How to take an AB's Temperature
There are five ways to take a temperature from a baby. In order of accuracy,(from worst to best) they are;
1.) axial (underarm measurement with a standard oral mercury thermometer),
2.) forehead (using a self-adhesive strip with a temperature-sensitive liquid crystal display [LCD}),
3.) oral (mouth measurement using a pacifier with a similar LCD),
4.) aural ( ear measurement using an electronic infrared sensing thermometer)
5.) rectal (anal measurement using a rectal mercury thermometer).
Every adult, including some older babies, agree that a rectal measurement causes the most psychological and physical discomfort. Therefore I shall address the last and most accurate method. In small babies, their crying usually stems from either positioning problems of the baby and/or the rectal thermometer or a medical problem like diarrhea which has made the area ultra-sensitive. As babies grow to twenty-four months and larger, they develop a sense of self and may feel that a rectal measurement invades their most private area causing psychological discomfort.
The Prime Rule: A Rectal Thermometer Must be Well-Lubricated and Inserted Correctly! The baby's mother should pre-inspect the insertion site of the thermometer, then well lubricate the rectal thermometer with either a grob of Nursery Vaseline (r) or KY-Jelly(r) before insertion. After the insertion, the mother must maintain position (90 degrees from the plane of the baby's rectum) of the stem of the thermometer and keep the baby under control until the thermometer is fully withdrawn.
The two best positions for taking a rectal temperature on a baby are:
a.) to place the baby over your lap with an uncovered bottom, preferably with the mother wearing shorts so there is direct skin-to-skin contact between the mother's legs and the baby's tummy and hips to reassure the baby (this reassurance is amplified by the touch of the mother's fingers and palm on the baby's bottom as she holds the thermometer secure between her third and fourth fingers, or
b.) b.) to lift the baby's legs while she is lying on her back and insert the thermometer while the baby lays naked on the crib or changing table (the restraining strap on the changing table can help mommy take a temperature by preventing wriggling). This method allows the mother to look into her baby face and reassure her with maternal coos with soft, soothing tones whilst the temperature is being taken. While the thermometer may be grasped between the thumb and forefinger, it is recommended that the mother secure the thermometer between the third and fourth fingers to allow contact of her fingers and palm to reassure the baby as above. Note: If the baby wriggles or otherwise threatens to loosen the mother's grip on the thermometer, than a thumb-forefinger grip on the thermometer should be used.
In every case, a baby should be calmed before the temperature is taken. The more skin-to skin contact there is immediately before the baby's temp is taken the better. The baby should be massaged (See the Baby Massage Section on this site.) and/or the baby's favorite lullaby cam be played (or sung) before the temperature is taken. If the baby takes a pacifier it should be used to calm the baby as well. Don't give the baby her bottle of formula to comfort her before you take her temperature, otherwise, the combined feelings of a full stomach and the anal stimulation will insure that you'll have a mess on your hands (and everywhere else)! Baby boys will produce a double mess as they squirt from the front and erupt from behind!
Don't let an older baby see the thermometer unless it's unavoidable. If possible, place the baby in position for the measurement before the massage is given. Talk to her in soft, soothing tones as you massage her limbs, back and bottom.
Note: In some babies that are over 100 lbs., there is a very real danger that the thermometer might be completely "sucked" into the baby's rectum by involuntary movements of the anal sphincter if the mother does not retain firm control of the thermometer stem. Extraction of the thermometer will require emergency and traumatic surgical extraction of the thermometer in an Emergency Room. Also, babies of this size can easily break the thermometer if they are prone to wriggle. With babies this large, I recommended that a 5" (veterinary) thermometer rather than the 3" rectal thermometer be used for the baby's safety because the stem is twice as thick.
While no one manufactures a human rectal thermometer larger than three inches, medical manufacturers who make veterinary equipment make a standard five inch long rectal thermometer that's every bit as accurate, marked the same way, but is nearly double the diameter of a three-inch human mercury thermometer.
Local PetsMarts carry the standard veterinary Cornell Thermometer, Veterinary 5", Ring top thermometer for large animals for $5.90 plus tax (look in the Equine medical supplies section), while the Veterinary supply company found at (http://www.empirenet.com/~calvet/catalog.html) sells the same thermometer for $3.22 plus shipping.
Don't worry your little head about there being any real differences between a veterinary thermometer and a human thermometer. While the upper range on a veterinary thermometer is 110 degrees Fahrenheit rather than the usual 106 degrees, the accuracy is the same. In some ways, it's safer to use a veterinary thermometer than a human one; because the shaft is almost twice as thick, there is less chance of it being accidentally "snapped" or broken while a temperature is being taken.