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Fever and Temperature Measurement in Children

General Information:

Fever is an abnormal elevation of body temperature that occurs as part of a specific biologic response. The temperature elevation that is considered “abnormal” depends upon the age of the child and the site of measurement. The temperature elevation that may prompt clinical investigation for infection depends upon the age of the child and the clinical circumstances.

Measurement method Normal temperature range
Rectal 36.6°C to 38°C (97.9°F to 100.4°F)
Ear 35.8°C to 38°C (96.4°F to 100.4°F)
Oral 35.5°C to 37.5°C (95.9°F to 99.5°F)


Age Recommended Technique
Birth to 2 years
  1. Rectal (definitive)
Over 2 years to 5 years
  1. Rectal
  2. Tympanic
Older than 5 years
  1. Oral
  2. Tympanic
  3. Axillary

How to measure the temperature from different areas of the body

  • Wash your hand before and after the procedure.
  • Clean the thermometer with alcohol before and after use.

Rectal Temperaturerectal

  • The child or infant should lie down on his or her stomach across an adult’s lap.
  • Apply a small amount of petroleum jelly (eg, Vaseline) to the end of the thermometer.
  • Gently insert the thermometer into the child’s anus until the silver tip of the thermometer is not visible (1/4 to 1/2 inch inside the anus)
  • Hold the thermometer in place. Digital thermometers need less than one minute or until it alarms.

Oral Temperature

  • Do not measure the temperature in a child’s mouth if he or she has consumed a hot or cold food or drink in the last 30 minutes.
  • Clean the thermometer with cool water and soap. Rinse with water.
  • Place the tip of the thermometer under the child’s tongue toward the back. Ask the child to hold the thermometer with his or her lips.
  • Keep the lips sealed around the thermometer. Digital thermometers need less than one minute.

Axillary or Armpit Temperature

  • Place the tip of the thermometer in the child’s dry armpit.
  • Hold the thermometer in place by holding the child’s elbow against the chest for four to five minutes.

Ear Temperatureear

Ear thermometers are not as accurate as rectal or oral thermometers. If the child has been outside on a cold day, wait 15 minutes before measuring the ear temperature. Ear tubes and ear infections do not affect the accuracy of an ear temperature.

  • To measure temperature accurately in the ear, the parent must pull the child’s outer ear backward before inserting the thermometer
  • Hold the ear probe in the child’s ear for about two seconds.

Changes in Body Temperature


Management of Fever

  • Drink a lot of fluid. Call or see the doctor if your child won’t or can’t drink fluids for more than a few hours.
  • Bed Rest
  • Give sponge baths using plain water then dry immediately with towel
  • Paracetamol or Ibuprofen can help lower the temperature
  • If you do not know how best to handle your child’s fever, see a doctor


RPH 20102016