Menu

Fever: If You Feel It, It's Probably There

May 16, 2001 -- When their child is sick, many parents don't immediately reach for a thermometer. Instead, more than half use their hand to feel some part of their child's body to determine whether or not they have a fever.

Just about every mom or dad has their own method for detecting fever -- whether using the back of the hand to touch the forehead or the fingertips to touch the neck -- but no studies have looked at which method, if any, is the most accurate. Until now.

Touching a child's forehead or neck with the back of the hand detected all fevers greater than 102°F and nearly all temperatures above 101°F, says Philip O. Ozuah, MD, an associate professor of clinical pediatrics at Albert Einstein College of Medicine and Children's Hospital at Montefiore, both in New York City.

Ozuah presented his study findings at the recent Pediatric Academic Societies' annual meeting in Baltimore.

These findings suggest that if a child feels warm to the touch on the forehead or neck, the parent can respond to that as they would if a thermometer had been used to take the child's temperature.

"Don't dismiss the fact that they feel warm," he tells WebMD. "If your child feels warm, do what you would ordinarily do," he says.

Still, Ozuah says, "If you have a thermometer and know how to use it, use it."

Overall, the study of more than 800 children found that using the back of the hand was more sensitive than using the front of the hand in detecting fever. For temperatures greater than 100.4°F, the forehead and neck were the most sensitive locations to measure for fever.

Though 98.6°F is considered the normal core body temperature, this value varies between individuals and throughout the day. Body temperature, especially in children, is normally raised by physical activity, strong emotion, eating, heavy clothing, elevated room temperature, and elevated humidity. A rectal temperature up to 100.4°F may be entirely normal, but a rectal temperature of 100.5°F or above should be considered a fever.

"I don't want to discredit the back of hand on forehead, but my experience is that a child's head or neck is usually sweaty from playing," says Paula Elbirt, MD, a pediatrician in New York City and the president of DrPaula.com, an online pediatric resource.

In fact, there is too much emphasis on fever, says Elbirt, who was not involved with the study. A fever is a just sign that a child is fighting off an infection somewhere in his or her body, she says

"We are fever phobic, and we have to diminish fever phobia among parents," she says. "We overreact to fever in children.

And sometimes we under-react if a fever is not present. "A sick child is sick," she says. "It doesn't matter if they have a fever or not."

That said, the best and most accurate way to detect a fever is to use a rectal thermometer, she says. "It takes just 30 seconds, [but] I am not advocating a rectal thermo every time they go 'boo.'"

Erica Rader knows when her 1-year-old son, Bryce, is sick by his behavior. "He acts lethargic and crankier than usual. Then I may take his temperature rectally," she says.

"I don't really judge for fever by hand because it's not accurate," she says. "He tends to get warm when he is running around, so if he feels hot to the touch I don't assume he is running a fever.

"You have to have your method," she says.

Other signs that may indicate fever include decreased appetitive, wheezing and/or vomiting.