I appreciate Dr Chamberlain's interest and respect his comments regarding my editorial1 that accompanied the article by Press and Quinn2 on the pacifier thermometer.
Certainly, I agree that there are a variety of temperatures within the body; therefore, temperatures at various body sites will be different. Hence, comparing mechanisms for measuring temperatures from the same sites would be best when possible. It is true that monitoring temperatures of the lower third of the esophagus, the tympanic membrane,3 or pulmonary artery (as suggested by Dr Chamberlain) reflects the changes of the core body temperatures more rapidly and accurately than rectal temperatures. However, this is impractical in the outpatient setting. Measuring axillary temperatures has been shown to be insensitive and the tympanic membrane temperatures may be unreliable for detecting a fever. Therefore, I believe rectal thermometry remains the best technique for temperature assessment in the outpatient setting when children are too young to obtain sublingual temperatures. The study population ranged between ages 7 days and 24 months. Consequently, comparing temperatures obtained by the pacifier thermometer with the rectal temperature is clinically relevant.
Rice TD. Pacifier Thermometer Comment—Reply. Arch Pediatr Adolesc Med. 1998;152(2):207. doi: