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Daycare Center and Family Home Forum>What Rectal Temperature Do You Send Home?
Lilbutterflie 07:17 AM 12-05-2011
I would like to know what rectal temperature do you send a child home for? I only take rectal temperatures on babies under 12 months.

My 5 mo daycare girl has a runny nose (clear), a rash on her face, and now a rectal temp of 100. My contract says I can exclude at a fever of 100 or higher (not specific of how temp is taken) but I am pretty sure her mom is going to question it b/c it's a rectal temp.
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SilverSabre25 07:20 AM 12-05-2011
I *think* that rectal is 1 degree higher , so translating for "usual" temps, it would be 99.

may I ask why rectal? I use an underarm thermometer for everyone...on babies I just "snuggle" them, trapping the thermometer where it belongs. They rarely mind.
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youretooloud 07:29 AM 12-05-2011
I've never done a rectal temp. I do it under the arm.

I don't exclude unless the child is visibly sick, and can't manage a normal day. Even with a low temp, I don't exclude.
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Unregistered 07:32 AM 12-05-2011
As a parent, I'd be extremely upset if I found out my daycare provider was taking my child's temperature rectally. When we attended baby care class before our daughter was born, the nurse told us not to even attempt to take a rectal temp, because it could result in serious injury. I don't do it, and I do not want anyone else doing it, either. Why not just take it under the arm, as the previous poster suggested, or buy a thermometer that works in the ear or on the forehead?
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Lilbutterflie 07:44 AM 12-05-2011
Originally Posted by SilverSabre25:
I *think* that rectal is 1 degree higher , so translating for "usual" temps, it would be 99.

may I ask why rectal? I use an underarm thermometer for everyone...on babies I just "snuggle" them, trapping the thermometer where it belongs. They rarely mind.
I know that so many of you use underarm, but I have never found underarm to be accurate. I can take it 3 times with the same thermometer and it will turn out different. A background story on this: I once took my daughter to urgent care (after hours) for a fever (at home it was 101.4) and super sore throat. The nurse took her underarm temp and it said 98.4. She looked at me like I was crazy since I told her at home her temp was 101.4 (taken with an ear thermometer). I told her to just touch my daughter to feel how warm she was! Then the nurse took it under the tongue, and the temp was 101.6. Turns out she had strep throat. I just do not trust underarm in my experience. And honestly, the babies never seem to mind rectal at all. It takes the temp much quicker than underarm, and they never really know the thermometer is in.
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Lilbutterflie 07:59 AM 12-05-2011
Originally Posted by Unregistered:
As a parent, I'd be extremely upset if I found out my daycare provider was taking my child's temperature rectally. When we attended baby care class before our daughter was born, the nurse told us not to even attempt to take a rectal temp, because it could result in serious injury. I don't do it, and I do not want anyone else doing it, either. Why not just take it under the arm, as the previous poster suggested, or buy a thermometer that works in the ear or on the forehead?
Digital rectal thermometers now have a line about half an inch from the tip that show you where to stop. There is no risk of injury at all as long as it is used correctly. I've taken enough infant temperatures to be very quick and efficient without any risk to the baby.

When did taking a rectal temperature become so frowned upon? It is absolutely the most accurate way of taking a baby's temperature. Underarm is not always accurate as you have a constantly moving infant to contend with, ear thermometers are not accurate at all on tiny little ear canals, and forehead thermometers (unless you have a hospital grade that costs $100+) are extremely inaccurate.

I do appreciate your opinion, but I really didn't post this to start a debate about how to take a baby's temperature, I would just like to hear from those who do take a rectal temperature, at what temp they send a child home.
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youretooloud 08:02 AM 12-05-2011
Originally Posted by Lilbutterflie:
When did taking a rectal temperature become so frowned upon? It is absolutely the most accurate way of taking a baby's temperature. .

It probably is, but I don't really care about accuracy. If I can feel that there's a temp just by touch and looking at the child, that's enough for me.

Again.... I just don't send them home very often. I'd rather keep them unless they are miserable. I'll call the parents and tell them, then let them make the call to go to the doctor or not.
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MarinaVanessa 08:05 AM 12-05-2011
I don't use rectal either, I use underarm or on the forehead also.

But what I did want to touch on here was the rash. Any form of undiagnosed rash here and they go home and must see a doctor, no matter what, fever or no fever. My son just recently got a small rash on his hands near his wrists and on his knees that looked just like it does when he plays in fresh cut grass (he has some type of reaction). I thought it was strange because the grass wasn't THAT freshly cut so I separated him from the rest of the DC kids just in case.

We asked about it at his 1st year wellness checkup the next day and he had hand foot and mouth Wouldn't ya know it, that night he got the blisters on his hands. He had NO fever, NO sores in his mouth, NO sore throat or any other symptom. Just the small rash on his palms and knees and 3 or 4 blisters on his palms. Be careful with that. I'd send home if you don't know what the rash is.
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Lilbutterflie 08:23 AM 12-05-2011
Originally Posted by MarinaVanessa:

But what I did want to touch on here was the rash. Any form of undiagnosed rash here and they go home and must see a doctor, no matter what, fever or no fever. My son just recently got a small rash on his hands near his wrists and on his knees that looked just like it does when he plays in fresh cut grass (he has some type of reaction). I thought it was strange because the grass wasn't THAT freshly cut so I separated him from the rest of the DC kids just in case.

We asked about it at his 1st year wellness checkup the next day and he had hand foot and mouth Wouldn't ya know it, that night he got the blisters on his hands. He had NO fever, NO sores in his mouth, NO sore throat or any other symptom. Just the small rash on his palms and knees and 3 or 4 blisters on his palms. Be careful with that. I'd send home if you don't know what the rash is.
Yes, I agree about the rash. That alone according to my contract is enough to send home. She was diagnosed with croup a week and a half ago, so I wonder if it's an after affect of the virus. It almost looks like baby acne, it's on her cheeks and forehead; but she is almost 6 months old and hasn't had baby acne for 3 months. She didn't have it on Friday when she left here. Her mom dropped off right before morning nap, so she is sleeping right now. If I still see a rash on her face when she wakes up, I'll make the call.
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MarinaVanessa 08:57 AM 12-05-2011
Originally Posted by Lilbutterflie:
Yes, I agree about the rash. That alone according to my contract is enough to send home. She was diagnosed with croup a week and a half ago, so I wonder if it's an after affect of the virus. It almost looks like baby acne, it's on her cheeks and forehead; but she is almost 6 months old and hasn't had baby acne for 3 months. She didn't have it on Friday when she left here. Her mom dropped off right before morning nap, so she is sleeping right now. If I still see a rash on her face when she wakes up, I'll make the call.
Good call. I just wanted to add that in my sons case his rash was only 5 or six pink dots (almost like tiny insect or gnat bites) on each hand and about 10 or so of the same on his knees. They weren't bad or anything or even dark and I almost missed them when I changed him. The blisters appeared the next day after seeing the doctor. I wouldn've never guessed that's what it was but I'm the paranoid type and now I'm glad because it paid off.

None of the other kids managed to get it but it threw me for a loop. I treated my own son like a DC kid and my hubby came home and stayed for a week so we could keep him quarantined upstairs. Hopefully in your case it's nothing
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Tags:fever - policy, rectal temperature, sick policy
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