As we head into cold and flu season I thought I would take a moment to discuss fever and assessment of fever in children. Whether you are a new parent to a newborn or a parent with school age children required to check daily temperatures prior to heading off to school for COVID screening, there can be a lot of questions on what is considered fever and what is the best way to check a child’s temperature.

First off, let’s talk fever. As you have heard “normal” body temperature is 98.6 degrees F (37 degrees C). This number is an average. Some individuals run higher and some lower for their “normal” temperature ranging from 97-100.3. Fever is considered a temperature of 100.4 degrees F or higher.

Now, let’s talk accurate measurement of temperature. There are several thermometers on the market today. The American Academy of Pediatrics (AAP) recommends use of a rectal thermometer in infants under 3 months of age. Children 3 months of age to 3 years of age the recommendation is rectal, axillary (underarm) or tympanic (in ear) for the most accurate reading.

Here is a guide based on age:

AGE	TYPE
Under 3 months	Rectal
3 months to 3 years	Rectal, axillary, tympanic
4 to 5 years	Rectal, oral, axillary, tympanic
5 years to adult	Oral, axillary tympanic

Other methods are available for taking temperatures, however at this time they are not recommended by the AAP to check your child’s temperature. The temporal (forehead) thermometer is an option on the market that is increasing in popularity, however, there have not been enough studies done to recommend this as a reliable method. It can be used as a screening tool though.

Finally, let’s talk when to be concerned. You have heard that fever is the body’s normal reaction to an illness and a good sign that it is fighting. However, fever can also be concerning and rather uncomfortable, accompanied by sweating, chills, flushed skin, headache, body aches, fatigue, loss of appetite, increased heart rate and dehydration. Fever concerns can also be age dependent. Fever in a newborn under 3 months of age is cause for concern and should be evaluated promptly. Fever at any age for more than 3 straight days or with symptoms of vomiting, headache, chest pain, stiff neck, rash or swelling of the throat or recent exposure to COVID warrants a call to our office for more prompt evaluation.

Hopefully this helps as we approach cold and flu season during a pandemic. Be healthy and stay safe!