TEMPERATURE TAKING - FEVER

There are now several ways to take your child's temperature. The tried and true rectal method is still probably the best for use at home. Remember to always use the correct type of thermometer.

To take a RECTAL temperature, place your baby on his or her belly, lubricate the thermometer with petroleum jelly, spread your baby's buttocks apart and insert the thermometer about 1/4 to 1/2 inch into the rectum, let the buttocks go back to their normal position, and remove and read the thermometer after one minute. The thermometer must not be placed either too far in or not in far enough or the temperature you read may be quite wrong. The rectal temperature is one degree Fahrenheit higher than true body temperature.

As your child gets older, you can use the oral or axillary (arm pit) methods. The oral temperature corresponds to true body temperature, while the axillary temperature is usually one degree (0.8 more correctly) Fahrenheit lower than true body temperature.

Two newer devices are the forehead or liquid crystal thermometer and the tympanic or ear thermometer. The forehead thermometer has been around a few years and is quite good at showing temperature change, but absolutely should NEVER be used because the temperature it gives is inaccurate. The temperature a crystal thermometer gives can be as much as 6 degrees off. The tympanic or ear thermometer became the new standard in hospitals in the 1990s because of its great speed, but they are being replaced by the temporal artery thermometer (detailed below). The tympanic thermometer senses infrared light waves emitted by the middle ear structures, is not affected by ear infections or ear wax and takes about 2 seconds to take a temperature. The home version tympanic thermometer should not be used in a child under 6 years of age and then should be used with caution. The home version costs about $50 to $60, while the professional version costs $3-600 and is more accurate. I have had 3 parents use the tympanic ear thermometer in the rectum (they all were fathers that called me at 3am to report a rectal temperature of 100 by the way). There is a switch that gives rectal equivalent, but it is not supposed to be used that way. Please read the directions if you want to use the ear thermometer. It is critical that the device be aimed and used properly. If the baby feels like the temperature read by the ear thermometer, then it is probably accurate. But if the baby feels different, then you should recheck the temperature with a different thermometer.

Temporal artery thermometer or forehead swipe thermometer: These have proven much more accurate than the ear thermometer and are just as quick. We use these exclusively in the office. The office version costs around $350, while you can buy the home version at Walmart for under $40. Exergen is the brand.

Forehead Touch Thermometer: These are not accurate, do not use them. If it does not say Temporal artery thermometer and the instructions do not mention swiping it across the temple, then don’t use it.

Touchless or no-contact Thermometers: These became widely used when COVID hit for screening large groups of people. They are horribly inaccurate and worthless for temperature taking.

FEVER

Fever is defined as a temperature of 100.5 F or 38.3 C or higher. 98.6 F is considered normal body temperature ( normal range = 96.5 to 100.4), but this can vary greatly during the day. Should your child feel warm, then take his or her temperature. You absolutely cannot tell your child's temperature by feeling their forehead. Should your child have a high temperature, then ensure that you are not overheating him or her with too many clothes or a hot environment. Next give your baby the correct dose of acetaminophen (Tylenol). NEVER give your child aspirin or anything that contains aspirin. Influenza or Chicken Pox and aspirin have been associated with Reyes syndrome. If you child is less than 2 months, then call me next. Should the acetaminophen not bring your child temperature down within 30 minutes, then give him or her a bath in water that is either lukewarm or room temperature or give him or her ibuprofen. Do not use cold water for the bath and never use cold water enemas, as this could harm your baby. Remember that this bath will only bring the temperature down to 102 F and not below. If your child's temperature does not come down or your child is ill, then please call me.

On the other hand, fevers are our bodies attempt to kill an infection. Every mechanism your body has to fight infection works better with a fever. Most infectious disease experts actually recommend never to treat a fever. Fevers are only harmful over 108 (eight is not a misprint) and I have never seen one over 106.7. One study actually showed that cold symptoms take an average of 2 days longer to resolve when the fever was treated. While your baby is under 2 to 3 months of age, we do want to reduce the fever to be sure of how ill your baby is. Generally, a fever that is easily reduced to below 101 rarely should cause concern, while one over 101 that is difficult to reduce or is associated with other signs if illness, should cause concern. Remember that fevers do not hurt you, what is causing the fever is what may hurt you