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     Parents Change Too
     Crises In The Family
     Health Aspects
     Your Sick Child
     Medicine Chest
     Infectious Diseases
     Other Problems
     Everyday Incidents
     Physical Handicaps


A rise in body temperature (pyrexia) is one of the effects and symptoms of many illnesses, particularly of infections, and is related to the process by which the body copes with the invading disease-causing organisms. Taking the temperature is therefore one of the objective ways of testing whether a child is ill, and the thermometer is a useful item to have in the family medicine chest.

Taking a child’s temperature

A thermometer consists of a glass tube marked in degrees, either in Fahrenheit (F) or Centigrade (C) or both. It contains mercury, a silver liquid, which expands or heating and the height of the column of mercury gives a measure of the body temperature. Before use make sure that the mercury column has returned to below the arrow marking the normal temperature (it does not matter how far below) by shaking it fairly vigorously.

A thermometer is very easy to read. Turn it so that you can read the numbers, then turn it again very slowly until the column of mercury becomes abroad and shiny. Degrees of temperature are divided into parts of a degree so that a more exact reading can be made. The temperature can be taken in a number of places:

The Mouth: The bulb of the thermometer should be placed under the tongue or, slightly less efficiently, between the cheek and gums, and the mouth closed for two minutes. This will be difficult for many young children, especially if their nose is blocked from a cold. Care must be taken that the thermometer is not bitten but, God forbid, if this does happen, do not worry! Give the child some bread to eat, to act as ‘wrapping’ for the glass. The amount of mercury absorbed will be insufficient to cause any serious problems.

Under the arm : Put the bulb of the thermometer right into the armpit (axilla) and hold the arm tightly into the chest wall. Although this is the easiest method, it does not always give an accurate reading as frequently the bulb of the thermometer is not completely covered.

Rectally: This is a reliable method which usually gives a reading one degree higher than by mouth. IT is a very convenient method for children up to two or three years old. A suitable position is to have the child curled up on his bed or lying over your lap. Use a little Vaseline as lubrication on the bulb of the thermometer and insert it about one inch (2.5 cm) into the rectum, steadying it by holding the cheeks of the buttocks together.

The significance of the various temperature levels is:

NORMAL TEMPERATURE 97.50 F to 98.80 F 36.40 C to 37.10C
MILD FEVER 99.00 F to 102.00 F 37.20 C to 38.90 C
MARKED FEVER 102.00 F to 103.50 F 38.90 C to 39.70C
HIGH FEVER Above 103.50 F Above 39.70C

The temperature frequently varies during different times of the day, usually being higher at night.

The temperature is only one indication of a child’s state of health and account needs to be taken of the overall picture. Thus normal children may get very hot at times, especially when they have been overactive or following excessive crying, whereas young babies may be very ill even with a temperature that is below normal. Thus use the thermometer as part of your assessment of the child and if you are worried about his general state of health do not let a normal reading prevent you from seeking medical advice.

A young child has only a rather poorly developed temperature –control mechanism and therefore the temperature will frequently go up and down and may reach quite high levels without the cause necessarily being very serious.

The chief method by which a child regulates its temperature is by direct heat loss from its skin, and it is most important therefore that this is not restricted by the use of excessive clothing. It is widely held belief that that an ill child should be kept warm, quite irrespective of what his temperature might be – one of the few instances when parents’ common sense lets them down. If a child is shivering, it is the result of the body raising its internal temperature; the rapid muscular activity releases stored energy in the form of heat. An important part of an ill child’s management consists of keeping the temperature under control.

Complications of a high fever

  1. Dehydration: A persistent high temperature will make the body lose a lot of fluid through increased sweating and, if this is not replaced , it can result in impaired kidney function and upset of the body chemistry.

  2. Fits (convulsions) A very high temperature (usually, but not always, over 103.50 F, 39.70 C) may cause epileptic – like fits (convulsions) in certain susceptible children usually between the ages of one and three, and hardly ever after the age of five.

Management of fever
The cause of the temperature should be identified wherever possible so that any appropriate specific treatment can be undertaken. Frequently the fever is the only symptom and management consists solely of keeping the child as comfortable as possible and controlling the fever until full recovery is achieved.

Clothing: All excess clothing should be removed, leaving just loose-fitting light garments or pajamas. Take care to avoid the child being in a draught.

Fluids: High fever can cause marked dehydration and extra fluids need to be given.

Diet: ‘Feed a cold and starve a fever’ is a useful maxim, as a feverish child usually has little appetite. When this returns, start with a small quantity of easily digestible and tasty foods.

Medication : Aspirin and paracetamol are very useful means of lowering temperature and may be given every three hours in the appropriate close (see ‘Family Medicine Chest’). If there is a danger of fits, your doctor may prescribe an anticonvulsant as a preventative.

Tepid sponging: If the temperature reaches very high levels (i.e. over 103.50F to 104.00F, 39.70 to 40.00C), sponging can be helpful. All clothes should be removed and the child liberally sponged all over with tepid (not cold) water. The water should not be immediately dried off but allowed to evaporate as it is this which has the main cooling effect.

  • If the temperature rises over 102.00F (38.80C).
  • If there is a persistent temperature for two to three days.
  • If there is a known tendency for fits to occur with fever.
  • If you are worried about the child .
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