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Care Share Bulletin

While a healthy adult’s body temperature remains fairly steady at about 98.6o F, the normal body temperature of infants and young children ranges anywhere from 97.1o F to 100.5o F depending on the time of day, the child’s activity level, and the site at which the temperature is measured.  As a rule, rectal temperature is one degree higher and axillary (armpit) temperature is one degree lower than oral (under-the-tongue) temperature.  While this rule of thumb is not always accurate, a temperature over 100.5o - 101oF usually indicates that the child has a fever.

Most fevers in children are due to viral infections.  When a child is ill, the temperature may rise to 104o F or more, but the fever is usually brief.  The height of the fever does not necessarily indicate the seriousness of the illness.  Some children may have a minor illness and run high temperatures, while others may be very sick and have little or no fever.

If however, an infant is under 2 months of age and has a temperature elevation of 100.5o F or higher, call your doctor.  At this age the infant may be more susceptible to serious infections which must be diagnosed early.

CAUSES OF FEVER:  Fever itself is not a disease but a symptom of an illness, usually an infectious one.  Colds, the flu, and other viral and bacterial infections are all common causes of fever in children.  Fever is one of the body’s defense mechanisms which enables it to fight infections more effectively.

WHEN AND HOW TO TREAT A FEVER:  Steps to reduce a fever need to be taken only if the child is uncomfortable.  The child will require additional fluids during periods of fever, especially if the child is also having vomiting or diarrhea.  Acetaminophen (Tylenol, Tempra, etc.) or ibuprofen (Motrin, Advil) are the recommended medicines for treatment of fever.  Dress the child lightly and keep the room temperature comfortable.  If the child is very uncomfortable, you may sponge with lukewarm water as often as necessary.

HOW TO TAKE A TEMPERATURE:  Mercury thermometers are no longer recommended and should be properly disposed.  Digital thermometers (for oral or rectal temperatures) and ear thermometers are commercially available. Temperature should be taken rectally in young babies.  Make sure the thermometer bulb is lubricated.  The baby should be lying on his or her stomach.  Gently glide the thermometer about one inch into the rectum; do not force.  Hold the thermometer in place by gently pinching the “cheeks” of the baby’s buttocks together with one hand.  The maximum temperature is usually reached within 30 seconds.

In toddlers the armpit method or ear thermometer may be used instead (especially if the child has diarrhea).  To take the child’s temperature by the armpit method, place the bulb of the thermometer under the armpit and hold the arm against the chest.  Use the ear thermometer as described by the manufacturer.  Keep in mind that neither method is as reliable or accurate as the digital rectal reading.  By the time the child is seven to ten years old, the thermometer may be placed under the tongue for an oral reading. 

SUMMARY:  Fever is very common in babies and young children.  It is not a disease in itself but a symptom of illness, usually an infection.  Most fevers require no special treatment and will resolve spontaneously or with treatment of the underlying disease.  While the fever itself is not serious, it is important to identify the underlying cause.  If your child appears ill or the fever persisits for 48 hours, call the office for an appointment.  In the case of an infant under two months of age with a fever, call immediately.