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Mandi Franklin, CPNP

Which Thermometer is Best for my Family



The thermometer market is HOT (pun intended), but can be very confusing as a parent!


There are so many different kinds and they can vary drastically in price!


So… What works? What doesn’t? Are they all the same? Does it even really matter?!


Check out my list below on the various thermometers on the market and what is best for your household:

Digital Thermometers

  • These thermometers are cheap, reliable, and good to have in your medicine cabinet

  • Digital thermometers can be used in many ways: orally (in the mouth), axillary (in the armpit), or rectally (in the bottom)

  • Rectal temperatures are the most accurate and is the preferred method from birth to 3 years of age

  • You can attempt taking your child's temperature orally once he or she is over 4 years of age, or able to sit with the thermometer underneath the tongue for a reading

  • Axillary (in the armpit) temperatures are not as accurate as the above methods, but if your child is sleeping, wiggling, or you are unable to get an oral or rectal temperature, this is always an option


Tympanic Thermometers (ear)

  • These thermometers are super convenient and fast but are not as accurate as digital thermometers

  • There are many factors that can affect the accuracy: ear wax, recent water exposure (bath, swimming), size of the ear canal, and placement of the thermometer in the ear

  • Tympanic thermometers should not be used under the age of 6 months (due to the size of their itty bitty ear can


Temporal Thermometers (forehead)

  • These are non-invasive and work by using an infrared scanner over the temporal artery (across the forehead)

  • Temporal thermometers are also easy and give you a quick reading

  • They allow you to get a temperature on your child without disturbing them too much

  • They are known to be more accurate than tympanic readings and axillary thermometers


Mercury, Forehead Strips, Pacifier Thermometers…Just no!

  • Mercury thermometers can be toxic and for this reason have been banned in many states

  • Forehead strips and pacifier thermometers- these just do not work well and can be pricy! Don't waste your money


Feel test

  • I have heard some variation of the following many times: "Hmmm... she felt like she was probably around 103°F." I will be the first to admit that parents DO have superpowers. However, estimating temperatures with the back of your hand or lips is not an accurate way to tell if your child has fever


Other Points

  • Please label your thermometers (rectal vs. oral)

  • Clean thermometers before and after using them with rubbing alcohol or soap and water

  • Don't take an oral temperature if your child has recently had anything to eat or drink. I always recommend waiting at least 20 minutes. (Also- don't leave them unattended with the thermometer- I MIGHT be guilty of holding the thermometer up to a light bulb as a high schooler to stay home from school "sick.") Kidding. Sort of.

  • When you tell a provider your child's temperature also include the method used (rectally, orally, axillary etc.)

  • A temperature of 100.4°F or higher (rectally) in a child 3 months or younger is considered a fever and is concerning- he or she should be evaluated immediately

  • I typically recommend having your child evaluated if the fever is lasting more than 4-5 days. With that being said, fevers can last >5-7 days with many viruses

  • If your child's temperature is high (>103°F) and is not going down with the usage of acetaminophen or ibuprofen OR lasting more than 2-3 days, contact his or her medical provider for an appointment. **Keep in mind that that Ibuprofen should only be used for children OVER 6 months of age. Contact your office for dosages. Better yet, ask for dosages based on his or her weight at every well visit

  • On most occasions I do not recommend alternating acetaminophen and ibuprofen due to the risk of dosage confusion, double dosing etc. As a sleep deprived caregiver, those bottles can look practically identical at 4 a.m., leading to a potentially dangerous double dosage of a medication. If it is recommended by your child's provider to alternate them, please be sure to keep an accurate log in order to avoid confusion

  • NEVER EVER give aspirin to children under the age of 18

  • WHEN IN DOUBT.... Call your child's primary care provider for an appointment. We love seeing you and your little one. We want to make sure there is nothing else going on. Never feel like you are a bother. An office visit can provide you with peace of mind, a diagnosis, and maybe a lollipop or sticker for your kiddo

  • If your child seems confused, disoriented, lethargic, develops severe abdominal pain, a severe headache, neck stiffness, difficulty breathing, repeated vomiting/diarrhea, new onset rash, is not tolerating fluids/not urinating regularly, or develops any other significant or worsening symptoms call 911 or go right to the emergency room

In conclusion.....

All kids get fevers. Fevers are a way the body is telling you, “hey, something is going on here.”


We don't necessarily want to treat the fever- it is waking up the body's natural defenses to put up a fight! In fact... "Fever plays a physiologic role in response to infection, inhibiting bacterial growth and viral replication, and enhancing the immune response" (Barbi, Marzuillo, Neri, Naviglio, & Krauss, 2017).


It is our job as medical providers to figure out what’s up and the cause of the fever.


In the meantime, treat discomfort. Whether that is with the appropriate dosage of acetaminophen or ibuprofen, or just a soothing back rub and plenty of fluids. We don't want your child cranky or uncomfortable.


If he or she is happy, playful, eating, and drinking, they probably do not need an unnecessary dosage of medication. Talk with his or her medical team if you have concerns, questions, and to discuss when you should treat at home versus bring them in for a visit.


Until next time,

Mandi



Reference

Barbi E., Marzuillo, P, Neri, E., Naviglio, S., & Krauss, B. (2017). Fever in Children: Pearls and Pitfalls. Children. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5615271/




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