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Axillary Temperatures in Full-Term Newborn Infants: Using Evidence to Guide Safe and Effective Practice

Friedrichs, Judy RN, MS, FT; Staffileno, Beth A. PhD, FAHA; Fogg, Louis PhD; Jegier, Briana PhD, CLC; Hunter, Ramona MS, RN-WHNP-BC; Portugal, Doreen RNC-NIC, BSN; Saunders, Jasmine K. MSN, RN; Penner, Janice L. RNC-NIC, BSN, MPH; Peashey, Joelle M. RN, BS

Section Editor(s): Dowling, Donna

doi: 10.1097/ANC.0b013e3182a14f5a
Original Research

PURPOSE: Although the American Academy of Pediatrics and the American Congress of Obstetricians and Gynecologists recommend obtaining temperature in newborn infants via the axilla, controversy still exists whether to obtain rectal or axillary temperatures. Of concern is the risk of perforating the rectum or colon during rectal temperature-taking. The purpose of this study was to explore the accuracy of electronic thermometer measuring temperature in the axilla compared with the rectum in full-term newborn infants.

DESIGN: This was an agreement study involving a purposive sample of newborn infants who were greater than 37 weeks' gestation. The general care nursery was located in a large, urban Midwestern academic medical center, and data collection occurred between May 2010 and August 2010.

METHODS: On admission to the general care nursery, both axillary and rectal temperatures were taken using the FasTemp device by Filac Electronic. Axillary temperatures were taken first, followed immediately by rectal temperature. Descriptive statistics, Pearson correlations, and scatter plots were computed.

RESULTS: In 69 newborns, the mean difference between rectal and left axilla temperatures was 0.23°C. There was a significant correlation between rectal temperature and the body temperature for the left axilla (r = 0.786; P = .01).

CONCLUSIONS: These preliminary data support the use of left axillary temperature measurement in the full-term newborn infant in the first few days of life to provide a safe and accurate alternative to rectal temperatures.

CLINICAL RELEVANCE: Nurses caring for newborn infants now have evidence showing that temperature-taking in the left axilla is an alternative to using rectal temperatures, possibly minimizing discomfort and potential risk of perforation.

Rush University Medical Center (Mss Friedrichs, Hunter, Portugal, Penner, and Peashey and Drs Staffileno, Fogg, and Jegier), Chicago, Illinois; and Ben Taub Hospital (Ms Saunders), Houston Texas.

Correspondence: Judy Friedrichs, RN, MS, FT, Armour Academic Facility, Rush University Medical Center, Ste 755, 600 S Paulina St, Chicago, IL 60612 (

Special thanks to Pratixa Patel for her assistance while a nursing student at Rush University.

This study was supported by the Rush College of Nursing Center for Research and Scholarship.

The authors declare no conflict of interest.

© 2013 by The National Association of Neonatal Nurses