clinician in the paediatric immunology and infectious diseases service at Bristol Royal Hospital for Children and the South West region and heads the Bristol Vaccine Centre. In addition, he was Chairman of the WHO European Technical Advisory Group of Experts on Immunization from 2011 to 2022. He has spent ten years as ex officio member of the WHO Strategic Advisory Group of Experts, Member of the UK Department of Health Joint Committee on Vaccination and Immunisation from 2014-2024). He also spent 4 years during 2015-2019 as President of the European Society for Paediatric Infectious Diseases.Disclaimer: Remember we are sharing our opinions and medical knowledge, and not associated with our affiliations. Note that knowledge evolves over time. Note that this is not direct medical advice as we are not your personal doctors however feel free to share any ideas expressed with your own healthcare professional as needed. This episode is unsponsored and received no financial incentive. 

Episode 10: Ever wondered how we know the Flu vaccine is safe specifically in pregnancy? Expert Guest: Professor Paul Heath
This episodes focuses on the safety of the Influenza vaccine in pregnancy and infants. Exploring the evidence for safety and the history behind vaccination safety. We hope to give mums-to-be clear advice and understanding on this topic. 
Paul Heath is a Professor and Honorary Consultant in Paediatric Infectious Diseases at St George's University Hospitals NHS Foundation Trust and St George’s, University of London, where he is the Director of the Vaccine Institute. His training in paediatrics and infectious diseases was at the Royal Children’s Hospital, Melbourne, Australia; the John Radcliffe Hospital, Oxford; and St George’s Hospital, London. His research interests are in the epidemiology of vaccine preventable diseases, in clinical vaccine trials, particularly in at-risk groups and in perinatal infections. He coordinates the UK Paediatric Vaccine Group (UKPVG), is a member of the JCVI, is the NIHR Speciality Lead for Children’s research for South London and is co-Chair of the UK Infectious Diseases Vaccine Research Forum.
Disclaimer: Remember we are sharing our opinions and medical knowledge, and not associated with our affiliations. Note that knowledge evolves over time. Note that this is not direct medical advice as we are not your personal doctors however feel free to share any ideas expressed with your own healthcare professional as needed. This episode is unsponsored and received no financial incentive. 

Ep9. Vax & Relax: Flu Protection for Mums-to-be & babies. Expert Guest: Professor Paul Heath
Paul Heath is a Professor and Honorary Consultant in Paediatric Infectious Diseases at St George's University Hospitals NHS Foundation Trust and St George’s, University of London, where he is the Director of the Vaccine Institute. His training in paediatrics and infectious diseases was at the Royal Children’s Hospital, Melbourne, Australia; the John Radcliffe Hospital, Oxford; and St George’s Hospital, London. His research interests are in the epidemiology of vaccine preventable diseases, in clinical vaccine trials, particularly in at-risk groups and in perinatal infections. He coordinates the UK Paediatric Vaccine Group (UKPVG), is a member of the JCVI, is the NIHR Speciality Lead for Children’s research for South London and is co-Chair of the UK Infectious Diseases Vaccine Research Forum.This episodes focuses on the vaccine benefits of the Influenza vaccine in pregnancy and infants. Exploring the reasons to vaccinate, the history behind vaccination and the effectiveness levels, we hope to give mums-to-be clear advice and understanding on this topic. The episode will touch on the best time to get the Influenza vaccine in pregnancy and what the different types of flu vaccines are and why they differ for different groups of people (children, pregnancy and the elderly). Join us for the next episode on Flu Vaccine safety next time ...Disclaimer: Remember we are sharing our opinions and medical knowledge, and not associated with our affiliations. Note that knowledge evolves over time. Note that this is not direct medical advice as we are not your personal doctors however feel free to share any ideas expressed with your own healthcare professional as needed. This episode is unsponsored and received no financial incentive. 

Ep8. Should you get your child their second dose of MMR at 18 months? Measles outbreaks and the MMR vaccine. Expert Guest: Professor Sir Andrew Pollard
In this episode we are joined by Professor Sir Andrew Pollard. Sir Andrew is Director of the Oxford Vaccine Group in the Department of Paediatrics at the University of Oxford and a consultant paediatrician at Oxford Children’s Hospital and Fellow of St Cross College. He received a knighthood in the Queen’s Birthday Honours in 2021 for services to Public Health, especially in the pandemic, and received the Order of Medical Merit (Grande Official) from the Federal Republic of Brazil in 2022 and is Commander of the Order of Rio Branco. We discuss the risks of measles, why there are ongoing outbreaks. We also discuss how the myths came about regarding the vaccine and what the evidence is that disproves the myths. We also discuss common and rare risks of the vaccine and their important benefits. Importantly we discuss changes to the UK vaccine schedule and what to expect if you are a parent of a child weighing up these decisions.
Whilst no information is perfect, it changes, we have done our best to bring together information to the best of our knowledge. Information is always subject to change. The views here are our own and do not represent that of any institution or affiliated body although we do discuss public health guidance in general. It is always important to discuss anything we talk about with your own healthcare provider. This is not direct personal medical advice as you are not our patients however, we want to give the public the information we already have, so you are more informed to make your own choices.Disclaimer: Remember we are sharing our opinions and medical knowledge, and not associated with our affiliations. Note that knowledge evolves over time. Note that this is not direct medical advice as we are not your personal doctors however feel free to share any ideas expressed with your own healthcare professional as needed. This episode is unsponsored and received no financial incentive.