Taking Baby's Temperature

At some point during your child's first year, you will undoubtedly need to take his temperature. There are several options for taking a child's temperature, with varying degrees of accuracy and comfort. Which method you choose will depend on how old your child is and how accurate you need to be.

If your child is younger than 3 years of age, taking his temperature with a rectal digital thermometer provides the best reading. Although not as accurate, if your child is older than 3 months of age, you can take his underarm (axillary) temperature to determine if he has a fever. Ear thermometers are generally not recommended for babies younger than 3 months because their ear canals are usually too small, and oral thermometers are generally recommended for children 4 years and older.

There are a variety of thermometers on the market at varying price points. Digital models are the quickest and easiest to read. The American Academy of Pediatrics recommends against using a mercury thermometer - the mercury poses significant health and environmental risks. If you have an old mercury thermometer, do not simply throw it in the garbage where the mercury could leak, contact your physician or your local health department to find out how to safely dispose of it. Most new thermometers can be used rectally, orally, or under the arm; however, once you use the thermometer rectally, it's best to use it only for rectal temperature readings and designate another for oral and under the arm use. If your thermometer is not designed to be used in multiple areas, never take your baby's temperature rectally using an oral thermometer. Rectal thermometers have a security bulb designed specifically for safely taking rectal temperatures.

You don't need to take your baby's temperature regularly; but take it if:

• He is especially irritable

• His skin is hot, or he is sweating excessively or has a rash

• His complexion is either very pale or flushed

• His breathing is unusually fast, slow or especially noisy

• He has a runny nose, is sneezing or coughing

• His appetite is poor; he has refused more than one regular feeding

• He rubs his ears, rolls his head or screams sharply

• He is vomiting or has diarrhea, or the stool has an unusual color or odor (if there is diarrhea, take an axillary temperature instead of rectal)

Never take your baby's temperature right after he has had a bath. Crying may also raise a baby's temperature. If your baby's temperature is high, check to make sure he is not over-dressed or bundled with blankets. If you think his temperature may be incorrectly elevated, remove layers of clothing or calm him, wait 30 minutes and retake his temperature.

A normal body temperature depends on how you take the temperature:

• Rectal: 97.9 to 100.4 F (36.6 to 38 C)

• Armpit: 94.5 to 99.1 F (34.7 to 37.3 C)

• Ear: 96.4 to 100.4 F (35.8 to 38 C)

• Mouth: 95.9 to 99.5 F (35.5 to 37.5 C)

If your baby has a rectal temperature of over 100.4 degrees F (38 C), call your doctor immediately.

Rectal

Experts recommend taking your baby's temperature rectally until he or she is at least 3 months old because a correct reading is most important when your baby's little. To take your baby's temperature rectally:

• Lubricate the end of the thermometer with a water-soluble lubricant or petroleum jelly.

• Place your baby face down across your lap or on the changing table. Place your hand nearest your baby's head on his lower back and separate his buttocks with your thumb and forefinger.

• With your other hand, gently insert the lubricated end of the thermometer, no more than one-half to one inch, or just past the anal sphincter muscle.

• The thermometer should be pointed down towards your baby's naval.

• Hold the thermometer in place loosely with two fingers, keeping your hand cupped around your child's bottom. Use your other hand to comfort and prevent your baby from moving around.

• Hold the thermometer in place for 2 minutes or until the thermometer beeps.

• Remove the thermometer and wipe the bulb. (Don't be surprised if your baby poops when you remove the thermometer; placing anything in your baby's rectum can stimulate his bowels.)

• Immediately read and record the temperature.

• Disinfect the thermometer with rubbing alcohol or an antiseptic solution.

Axillary

The American Academy of Pediatrics (AAP) suggests that you not use the axillary method for babies under 3 months of age, when an accurate reading is most important. To take your baby's axillary temperature:

• Clean the thermometer with cool, soapy water and rinse. If you are using a digital thermometer with disposable sleeves, apply a fresh sleeve.

• Remove your baby's shirt; the thermometer must be placed against skin, not clothing.

• Place the tip of the thermometer in the center of your child's armpit.

• Tuck your child's arm snugly against his body.

• Leave the thermometer in place for at least 3 to 5 minutes or until a digital thermometer beeps.

• Remove the thermometer, read, and record the temperature.

• Clean the thermometer.

If your child is under 2 years old and you find a fever when taking the temperature under the arm, confirm it by taking a rectal temperature. An axillary reading can be up to 2 degrees lower than an internal rectal reading.

Tympanic

Ear thermometers are generally used in urgent care centers because they're quick and painless. Ear thermometers measure the thermal radiation coming from the ear drum and the ear canal. Since the ear drum's blood supply is very similar in temperature and location to the blood in the brain, this method is an ideal location from which to get an estimation of body temperature. However, they are a little more difficult to use correctly than other thermometers, and if you don't insert the ear thermometer exactly right, it can be hard to get an accurate, consistent reading.

• Use a clean probe tip each time, and follow the manufacturer's instructions carefully.

• Gently tug on the ear, pulling it back. This will help straighten the ear canal, and make a clear path inside the ear to the ear drum.

• Gently insert the thermometer until the ear canal is fully sealed off.

• Squeeze and hold down the button for one second.

• Remove the digital thermometer and read the temperature.

Having an accurate temperature is important when your baby is ill because it can determine the doctor's course of treatment and ensure effective and immediate care.