How to Check Children’s Temperature Correctly

How to Check Children’s Temperature Correctly

Sick kids? Here’s how to check children’s temperature correctly when they’re running a fever.

It’s cough and cold season again, and that brings with it the dreaded fever. Boo! I am asked all the time what temperature is a fever and when to rush your child down to the hospital. Truth is, as far as I am concerned, there is no one temperature that makes me particularly nervous. A child can have a very high fever with a viral infection, and no fever at all with a bacterial infection. The fever itself is not necessarily a signal that your child needs medication or treatment.

But let’s start with the basics.

 

There’s several ways to check children’s temperature:

  • Rectally – in the rectum (bum)
  • Orally – in the mouth
  • Axillary – under the armpit
  • Temporal artery – on the forehead or over the temple
  • Tympanic – in the ear

 And there’s different kinds of thermometers to do them with. So make sure you use the appropriate thermometer the appropriate place!

 

What is the best way to check children’s temperature?

Hands down the most accurate way to take your child’s temperature is in the rectum. Many of us don’t want to do that all the time, and many children don’t appreciate it. We rely on other ways.

My current favorite way is through the use of our Braun No-Touch forehead thermometer. I wasn’t convinced before, but did use it on two of my kids, and compared the rectal temperature with the one read on the Braun, and it was VERY close. It is now my go-to. I don’t even have to touch it to their skin when they are sleeping!

But in general, I tend to avoid tympanic temperature measurements, as I find them inaccurate. For example, if you child has an ear infection, that ear may register as a fever, and the other with normal temperature. Fever strips are generally inaccurate so I avoid these too. Children older than 5 years can usually allow an oral temperature, which is accurate and painless. Of course, ensure you have cleaned your thermometers thoroughly, as many rectal thermometers can double as oral or axillary (armpit) ones.

Gross (and unsanitary).

 

What is a normal temperature for children?

The normal temperature range varies depending on what method you are using to take the temperature.

 

What temperature is a fever?

Rectally – above 38 °C or 100.4 °F

Orally –  above 37.5 °C or 99.5 °F

Axillary or tympanic – above 37.3 °C or 99.1 °F

 

Some simple rule of thumbs:

  • Avoid using mercury thermometers – if they break you may expose your child to this toxic substance.
  • Treat discomfort, more than the number itself. My children often have low-grade fevers and feel fine. I treat discomfort and pain, and the number is less important for me.
  • Ensure your child has enough to drink. Appetite may be suppressed, and that is ok. As long as you child is drinking small amounts, often, hydration should be maintained.
  • See your doctor if you child looks unwell, is not drinking, is sleeping excessively or has a fever for more than 72 hours. This may need to be investigated.

 

Is there a dangerous temperature? Yes, of course. A human body is not happy above 40 °C or 104 °F. Your child may be lethargic, incoherent, with fast breathing and a quick heart rate. At this temperature most kids look unwell.

Do you need to rush to the nearest emergency room? Not necessarily.

When you child has a high fever, calm yourself, give some medicine such as Acetaminophen or Ibuprofen (see blog on dosage!) and provide comfort to you child. In 15 or 20 minutes the fever will likely begin to come down. Is your child now looking and behaving better? If so, please see your doctor to ensure there is no infection. But you do not necessarily need to rush to your emergency room. When you get there, your child may not even have a fever anymore!

If the medicine does not lead your child to look and behave more normally, you should seek out medical attention. The trick here is to pause, treat the fever and then react.

Please ensure your child is well hydrated by giving small amounts of fluids often. Avoid the temptation to strip your child of all of his or her clothing or putting in a cold bath. When a child has a fever, they feel cold, not hot. Making them feel more cold can lead to shivering, thereby elevating the temperature – the opposite of what you want to do.

Similarly, alcohol baths and rubs are not recommended.

 

Do you always have to use medicine to lower a fever?

No! I advise treating for comfort, not to change the number on the thermometer. If your child is acting normally and drinking well, there is no need to treat it with any medicines.

 

Important! See your health care provider if your child:

  • Is less than 3 months of age
  • Has a fever for more than 72 hours
  • Is excessively fussy or irritable
  • Is persistently coughing or wheezing
  • Is excessively sleepy or lethargic
  • Has a rash or other signs of illness that worry you
  • Is excessively vomiting or having diarrhea in large volumes.
Dina M. Kulik, MD, FRCPC, PEM

About Dina M. Kulik, MD, FRCPC, PEM

Dina is a wife, mother of 4, and adrenaline junky. She loves to share children’s health information from her professional and personal experience. More About Dr Dina.

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