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Caregiver education: Fever in children

A person's body temperature differs from time to time and individual to individual. A body temperature that is 100F (37.8 C) or higher is considered to be a fever.

There are many symptoms of fever:


  • Sweating

  • Chills and shivering

  • Headache

  • Muscle aches

  • Loss of appetite

  • Irritability

  • Dehydration

  • General weakness

Many different thermometers are available in the market, including oral, rectal, ear (tympanic), and forehead (temporal artery) thermometers. When the temperature is reported, it is better to give the healthcare provider both the reading and the type of thermometer used.

The temperature of a child depends on many factors like age and the symptoms. Usually, children older than four or five years can hold a thermometer under their tongue. If not, take the armpit temperature of the child. If the armpit temperature is over 99°F (37.2°C), there is concern the child is ill. A rectal temperature is also appropriate for infants from birth to three months of age. In the hospital setting, a rectal temperature is usually obtained before making medical decisions (e.g., whether to obtain laboratory tests).

Temperatures measured in the ear or on the forehead are less accurate than temperatures measured rectally or orally and may need to be confirmed by one of these methods (Orally/Rectally).

Tactile temperature, i.e., measuring or estimating a child's temperature by feeling the child's skin, is not accurate as it is highly dependent upon the temperature of the person who is feeling the child's skin.

It's a fever when a child's temperature is at or above one of these levels:

· rectal (in the bottom), tympanic (in the ear), or temporal artery (across the forehead): 100.4°F (38°C)

· oral (in the mouth): 100°F (37.8°C)

· Axillary (under the arm): 99°F (37.2°C)

HOW TO TAKE TEMPERATURE Oral temperature – Do not measure the temperature in a child's mouth if they have consumed a hot or cold food or drink in the last 30 minutes.

•Clean the thermometer with cool water and soap. Rinse with water.

•Place the thermometer's tip under the child's tongue toward the back. Ask the child to hold the thermometer with their lips.

•Keep the lips sealed around the thermometer. A glass thermometer requires approximately three minutes, while most digital thermometers need less than one minute. Armpit temperature

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

•Hold the thermometer by holding the child's elbow against the chest for four to five minutes. Ear temperature – Ear thermometers are not as accurate as rectal or oral thermometers. If the child has been outside on a cold day, wait 15 minutes before measuring the ear temperature. Ear tubes and ear infections do not affect the accuracy of an ear temperature.

•To measure temperature accurately in the ear, the caregiver must pull the child's outer ear backward before inserting the thermometer.

•Hold the ear probe in the child's ear for approximately two seconds. Temporal artery temperature – The temporal artery temperature can be taken by a device that is run over the forehead and in front of the ear (contact) or one that takes the temperature without touching your child using an infrared sensor (noncontact). These devices are not as accurate as a rectal or oral temperature but may be used to screen for fever in children older than four.

The child Caregiver should ensure that apart from taking medicines, it is essential to keep the child hydrated. To reduce dehydration caregiver should encourage the child to drink fluids. The child may lose appetite; make the child have light food. Do not make the child eat forcefully. If the child is unwilling or unable to drink fluids for more than a few hours, the caregiver should consult the child’s health provider.

In fever, most children feel tired and achy. Of course, caregivers should encourage their child to rest as much as the child wants. But it is unnecessary to force the child to sleep or rest if they begin to feel better. The child can resume school if the temperature is normal for 24 hours.

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