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Temperature Taking: Overcoming the Fever Fear Factor

By: Laura Jana, M.D., FAAP 

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Temperature Taking: Overcoming the Fever Fear What is considered fever? What is a "normal" body temperature? Parents should have an understanding of fever and safe, accurate temperature taking, as well as the risk of fever in a newborn and that in older infants and children. Overcome the fever fear factor by learning how to take temperature correctly and know when it’s important to call to the pediatrician.

Whereas fevers during a baby’s first few months of life may be caused by common cold viruses, newborns run the small risk of having a more serious underlying infection. The younger the infant, the less prepared the immune system is to fight infection and the more seriously an elevated temperature should be taken. Therefore, any young infant with a fever should be brought to the immediate attention of a doctor. 

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Old-fashioned mercury-in-glass thermometers have been replaced with new digital models that allow for safe and accurate temperature readings and offer features such as color-changing displays and faster response times that contribute for ease of use. Reduce anxiety and increase confidence associated with taking temperatures by becoming familiar with the use of the thermometer on a “normal” day -- a day when there is no reason to suspect your child has a fever. 

Temperatures are taken most commonly in the mouth (orally), in the bottom (rectally), under the arm (axillary) or in the ear (tympanic). Check with your pediatrician regarding the method which is best for your child.

Rectal Temperatures

Rectal temperatures are recommended for infant temperature taking since the readings are the most accurate measure of core body temperature. 

• Lay baby on either his belly or back on a comfortable, but firm, flat surface -- across your lap, on a changing table, sofa or even on the floor.

• If on his back, hold baby’s legs up just as you would if changing a diaper.  If on his belly, position so that his bottom sticks up a bit by tucking his knees under or letting his legs drape over your lap. Dab some lubricating jelly onto the short, round tip of the thermometer.

• Carefully insert the thermometer tip into the rectal (anal) opening until the metal tip is no longer showing (approximately ½”).

• Consider purchasing more than one thermometer so that one is designated “For rectal use only.”

• A rectal measurement of above 100.4ºF is generally considered fever.


Axillary (Underarm) Temperatures

This is a safe and straight-forward method for toddlers and older.

• Make sure the child’s clothing doesn’t come between the thermometer and the skin.

• Tuck the thermometer tip high up in the armpit and hold it in place by lowering the child’s arm and keeping it snugly up against the chest until long enough to secure the temperature reading.

• An underarm measure of above 99ºF is generally considered fever.

Oral Temperatures

Oral temperature taking is generally recommended for children who are at least four or five years of age. When taking an oral temperature:

• Make sure that your child has not had a cold or hot drink within the last 30 minutes.

• Gently place the tip of the thermometer under one side of the tongue and towards the back.

• Teach your child to hold the thermometer securely in place using both his lips and his (or your) hands. Unlike glass thermometers, digital thermometers can easily withstand biting which helps hold the thermometer in place.

• An oral measurement of above 100ºF is generally considered fever.

When reporting the child’s temperature to your pediatrician, there is no need to add, subtract or otherwise mathematically manipulate the results based on where the temperature was taken. Instead, simply be sure to mention how, when and where you obtained your measurement.

© 2007, Dr. Laura Jana, M.D., FAAP

Dr. Laura Jana is the co-author of Heading Home with Your Newborn: From Birth to Reality (American Academy of Pediatrics). A pediatrician, mother of three and Associate Director of the Boys Town Institute for Child Health Improvement, she co-founded the Dr. Spock Company in 1999.
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