Why were rectal temperatures taken until 13?

Has anyone ever read an older medical journal or some policy manual that explained the rationale for taking routine rectal temperatures until the age 13 in clinical settings? I’ve scoured the internet and libraries for years but never came across any medical literature that ever suggested continuing rectal temperatures to that age neither at home nor in a pediatric office. In fact, everything I’ve read completely contradicted this by stating that rectal temperatures were never recommended for children over 4 or 5 unless the child was unconscious or an accurate core temperature was critical for a more serious medical diagnosis.

Throughout my childhood in the 70’s and 80’s most pediatric offices reserved rectal thermometer use for babies and toddlers during sick visits. Although no parents or even public school nurses would have ever taken the rectal temperature of a 12 year old, there remained a few pediatric offices like mine who strangely continued them up to 13 with no logical explanation ever given. I’m not sure what significance the age of 13 had with determining the policy but it seemed arbitrary and was far above the age which every medical encyclopedia recommended. Perhaps there was some scant reasoning for taking the rectal temperature of a 12 year old who was too sick for an oral thermometer but there was certainly no legitimate medical reason for taking their temperature rectally during routine checkups. But even for that sick 12 year old choosing a rectal temperature over an oral one adds nothing different to their treatment (fluids, acetaminophen, ibuprofen) so it didn’t make much sense to needlessly subject kids to such an embarrassing procedure. I recall one memorable doctor visit around the age of 11 when a branch poked my eye while climbing a tree. Although I showed no signs of illness my temperature was taken rectally upon arrival just because it was their policy. I also found it strange how my mom never questioned this since she had discontinued rectal temperatures at home when I was around 5. As a preteen kid I questioned my mom as to why my temperature was still taken rectally at my doctor’s office but gave no reasonable answer, only saying things like “that’s just how they do it there” or “don’t make such a big deal out of it”.

I’ve always been extremely curious about the origins of the age 13 policy so if you have any information to share I’d really appreciate it.

In my country, rectal temperatures are only measured for infants up to about 2-3 years of age. I don't think there's a medical reason to measure rectal until the age of 13. The only explanation would be going through puberty. Until the age of 12-13, patients are treated like children. I once read that in countries where it is practiced, boys' temperature is measured in this way longer than girls. It's reasonable for girls to start puberty earlier.

My parents quit taking my temp rectally when I could hold the thermometer under my tongue and breathe through my nose to get a consistent reading. That probably was age 5 or 6, I guess.

Rectal temperatures in medical settings were taken, most likely as per policy or the patient’s condition. In a domicile setting it was a/the parent's decision.

All doctors, nurses, mothers and babysitters (used to) adhere to Dr Spock’s pediatric methods for many decades. He recommended that rectal temperature taking stop between the ages of five and six. While many adhered to that recommendation, some clinics, and some parents extended those age limits, sometimes adding several or even more years.

I’ve never heard of age thirteen being a recommendation.

I agree with others. It's only a fantasy that RT would be taken at teens. Most parents stop it at 4-5 years.

I’m aware of this being common during the 60’s, when I was a kid, in some households and pediatric clinics. I never experienced this after around age 5, from any sources. I never understood why you would stick a thermometer up a teens ass, unless the doctor or parent had a sexual fetish. In that case, they should have done it to themselves, or their partner.

Yes. I received a gift set of books for my 12th birthday with all of the classic titles (Huck Finn, Tom Sawyer, Moby Dick)... and the 10th book was a book called Infant and Child Care. The book recommended taking rectal temperatures for children of all ages, including teenagers. This was in 1986. You're asking the opposite question than the book asked. The book made it a point to ask why you WOULDN'T use the most accurate method available?

I remember reading this with great nervous fascination, as it described the procedure for taking a rectal temperature. It told parents to place children over their lap, then to insert and hold the thermometer in place "like a cigarette" between their index and middle fingers, while cupping their hand over the child's bottom. It offered the procedure for an oral temperature as a concession to parents who were too worried about non-issues like temporary embarrassment. The underarm method was listed as a method no responsible parent should ever use due to it's gross inaccuracy.

Consider that it was safer for children to have a glass thermometer filled with mercury safely planted in their tight rectum held in place by a parent's hand than in a mouth that could cough, sneeze, talk or laugh and eject it causing it to break and create a toxic health hazard. (I had an evil aunt who once tried to make me laugh during an oral temp so she could have an excuse to take my rectal temp. (As if adults needed an excuse to do whatever))

My clinic stuck to the policy of rectal temps to age 12, also. My mother had started using oral around 6 or so, and the school also used oral on smaller children. I remember the first time I went to the nurse's office in 2nd grade and got my temp taken orally. I was shocked, because doctors always took it rectally my whole life. I made it a point of asking what the other thermometers were for...after all if they took oral temps on 2nd graders why have rectal thermometers at all? The nurse told me it was for little kids in kindergarten.

Most hospitals took rectal temps on any patient in the pediatric ward including teenagers. I was only hospitalized once at 6, and never saw anyone get an oral temp taken. In fact, the cart they pushed around only had red thermometers in a large jar, along with lube packets and tissues. Anyone who doubts this is true can go back and watch the Diffrent Strokes episode where Sam has to go the hospital and "Mr. D" has to go at the same time and goes to the pediatric ward with Sam to make him less scared. The nurse tells him it's time for a temp and when he opens his mouth, the nurse says "that's not how we take temperatures in the pediatric ward". This is accurate for hospitals of that time period.

I grew up in South Dakota in the 60s and 70s. Turned 13 in 1971 my doctor only asked if wanted oral after your 14th birthday, before that it was always rectal. The school nurse in high school did oral temps though once when I was throwing up I got a Rectal temp in high school. But my first real oral temp was at the Navy induction center.

The thermometers used to be glass with Mercury in them. For safety sake it was recommended to obtain a rectal temperature because it was more accurate with those type of thermometer. It was too dangerous to take a chance that a child would bite down on the glass and break it causing not only possible cuts but possibly ingesting dangerous mercury. That's the entire reasoning when this recommendation that you are talking about was made. When I was a child, there wasn't any digital thermometers or cell phones or electronics! We were one of the first families in our neighborhood to get a black and white tv when it first came out! LOL Anyway, I hope this helps to clarify your understanding on this topic.

@Antonx,

Some years ago I was looking at a book in the medical section of a book store. I came across material in the book stating that a study had been done involving 2,000 female adult patients that required that their temperatures be obtained rectally.

Oldskoolotk. I think I had that SAME volume of books! I was and still am a voracious reader. I recall that 10th volume and the RT reference. Long time ago Amigo.

I don't know why my dad liked doing the rectal temps, but that's always what he did. All the way through college. I never thought anything of it really.

My guess is that were doing it until the onset of puberty. Prior to that age, you were seen as a child, and children got their temperatures taken rectally, whether you were 5 or 12. I have old medical textbook that recommends rectal temperatures for virtually all pediatric patients. It said that accurate oral temperatures can be difficult to obtain, even in children over the age of 10. I know I tended to have a hard time with oral temperatures, even around age 12 sometimes.

One argument against having a nurse or parent take a rectal temperature on a pubescent girl: just imagine if the girl is having her period.

I was born in1952 and in my familly rectal temperature has allways been the norm, even for adults. When I was 13, my parents stopped taking my temperature and gave me a brand new rectal thermometer. I stll use it.

At the doctor's, I have had my temperature taken in my ear on some occasions. I have never been presented with a mouth thermometer and I would not be able to use it. I would probably heve to ask for some help or for a rectal temperature. LOL.

As i've posted in other threads, in real exams, i really don't recall rectal temps at all so they would have had to been early in life. What I do remember is one when I was probably around 11 or 12, having a really bad asthma attack and in the emergency room, they were struggling to get my temperature via mouth (they thought I kept drinking water and couldn't understand why I had a temp of 97 degrees and took it like 5 times with one of those "new" digital thermometers over the course of an hour), and they then moved to my armpit ... even then -- they didn't try a RT. In hindsight and reading far too much here, I now wonder why they didn't flip me over and just go for "the gold standard."

(Truth be told, my temp is always a little low, so the whole 97 thing may have been pretty accurate to begin with.)

I suppose it all depends on the doctor, the practice, and what they were most comfortable with.

It seems that pediatricians had their own policies regarding switching from rectal to oral temperature taking. Our pediatrician in Indiana switched you over at age seven. Hospitals were a different story. Everyone in the pediatric ward had their temperature taken rectally, no exceptions.

Mine were taken that way until slightly later at our pediatrician's office, and several years later by my mom at home.

At my pediatricians office mine was taken all the time. Even at 13 yrs old

As a little kid, I remember my temperature being taken under my arm until I was old enough to hold the thermometer in my mouth.

I don't think I have any memory of having my temperature taken rectally, at least not for legit medical purposes.

As I can recall I only had oral temps taken even as a kid. I do remember the under arm temp taken as well. Even in HS and undergrad I never recall having a anal temp taken. I grew up in the 1970s and 1980's and I would have thought during that timeframe this would have been a normal thing?

It may depend on the area of the country. As I stated before on here I grew up in South Dakota in the 60s and 70s and my doctor did RT to age 13 when his nurse asked my parents how they wanted it done. I had a same-age friend that told me it was the same for him.

Never hear of RT's being taken so late. maybe you had a medical condition that required it to be taken that way at that age?. I was 9 last time I had it done but it was due to hospital policy. could it be you had a kinky doc?.

I have no exactely momories of taking RT as a child, thing at age 5 or 6 my mom changed to take it under arm. That was the normal way until adult age. For I was ever fascinated about, I switched back to take my temp rectally.

I think the most logical explanation has to do with the customary practice of taking rectal temps some 15 to 20 years ago and before on children and teens. I suspect it was also a preferred way for adults presenting with symptoms of fever or feeling unwell. It surely was mandatory in hospital settings. With the advent of electronic thermometers or digital ones, it is no longer a preferred method and likely spares embarrassment.

No real age limit, being there may well have been and probably still are times where due to medical necessity and/or protocol, rectal temperatures are still taken.

I don't know why this is. Could be "old-school tradition" with some pediatricians, even when it wasn't medically necessary. I can visualize a 12-year-old, at the first sight of a nurse holding a rectal thermometer, turning over and burying her head in the pillow.

At home, we changed to orals when the girls were 5. Our pediatrician stopped around age 6, except when our oldest was in high school and came down with pneumonia. "Doc Grams" our family doctor took Jen's temp rectally during two office visits, as I did at home during several days until she was breathing more normally.

When an illness is bacterial like pneumonia,!it is probably prudent to ascertain a patient’s temperature rectally..

@oldskoolotk When I was sent to hospital for appendectomy, age 9 approximately, at some point a nurse came and handed me a thermometer. At home, I was supposed to stick it in my behind, but I had seen films, cartoons and comics with people in hospital with a thermometer in the mouth so I hesitated and slowly moved it towards my mouth. The nurse tut-tutted and said "here at the hospital we do not take it in the mouth". I immediately understood.

The same applied to adults - comic stories from those days refer to adults in hospital being asked to take their temperature rectally.

(Note: in France older children and adults were supposed to know how to stick a thermometer in there by themselves. I suppose that if I had seemed not to understand, the nurse would have do it herself, or would at least have shown how to do it once.)