|What is the definition of a fever in my child and how should I take his or her temperature?|
From November 2009 AAP News (copyright 2009, American Academy of Pediatrics, may be freely copied and distributed with proper attribution; author is Alyson Sulaski Wyckoff); see end for additional thoughts not included in this AAP article:
AAP News Parent Plus: Information from Your Pediatrician
Thermometer use 101
If your child feels warm, looks flushed, is sweating or shivering, or has flu symptoms, you might suspect fever. Using a thermometer is the only sure way to know if a fever is present.
A basic digital version may be the most practial and reliable way to determine if your child has a fever. Mercury thermometers should not be in your medicine cabinet; the silver liquid inside is dangerous if the thermometer breaks.
Use a digital thermometer to take a rectal (in the bottom), oral (in the mouth) or axillary (under the arm) temperature. A tympanic (ear) thermometer, which is more expensive, is another option. Other methods are available but are not recommended by the American Academy of Pediatrics (AAP) at this time.
Temperatures taken rectally or orally are more accurate than those obtained using the axillary or tympanic methods. If your child is younger than 3 years old, a rectal temperature gives the best reading. At around 4 or 5, you can feel comfortable taking a temperature by mouth.
A normal temperature for a child may range from 97 degrees Fahrenheit (F) to 100.4 degrees F. In general, the AAP considers anything over 100.4 degrees F to be a possible fever.
Taking a rectal temperature:
Taking an oral temperature:
Taking an axillary temperature:
Taking a tympanic temperature:
The AAP advises against using this method for infants younger than 3 months. While a tympanic thermometer provides speedy results, the device needs to be inserted at the right angle in a child's ear to provide an accurate reading. Don't use these devices right after a child has been swimming or bathing or if ear pain is present.
Additional input from Virginia Pediatric & Adolescent Center:
We consider 100.4 or higher a fever (and a reason to call us immediately, day or night) in children under 3 months old. If your child is 3 months or older, most physicians in our group use a definition of 101 or higher as a "true fever." Teething should not cause a fever of 101 or higher. Unless a child has known allergies or other contraindications, acetaminophen (Tylenol) can be used in children of any age, and ibuprofen (Motrin or Advil) can be used in children age 6 months and older for a child with a fever.
If your child is 3 months or older and has clear upper respiratory symptoms (runny nose and cough) and is drinking well and is not struggling to breathe, there may be a fever the first 2-3 days of a cold. Please call or come to walk-in clinic if your child has persistent fevers of 3 days or more with a cold, a fever whose onset does not correspond to the onset of cold symptoms (such as starting a fever after several days of cold symptoms), fevers without an obvious cause, lethargy (it is normal for children to be a bit tired with a fever, but your child should still be responding to you appropriately), poor fluid intake, urine output fewer than 4 times in a 24-hour period, no tears when crying (a sign of dehydration), pain or ear-tugging or inconsolable crying, a stiff neck or eye sensitivity to light, purple skin spots, asthma or wheezing along with cold symptoms, or any other concerning symptoms.