A Parent's Guide: How to Manage Your Child's Fever at Home

When your child is sick with an infection (caused either by bacteria or virus), it is common for them to have a fever. In most cases, a fever will not hurt a child and will usually go away after 72 hours (3 days). Babies younger than 6 months should see a doctor when they have a fever. Older children can be treated at home as long as they get enough liquids and seem well otherwise. However, they should also see a doctor if their fever lasts for longer than 48 hours.

Common Methods for Taking Your Child’s Temperature

• Rectal method (by the rectum or ‘bum’)
• Oral method (by the mouth)
• Axillary method (under the armpit)
• Tympanic method (in the ear)

The right method depends on your child’s age. It’s important that the measurement is accurate.
For instance, taking a rectal temperature is still the best way to get an exact reading for children younger than 2 years, but most children don’t like to have their temperature taken this way. Although taking a temperature under the armpit isn’t as precise, it may let you know whether your child has a fever.

Guidelines for Temperature-taking

• Do not use a mercury thermometer. If it breaks, you and your child may be exposed to this toxic substance.
• Do not use an oral thermometer to take a rectal temperature or a rectal thermometer for oral temperature taking.
• A digital thermometer can be used for both rectal and oral temperature taking. It is made of unbreakable plastic, is easy to read and measures temperature quickly.
• Ear thermometers are expensive and can be complicated to use.

Age Recommended Techniques

The method used for taking the temperature depends on the child’s age.

Birth to 2 years

• 1st choice: Rectum (for an accurate reading)
• 2nd choice: Armpit

2-5 Years

• 1st choice: Rectum (for an accurate reading)
• 2nd choice: Ear, armpit

5 Years or Older

• 1st choice: Mouth (for an accurate reading)
• 2nd choice: Ear, armpit

Tips for Taking Your Child’s Temperature

To get an accurate reading of your child’s temperature, you’ll need to make sure it’s done right. Here’s how:

Rectum

• Clean the thermometer with cool, soapy water and rinse
• Cover the silver tip with petroleum jelly (such as Vaseline)
• Place your baby on his back with his knees bent
• Gently insert the thermometer in the rectum, about 2.5 cm (1 inch), holding it in place with your fingers
• After about 1 minute, you will hear the ‘beep’
• Remove the thermometer and read the temperature
• Clean the thermometer

Armpit

The armpit (axillary) method is usually used to check for fever in newborn and young children but is not as accurate as a rectal temperature. If an axillary temperature does not identify a fever but your child feels warm and seems unwell, confirm the temperature with a rectal measurement.

• Use a rectal or oral thermometer
• Clean the thermometer with cool, soapy water and rinse
• Place the tip of the thermometer in the centre of the armpit
• Make sure your child’s arm is tucked snugly against her body
• Leave the thermometer in place for about 1 minute, until you hear the ‘beep’
• Remove the thermometer and read the temperature
• Clean the thermometer

Mouth

• The mouth (oral) method is not recommended for children younger than 5 years because it is hard for them to hold the thermometer still under their tongue long enough to take a reading

• Clean the thermometer with cool, soapy water and rinse
• Carefully place the tip of the thermometer under your child’s tongue
• With your child’s mouth closed, leave the thermometer in place for about 1 minute, until you hear the ‘beep’
• Remove the thermometer and read the temperature
• Clean the thermometer

Ear

• Though easy and quick to use, the ear (tympanic) method can produce temperature readings that are too low, even when manufacturer’s directions are followed. It is not considered to be as reliable or accurate as rectal temperature taking
• Use a clean probe tip each time and follow the manufacturer’s instructions carefully
• Gently tug on the ear, pulling it back. This will help straighten the ear canal and make a clear path inside the ear to the eardrum
• Gently insert the thermometer until the ear canal is fully sealed off
• Squeeze and hold down the button for 1 second
• Remove the thermometer and read the temperature

Normal temperature Ranges

What Should I do if my Child Has a Fever?

The degree (or height) of a fever does not tell you how serious your child’s illness is. How a child acts is usually a better sign. A child with a mild infection can have a high fever, while a child with a severe infection may have no fever at all. Keep your child comfortable and offer plenty of fluids.

If your baby has a fever, remove extra blankets and clothing so heat can leave her body and help lower the body temperature, but don’t take off all of your child’s clothes because she may become too cold and start shivering, which produces more body heat, causing the temperature to rise again. Sponging your child with tepid (lukewarm) water, alcohol baths, and rubs are not recommended.

Medication is not always needed to reduce a child’s temperature. In fact, the best reason for giving your child medicine is not to reduce the fever but to relieve associated aches and pains.

Paracetamol (such as crocin, calpol, etc and others) is the best medication for a fever. Unless your physician says otherwise, parents can give the dose recommended on the package every 4 hours until the child’s temperature comes down. The temperature usually comes down in 1.5 to 2 hours and then rises again, in which case the medication may have to be repeated. It is important not to exceed 5 doses in 24 hours.

You can also use ibuprofen, which is found in products such as ibugesic. Be sure to follow the directions on the package. Ibuprofen can be given every 6 to 8 hours, up to 4 times in a 24-hour period. Ensure that you do not exceed the recommended dose.

Warning: Do not give acetaminophen and ibuprofen at the same time.

When to Seek Help

While fever may not cause damage, it can be a cause of concern if your child,

• Has a fever higher than 39°C
• Has a fever and is younger than 6 months
• Has a fever for longer than 48 hours
• Is excessively cranky, fussy or irritable
• Is excessively sleepy, lethargic or does not respond
• Is persistently wheezing or coughing
• Has a fever and a rash or any other signs of illness that worry you

This information should not be used as a substitute for the medical care and advice of your pediatrician.