Age: 4 Months

Whooping Cough and Flu

Protect your baby from Whooping Cough and Flu!

Whooping cough is a bad bacterial illness easily passed from person to person. Flu is a virus that is also easily passed from person to person.

Whooping cough and flu are life threatening to babies. What can you do about it?

Surround your baby with protection.

  • Tell the people who have contact with your baby to get the whooping cough shot (Tdap) and the flu shot!
  • They can get the shots from their doctor.
  • Or they can call the “BIG SHOTS” program at 512-972-5520.
  • Get the Flu shot every year during flu season.
  • The Tdap shot is for people 11 years old and older.

Choosing the Right Seat for Your Child

REAR FACING CAR SEAT

  • Children under the age of 2 years should ride in an infant-only carrier-type rear facing car seat in the back seat.
  • Convertible car seats can also be used, but the rear facing setting should be used for children under 2 years old and under the maximum requirement for rear facing.

Illustration of a rear facing car seat

FORWARD FACING CAR SEAT

  • Forward-facing car seats are for children between 2-4 years old and 40-80 pounds.
  • Forward-facing car seats should only be used in the back seat.

Illustration of a forward facing car seat

BOOSTER SEAT

  • Booster seats should be used with children after age 4 and over 40 pounds.
  • Booster seats must be used with the adult lap and shoulder belt.
  • Booster seats should only be used in the back seat.

Illustration of a booster seat

SEAT BELT

  • Seat belts can be used after age 10 and your child is 4’9” tall.
  • Lap belts should be positioned low over the hips and tops of thighs.
  • Shoulder belt should cross the center of the shoulder and chest.

Illustration of a seat belt in a car

ALL children younger than age 13 should ride properly restrained in the back seat.

NEVER place a car seat in the front passenger seat.

For additional information and assistance contact EMS Car Safety Checks and Infant Safety Education at 512-972-7233 or www.atcems.org.

For other car seat check option call Dell Children’s Medical Center 512-324-8687 or Safe Riders 1-800-252-8255.

Never leave a child alone in a car!

How to Take Your Child’s Temperature

During the COVID-19 pandemic, parents may need to check their children for symptoms, including fever, before they go to school, child care, or sports activities. Feeling your child’s forehead is quick but not very exact. Most modern digital thermometers work fast and are easy to use.

What type of thermometer is best for my child?

It is best to use a digital thermometer to check your child’s temperature. Do NOT use a mercury thermometer. Thesethin glass devices filled with the silvery metal can break and release toxic levels of mercury fumes. In fact, if you have a mercury thermometer at home, you should remove it.

What is a normal temperature, and what is considered a fever?

A “normal” temperature varies with the child’s age, activity, and time of day. A fever usually is a temperature of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher. This is a sign that the body is fighting an illness. Your child’s temperature, age and other signs of illness will help your doctor recommend treatment that is best for your child.

Call your pediatrician right away if your child:

  • is 2 months old or younger with a rectal temperature of 100.4 degrees Fahrenheit or higher, or if fever rises above 104°F (40°C) repeatedly at any age.
  • looks very ill, is unusually drowsy, or is very fussy.
  • has been in a very hot place, such as an overheated car.
  • has other symptoms, such as a stiff neck, severe headache, severe sore throat, severe ear pain, an unexplained rash, or repeated vomiting or diarrhea.
  • has immune system problems, such as sickle cell disease or cancer, or is taking steroids.
  • has had a seizure.

What are some different types of digital thermometers?

There are different types of digital thermometers that measure temperature at different areas of the body. Rectal (in the anus) temperatures are the most accurate. Forehead temperatures are the next most accurate. Oral and ear temperatures are accurate if done properly. Armpit temperatures are the least accurate, but you can use this method to screen a child of any age.

Whatever approach is used, follow the cleaning instructions on the package before use.

Here are 3 types of digital thermometers:

Digital multi-use thermometer

Digital multi-use thermometer

  • Measures temperature in child’s bottom (rectal), mouth (oral) or armpit (axillary).
  • Oral use is not recommended until a child is age 4 or older.
  • Reads body temperature when the sensor located on the tip of the thermometer touches that part of the body.
  • It’s important to label the thermometer “oral” or “rectal” so it isn’t used in both places.
A no touch thermometer that measures the temporal artery

Temporal artery

  • Measures infrared heat waves coming off the blood vessel that runs across the forehead just below the skin.
  • Can be used for all ages.
  • Temperature is taken on the side and front of the forehead, depending on whether it is a non-contact or “no-touch” model. Check the instructions to find out how close to the forehead and other tips before using.
  • Non-contact models may help reduce the risk of passing germs.
  • Direct sunlight and cold temperatures after being outside may affect reading.
A tympanic thermometer

Tympanic

  • Measures temperature in a child’s ear by reading infrared heat waves from the eardrum.
  • Can be used on children age 6 months and older. Not reliable for younger babies, whose ear canals are too narrow.
  • It needs to be placed correctly in your child’s ear canal to be accurate (see “Ear temperature,” below).
  • Cold temperatures after being outside can affect reading.

How to Use a Digital Thermometer

To get the right thermometer reading, it is important to always follow the instructions that came with the device.

Rectal temperatureParent gently inserting thermometer into the anus with infant on their belly

Taking a rectal temperature gives the best reading, especially for infants under 3 months of age. Here is how to take a rectal temperature:

  • Put a small amount of lubricant, such as petroleum jelly, on the end of the thermometer and on your child’s bottom.
  • Place your child belly down across your lap or on a firm surface. Another way is on the back with the legs pulled up to the chest. Turn the thermometer on and slide it 1/2 inch (for babies less than 6 months old) to 1 inch into the anus. Be gentle. There should not be any resistance. If there is, stop. Hold your child still. Leave the thermometer in place until it beeps. Then remove and check the digital reading.
  • Thermometers should be disinfected before and after use with disinfecting soap and water or disinfecting alcohol swab.
  • Label the rectal thermometer so it is not accidentally used in the mouth

Infact on their back with parent inserting thermometer gently into anus

Oral temperature

Young child with thermometer in mouth, under the tongueOnce your child is 4 years old, you can take a temperature by mouth. Here is how to take an oral temperature:

  • If your child has had a hot or cold drink, wait 30 minutes.
  • Turn the thermometer on and place the tip under one side of your child’s tongue toward the back of the mouth. Have your child hold the thermometer with their lips and fingers.
  • Do not use the teeth to keep in place.
  • Keep the lips sealed over the thermometer until it beeps. Check the digital reading.

Forehead temperature
Temporal artery (forehead) thermometers can be used on children of any age. Here is how to take a forehead temperature:

  • Follow the instructions on the package to know how and where to slide or aim the sensor across the forehead to get the most accurate measurement.
  • The sensor measures the heat waves coming off the temporal artery. This blood vessel runs across the forehead just below the skin.
  • Read your child’s temperature on the display screen.

Ear temperature
Tympanic (ear) thermometers can be used on children 6 months of age and older, as young infants have narrow ear canals. Here is how to take an ear temperature:

  • Follow the instructions on the package.
  • A correct temperature depends on pulling the ear back. Pull the ear back and up if the child is over 1 year old. Then aim the tip of the ear probe between the opposite eye and ear.
  • Being outdoors on a cold day may cause a low reading. Wait 15 minutes after coming indoors to take the temperature.

Some quick screening ways may not be best

Some products and quick methods are not as accurate at checking a child’s temperature. For example, taking the temperature under the armpit can help schools and child care centers quickly check, but is not very accurate.

Other less accurate ways of checking for fever include using a pacifier thermometer (for children 1 year of age and younger) and fever strips on the forehead. While parents can use them for quick screening, they do not work as well as measuring your child’s rectal, forehead, ear, or oral temperature with a digital thermometer.

Remember
Fever is just one sign of illness, but an important one. Talk with your child’s pediatrician if you have any questions about fever and taking your child’s temperature.

More Information

*Digital thermometer drawings by Anthony Alex LeTourneau.

Last Updated: 10/12/2020
Source: American Academy of Pediatrics (Copyright © 2020)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.