Kidstuff Kidstuff By Paul L. Marz, M.D.
"Hmm...My baby is not quite right...I wonder if it's a fever? How do I tell?"
This is a great question! Exhaustive research has been done on this very topic. A study was performed by interviewing mothers and their babies. (The mothers did all the talking for this one). In cases that the Mom believed that the baby had a fever, they did. And when Mom thought the baby was fine, the baby was fine.
That would seem to settle that, but the goal of this article is not to discuss fever itself, but to cover the technical aspects of how to take the temperature...and then what to do with the number once you have it.
Tools: The age of the old glass thermometer has passed. The American Academy of Pediatrics recommends that any glass or mercury-containing thermometers found in the home should be removed and disposed of safely. The mercury inside the thermometer actually is harmless...until the device is broken. It's just better to remove this threat from the home.
Today there are a multitude of products available to take the child's temperature. Always follow the directions for the proper use of the device you select.
One note, ear thermometers are not suitable for infants. Follow the instructions for the age range for this device.
The following instructions are based on common digital thermometers.
Infants: Babies are not so good at keeping their mouths closed, and have a tendency to eat anything you put in there, so the oral procedure is not appropriate. For the medical world, the gold standard for taking a temperature is the rectal temp. You have seen it on TV and in comedy scripts, but is this the thing to do? Well, putting something in your baby's bottom is not the most socially acceptable maneuver. If you choose to practice this technique, I recommend discussing it with your pediatrician or having the nurse demonstrate it to you, as it could cause problems in inexperienced hands.
Rectal Temp: First, clean the rectal digital thermometer. For children that you can physically control, usually younger than three years of age, place them over your lap or suitable solid surface. Lubricate the tip of the device and insert into the proper opening. DO NOT PLACE MORE THAN THE METAL TIP INSIDE. Hold in place securely until the device chirps, beeps or whatever the instructions say will happen. Remove and read off the temperature. Please remember to clean the device before putting it away.
Axillary or Underarm Temperature: The last reasonable option for infants is the axillary or underarm temperature. Place the device under the arm, with the tip inside the armpit and leave it there about three minutes before getting a reading.
Ear Thermometer: This is an option in addition to what we have already discussed. Tympanic or ear thermometers work by measuring the temperature of the surface of the ear drum deep within the ear. In infants, the position of the ear drum is not suitable for use of this device. But, as your child grows, this is a fast and efficient method of obtaining your child's temperature.
Insert into the ear canal gently aiming just forward toward the front of the skull. Press the start button and read off the answer.
Oral Temperature: When your child is over the age of three, this method is most common. Make sure you are not using a rectal thermometer. Some devices have a setting to be used for either oral or rectal. Check instructions before using.
If your child recently had a cold or hot drink, wait at least 15 minutes before taking the temperature orally. Once enough time has passed, put the tip of the device under the child's tongue toward the back of the mouth. Press start and await the signal to read off the temperature.
There are other devices on the market that use skin contact, or other methods. Consult your family doctor before trusting in them.
Well, finally, you have the number, so what do you do with it? As a general rule, the number is adjusted according to the method used. For an oral temperature, leave it as it is. If this is a rectal temperature, subtract one from the value; for an axillary temperature add one.
Now you are the expert on extracting the needed information from even the most resistant child.
(Dr. Marz, a board certified pediatrician, is supervising physician for the Town of Barnstable school system. He practices with Bass River Pediatrics in South Yarmouth.)