Determining if Your Child Has a Fever

An accurate temperature reading is especially important during the first 3 months of your child’s life. During this time, a rectal thermometer is the most accurate way to measure your child’s fever. To assure an accurate temperature, be sure the child is not overdressed or warm from activity, a hot bath, or hot weather. If your child’s rectal temperature is higher than
100.4°F, call your child’s doctor.

Temperatures taken orally, under the arm, or with an ear thermometer should be used for screening. If your child is mature enough and can keep his or her lips closed tightly around a thermometer, take the temperature orally. Warm food or drink can elevate an oral temperature. Wait at least 30 minutes after drinking or eating to take your child’s temperature. If the temperature is more than 99.6°F, you should recheck your child’s temperature rectally. Also, if the child’s nose is stuffed up or if he or she has a frequent cough, then taking the child’s temperature rectally is more accurate. A fever is defined as having a temperature greater than 99.6°F orally or with an ear thermometer, 98.6°F under the arm, or 100.4°F rectally.

How to Take Your Child’s Temperature Rectally

Because most children younger than 2 years of age cannot keep their mouths closed or remain still for an oral temperature, it is best to take their temperature rectally. Lay the baby on your lap, bottom up, with legs hanging down. Be sure to support the baby’s head. If the baby is too squirmy, lay the child on a firm, flat surface. Be sure to use a rectal thermometer, which has a shorter bulb than an oral thermometer. Put petroleum jelly on the end of the thermometer to make it more comfortable, and insert the thermometer about an inch into the rectum (until you can no longer see the silver end) for about 3 minutes. Always stop at less than 1 inch if there is resistance. Be sure to hold on to the thermometer while it is in the child’s rectum, so that the child doesn’t roll over or move and puncture his or her colon. A rectal temperature is normally 1° higher than an oral temperature.

Self-Care

• Give plenty of fluids—water, juice, soup, flavored gelatin, ice pops—to prevent dehydration. A desire for solids usually decreases with a fever.
• Use acetaminophen (Tylenol or Tempra) if your child’s temperature is more than 102°F. Be sure to follow the package’s instructions for your child’s age and weight. Do not give children and teenagers aspirin or aspirin-containing products, because they have been linked to Reye’s syndrome, a serious condition that can lead to coma and death.
• Give infants and children a sponge bath in lukewarm water. Do not use cool or cold water, which may cause shivering.
• Dress the child lightly and use lighter bedclothes to avoid overheating. Cover the child with a blanket if chilled.
• When calling your child’s doctor about a fever, tell him or her if you took your child’s temperature rectally, orally, or with an ear thermometer.
• Children between 6 months and 5 years of age sometimes have seizures or “fits” (called febrile seizures) when they have a high fever. These seizures are seldom harmful. During a seizure, protect children from hurting themselves by keeping them away from nearby objects and making sure they are breathing freely. Report the seizure to your child’s doctor. If the seizures continue, go to the emergency room.