Healthy baby temperature not constant
Donya Betancourt, Pediatrician, Bali, drdonya@hotmail.com
Parents must get confused at times over their children's body temperature. The fact is, a healthy child's body temperature does not stay fixed at 37 degrees Celsius or 98.6 degrees Fahrenheit.
It is always going up and down a little, depending on the time of day and what the child is doing.
The temperature is usually lowest in the early morning and highest in the late afternoon. Right after running, the temperature of a perfectly healthy small child could be 37.5 C (99.6 F) or even 37.8 C (100 F) but a temperature of 38.5 C (101 F) probably means illness; whether the child has been exercising or not.
The body temperature of an older child is less affected by activity. It is best to take the child's temperature only after they have been really quiet for an hour or more. Although a fever technically is any body temperature above the normal of 37 C (98.6 F), in practice a person is usually not considered to have a significant fever until the temperature is above 38 C (100.4 F). How high or low the body heat is, is less important than whether the child seems really sick.
A young baby can be quite sick with little or no fever. Above the age of three or four, a high fever often accompanies a mild infection.
A general rule for taking care of any fever is, consult the doctor if the baby has a temperature of 101 F, especially in infants less than three months old.
* Taking your child's temperature
Let's start with the thermometer. There are two different types of thermometers; oral (mouth) and a rectal. The markings on the two thermometers are exactly the same and mean the same thing. The difference in body temperature between mouth, axillary (armpit), tympanic (ear) and rectal is the rectum orifice will yield the highest reading, the mouth reads the lowest and the temperature of the axilla is in the middle.
There is usually less than a one degree difference in body temperature between the rectum and the mouth. Taking the body temperature via the rectum can be done quickly, it usually gets a degree reading in the first twenty seconds. It takes longer to measure the correct temperature through the mouth, which usually takes one and a half to two minutes and up to four minutes to take an accurate armpit (axillary) temperature.
When taking the rectal temperature, the best position for a baby is for it to lie on its stomach across your knees. Insert the thermometer gently into the rectum an inch or less. Push it in with a light touch, letting the thermometer find its own direction. Then lay the palm of your hand across the baby's buttocks, lightly holding the thermometer between two of your fingers.
By the time the child is one year or older, it is psychologically preferable to take the temperature in the armpit (axilla), because a child begins to be aware of its body, its dignity and security.
When taking a thermometer reading via the armpit, place the bulb of the thermometer in an armpit and then hold the child's arm flat against their chest for four minutes. There should be no clothing between the arm and the chest. You can use a rectal or mouth thermometer in the armpit.
After the age of five or six, a child can usually cooperate in keeping the thermometer bulb under their tongue with the lips closed. When you report the temperature to the doctor, tell the doctor what the actual reading of the thermometer was and if it was taken by mouth, axilla, or by the rectum.
You can clean a thermometer by washing it with water and soap. You can rub it with alcohol, but be sure to rinse it with cold water to get rid of alcohol before using it again. Remember in most circumstances, children should be kept home from school until their high temperature has disappeared for at least 24 hours.