By Sue Hubbard, M.D.
Throughout the year, especially during flu season, the questions surrounding how to take a child’s temperature and how to treat a fever seem never ending. So let’s jump right in with a discussion on taking temperatures in children of all ages.
There are many different thermometers out there, and many different methods for taking a child’s temperature. One way I know that is not accurate is by “touch of hand.” Many parents report that their child had a fever, but have never taken their temperature. Neither your hand, nor mine is accurate in detecting a fever in a child. I am not a fanatic about taking temperatures all day long, but it is important to document your child’s body temperature with a thermometer if you think they a fever. Also, a fever to a parent may mean 99.6 degrees (I know your child has a different body temperature than others), but in terms of true fever most doctors use 100.4 degrees or higher. For everyone!
Body temperature in infants is very important, and a fever in a child under 2 months of age is something that always needs to be documented. The easiest way to take a temperature in an infant is rectally and is actually quite easy. Lay your child down, like you would be changing their diaper, and hold their legs in one hand while you gently insert a digital thermometer (lubricating it with some Vaseline, makes it slide in more easily) into their rectum (bottom). It will not go too far, don’t worry, only about 1/2 inch. Keep the thermometer in their bottom for about a minute and by then you will be able to see if they have a fever. Again, 100.4 degrees or higher. I use rectal thermometers in children up to about 2 years old, as they are usually pretty easy to hold and it is not painful at all. It is also accurate. Keep this digital thermometer labeled for rectal use.
Axillary temperatures are taken under the arm and can also be taken with a digital thermometer. It is often confusing if your child’s temperature is in the 99 to 100 degree range, so if in doubt take rectal or oral temperature. I am not a huge fan of axillary temperatures, and it actually requires more cooperation than a rectal temp.
An oral digital thermometer, which is placed under the tongue, is easy to use on a cooperative child. By the time your child is 3 or 4 years old, it is fun to teach them how to hold up their tongue and then hold the tip of the thermometer under their tongue and close their lips. Especially with digital thermometers, elementary children like to read you what the thermometer says, and discuss their temperatures. My children always loved to show me they were REALLY sick when it said 103 degrees. It is then a “sick day activity” to take the acetaminophen and watch your temperature come down over the next several hours. They loved making charts of their body temps. It won’t win a science fair, but does keep them busy. Also, if they can play this game they are not too sick. Lastly, do not let your child drink a hot or cold beverage right before taking an oral temp (note for parents of older kids, remember Ferris Bueller?), as the reading may not be accurate.
There are also fancy tympanic (ear) thermometers and temporal artery thermometers. I still prefer digital in my own house, and I have never purchased a “fancy” thermometer. You can buy tons of digital thermometers for every child to have their own, and still save money. We also often hear parents report that there was more than a degree of difference between the same child’s ear. I also do not like ear thermometers in little ones, as their ear canals are too small to get accurate readings. Now that you know how to take a temperature I will discuss fever in another post.
Dr. Sue Hubbard is an award-winning pediatrician, medical editor and media host. “The Kid’s Doctor” TV feature can be seen on more than 90 stations across the U.S. Submit questions at http://www.kidsdr.com. The Kid’s Doctor e-book, “Tattoos to Texting: Parenting Today’s Teen,” is now available from Amazon and other e-book vendors.
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