What’s fever and what isn’t?

Taking the temperature is a bugaboo to many mothers. They find a thermometer hard to read. They are confused by the difference between mouth and rectal temperature’s.
it might be easier for you to get someone else to show you how to read one, but here goes. Most thermometers are engraved the same. They have a long mark for each degree and a short mark for each fifth of a degree. Only the even degrees-94, 96, 98, 100, 102, 104—are numbered on the thermometer, be-cause of lack of space. There is an arrow point-ing to the “normal” mark, 98%. Many thermometers are marked in red above the normal point.
The first thing to realize is that a healthy child’s body temperature doesn’t stay fixed at 98%. it is always going up and down a little, depending on Âe time of day and what the child is doing. It’s usually lowest in the early morning and highest in the late afternoon. This change during the day: is only a slight one, however. The change beteen rest and activity is   greater.   The   temperature   of  a   perfectly healthy   small   child   may   be   99%   or   even 100° right after he has been running around. (On the other hand, a temperature of 101° probably means illness whether the child has been exercising or not.) The older child’s temperature is less affected by activity. Ali this means that if you want to know whether your child has a slight fever due to illness, you must take his temperature after he has been really quiet for an hour or more.

in most feverish illnesses the temperature is apt to be highest in the late aftemoon and lowest in the moming. But there is nothing to be surprised at if a fever is high in the morn- >_ ing and low in the aftemoon. There are a few diseases in vhicfc the fever, instead of climbing and fall-ing, stays high steadily. The commonest of these are pneu-monia and roseola infantum. A below-normal temperature (as low as 97°) sometimes occurs at the end of an illness, and also in healthy babies and small children on winter nights. This is no cause for concem so long as the child is feeling well.
Now about the difference between mouth and rectal tem-peratures. Every part of the body has a different temperature. The trıınk is varmest, because it is thick throughout and pro-tected by clothing. A child’s temperature is taken by rectum until about the age of 5 or 6, because he can’t keep a thermometer under his tongue and because he might bite it. The rectal temperature is a little higher than the mouth temperature, but it’s usually not a full degree higher. It’s nearer half a degree.

The thermometer

The only difference between a mouth and a rectal thermometer is in the shape of dıe bulb. The bulb of the rectal thermometer is round so that it won’t be so sharp. A mouth thermometer has a long slender bulb so that the mercury can be warmed more quickly by the mouth. The markings on the two thermometers are exactly the same and mean the same thing. (in other words, they are not marked differently to allow for the difference of temperature between the mouth and rectum.) You can use a clean rectal thermometer perfectly well in the mouth, and a mouth thermometer in the rectum, if inserted gently.

Most thermometers register well enough in a minute in the rectum. If you watch a thermometer sometime when it is in a baby’s rectum, you can see that it goes up very rapidly at first. it gets within a degree of where it is going to stop in the first 20 seconds. After that it barely creeps up. This means that if you are nervous taking the temperature of a struggling baby. you can take the thermometer out in less than a minute and have a rough idea what the temperature is.
it takes longer to register the correct temperature in the mouth—154 to 2 minutes. This is because it takes the mouth a whle to warm up after being open and because the bulb is partly surrounded by air.

Taking the temperature.

Before taking a temperature. shake the thermometer down. You hold the upper end of the thermometer (the opposite end from the bulb) firmly between your thumb and finger. Now shake the thermometer vigorously, with a sharp, snapping motion. You want to drive the mer-cury down at least as far as 97″. If it doesn’t go down, you aren’t snapping hard enough. Until you get the hang of it, shake the thermometer over a bed or couch. Then if it slips out of your hand, it won’t be broken. The bathroom is the worst place of ali to shake a thermometer because of the hard surfaces.
İf you are taking a rectal temperature, dip the bulb of the thermometer into petroleum jelly or cold cream. The best po-sition for a baby is on his stomach across your knees. He can’t squirm out of this position very easily, and his legs hang down out of the way. Insert the thermometer gently into his rectum. Push it in with a light touch, letting the thermometer find its own direction. If you hold it stifHy, it may poke him inside. once the thej-mometer is in, it is better to shift your grip off the end of” the thermometer, because if the baby struggles, the twisting might hurt him. Instead, lay the palm of your hand across his buttocks, lightly holding the thermometer behveen two of the fingers, the way you’d hold a cigarette.
You can also take the temperature easily, especially when the child is old enough to he stili, with him lying on his side on a bed widı his knees drawn up a httle. it is harder to find the rectum when a child is lying flat on his stomach. The worst position is with the child lying on his back. it is hard to get to his rectum, and his feet are in position to kick your hand accidentally or on purpose.
Reading the thermometer is very easy, once you get the knack. Most thermometers are somewhat triangular in shape, with one edge sharper than the rest. This sharp edge should point toward you. in this position the marks of the degrees are above and the numbers are below. Between them is the space in which the mercury shows. Roll the thermometer very slightly until you see the band of mercury. Don’t vrorry too
much over the fractions of degrees. it makes little difference if the temperature is 99% or 99%°. What the doctor will be interested in is about what the temperature is. When you report the temperature to the doctor teli him what the thermometer actuaily says, and then add “by moutlı” or “by rectum.” I say this because sometimes a mother who has the mis-taken idea that the mouth temperature is the only correct one takes a temperature by rectum and then telis the doctor what she figures the mouth temperature would be. Usually the best times to take the temperature are in the first part of the mom-ing and late in the afternoon.
The next question is how many days to go on taking the temperature. Here is what happens occasionally. A child has a bad cold with fever. The doctor visits regularly and has tlıe mother take the temperature twice a day. Finally the fever is gone, the child is convaleseing welL has only a mild cough and mnning nose. The doctor finds everydıing satisfactory at his last examination, telis tbe mother to let the child outdoors as soon as the cold is gone completely. Two weeks later the mother telephones to say that she and the child are getting desperate staying indoors, that running nose and cough have been completely gone for ten days, that the child looks wonderful and eats well, but that the “fever” is stili going to 99.6° each afternoon. As I explained earlier, this is not neces-sarily a fever in an active child. The ten days of staying indoors and of worrying over the temperature have ali been a waste and a mistake. When the temperature has stayed under 101° for a couple of days, it’s a good general rule to forget about the thermometer unless the doctor asks you to continue or unless the child seems sicker in any way. Don’t get in the habit of taking a child’s temperature when he is well.

Emergency treatment of high fever.

Between the ages of 1 and 5 years, children may develop fever as high as 104° (sometimes even higher) at the onset of mild infections, such as colds, sore Uıroats, grippe, just as often as with serious infections. On the odıer hand, a dangerous illness may never have a temperature higher than 101°. So don’t be influenced too much, one way or the other, by the height of the fever, but get in touch With the doctor whenever your child appears sick in any way.
If c- the first day of an illness a child’s temperature is 104° or higher, and if it will be an hour or more before you can speak to doctor, even on the telephone, it’s wise, as an emergency measure, to bring the fever down a little with a wet rub and aspirin—1 tablet of “baby” aspirin ( grains) under a year; 2 baby tablets (2 grains) between 1 and 5 years. (Be sure to keep aspirin out of your child’s reach.)
The purpose of the wet rub is to bring the blood to the surface by rubbing and to cool it by the evaporation of the water off the skin. (Alcohol has traditionally been used in a wet rub, but if it is applied very freely in a small room, too much may be inhaled. Anyway, water is just as good even if it doesn’t smell so important.)
Undress the child and cover him with only a sheet or light. blanket. Wet your hand in a haşin of water. Expose one of his arms and rub it gently for a couple of minutes, wetting it agahı any time it becomes too dry. Theıı put it back under the sheet. Proceed, in turn, to the other arm, each leg, the ehest, dıe back. Take ‘the temperature again in half an hour, and if it isn’t under 104° give another rub. You prefer to keep the temperature under 104° uııtil the doctor coitifs because a small child who develops a sudden high fever the first day of an illness may become trembly or even ha ve a convulsion (see Section 700). When a child’s fever is very high and he is flushed, use only light covers at ordinary room temperature, perhaps as little as a sheet. You can’t get his temperature down very well if he’s heavily covered. Naturally, if he feels chilly, he needs more covers.
Many parents assume that the fever itself is bad and want to give medicine to bring it way down, no matter what degree it is. But it’s well to remember that the fever is not the disease. The fever is one of the methods the body uses to help over-come the infection. it is also a help in keeping track of how the illness is progressing. in one case the doctor wants to bring the fever down because it is interfering with the child’s sleep or exhausting him. in another case he is quite Willing to leave the fever alone, and concentrate on curing the infection.