Dear "concerned" friend:
Thank you for your question.
It's clear from the available evidence that temperatures taken rectally
are the most accurate. The most accurate temperature is rectal. An axillary
temp (one taken under the arm pit) is an approximation, at best, since it
is rarely done properly. In most instances, it may be of limited value to
know the exact measurement of your child's temperature when you are evaluating
their medical needs. Temperature is just one of many factors used in the
management of common childhood illness. Other factors, such as irritability,
pain, playfulness, appetite and rashes may in fact be either just as important
or more so in making a decision on how to proceed. There is no magic temperature
that can be used as a criteria by itself for deciding whether a child's illness
is serious or life threatening except in very small infants.
Because of all of these variables in the management of childhood illness,
there are many different philosophies as to how temperature should be measured.
In my own practice, In most physician's offices where temperature is taken,
temperature is screened with a digital thermometer in the armpit or an ear
probe thermometer. Then the child is evaluated for alertness, misery and
fluid intake before making a decision about future action. An exception to
this rule is in infants less than 3 months of age. In these children, it
is important to know the exact degree of fever and parents should consult
medical help for temperature greater than 100.5 degrees rectally.
In a one year old child with a fever who does not appear ill otherwise,
we would actually suggest not taking the temperature automatically. Treat
with anti-pyretics (fever reducing medication) in those children who appear
miserable for symptomatic relief.
Over the years most pediatricians have learned that the Mom thermometer
(her hand) is more accurate than any thermometer. Again, what is most important
is not the degree of fever but your child's appearance, appetite, alertness,
and playfulness. If after giving your child medication they are still very
lethargic, for example, their pediatrician should be consulted, no matter
what the thermometer says!!
Different doctors may take different approaches, and you may want
to discuss this matter with your physician the next time your child is
For more information, see
Feverish - Keep your Cool" and
Often a Friend - Not a Foe" on our site.