Managing a Child's Fever at Night: When to Check Their Temp and More

If you are the parent of a baby or toddler, this may be a familiar scenario: A nasty cold or flu has left your little one burning up with a fever all day. The pediatrician has assured you that with some TLC and perhaps some fever medication, the temperature would return to normal as soon as the infection clears.

Now that it's bedtime, though, you're not sure what to do. Generally, it's best not to wake your child up to check their fever at night. Instead, here's what you can do to manage their fever and keep them comfortable so they can rest and kick that cold.

Understanding Fevers

It is important to remember that a fever—defined in children as a rectal temperature of 100.4 degrees F or greater—is a symptom of a disease and not a disease itself. In babies and toddlers, fever is a symptom of common viral and bacterial illnesses such as croup, flu, colds, gastroenteritis, ear infections, bronchiolitis, and urinary tract infections.

As distressing as a fever may be, try to remember that it is a normal part of the body's immune response. It serves as a defense mechanism by stimulating the production of white blood cells (such as T-cell lymphocytes) that actively target, control, and neutralize an infection.

One of the things that happen when you sleep is that you get a better fever response. What this means is that, even if the temperature rises, your body is more actively focused on fighting infection.

Managing the Fever

Helpful or not, a high fever can make a child feel absolutely miserable, so there is a good reason to do all you can to relieve it. Fevers lower than 102 generally do not need treatment. If your child's fever is higher than 102, you should consider using fever reducers to bring it down, especially if your child is uncomfortable.

To this end, the American Academy of Pediatrics (AAP) recommends that you take the following steps to manage your baby's or toddler's fever.

Keep your child hydrated.

A fever can cause your little one to lose fluids quickly and become dehydrated. This can lead to serious complications and the worsening of symptoms. To avoid this, push fluids as necessary to keep your child properly hydrated.

Water, broth, herbal tea, and juices are recommended. If there are signs of dehydration, you can use an oral rehydration solution like Pedialyte. If you are breastfeeding, nurse your child more often. Breastmilk also provides antibodies to help your child fight off infection, while skin-to-skin contact should help comfort your child.

Try fever reducers.

Children's Tylenol (acetaminophen) or Children's Motrin or Advil (ibuprofen) will usually do the trick. Though acetaminophen can be used in children as young as 2 months old, ibuprofen can only be used in children 6 months and older. If your child is younger than 3 months, or you are unsure of the dosage, speak with your pharmacist or pediatrician before giving any medicine.

For children who are vomiting or otherwise unable to use oral medications, fever-reducer suppositories are also available over the counter.

Use a fever reliever only when needed.

Not all fevers need to be treated. According to the AAP, fever relievers are only needed if the fever is causing discomfort, usually above 102 or 103 degrees F. If you do decide to use one, give it just before bedtime to aid in a good night's sleep.

Keep in mind that fever reducers only lower the temperature by two to three degrees. If your child is running a high fever, fever reducers will not make the fever go away completely, but they should decrease it enough so that your child will be more comfortable.

Avoid outdated or unproven remedies.

The AAP also advises against alcohol baths, ice packs, or "starving a fever," which can do more harm than good. You should also not give a cooling sponge bath to your baby without first providing a fever reliever. Doing so can cause shivering and may actually increase body temperature.

If you do choose to give your child a sponge bath, use lukewarm water, not cold. Water temperature that is a little lower than normal body temperature is fine.

How To Dress a Baby With a Fever at Night

It is important to dress your child lightly at night when they are running a fever. While your first instinct may be to bundle your child up when they are sick, it may only add to their discomfort. If the room temperature is comfortable (between 70 and 74 degrees Farenheit), it is better to dress the child in light clothing. Forcing a sweat is not a good way to treat a fever, and it may lead to trouble sleeping.

When to Wake Up Your Child

It's understandable to be concerned when your child has a fever. If your child is able to fall asleep, don't wake your child up just to take their temperature or give them fever medicine. Unless their symptoms are severe enough to warrant an emergency room visit, getting a good night's sleep is more important to the healing process than monitoring their temperature.

There are a few exceptions to this rule. For example, if your child is sleeping restlessly, they may rest better after a nighttime dose of Tylenol, Motrin, or Advil. Similarly, if your child is breathing faster than normal or irregularly, you may want to check their temperature to decide if further action is needed.

When to Call the Doctor

Typically, fevers can be managed at home with supportive care and fever reducers. However, there are times when you should not hesitate to call your child's healthcare provider or visit an urgent or emergent care facility. Generally speaking, you would need to call a doctor or seek emergency care if:

• Your baby is two months or younger and has a temperature of 100.4 degrees F or more. Any fever in a newborn is considered an emergency.
• Your baby is three to six months and has a temperature of 101 degrees F or more
• Your child is over six months and has had a temperature of 102 degrees F or higher for more than two days
• Your child has shaking arms and legs, trouble breathing, and eyes that are rolling back. These are signs of a febrile seizure. While most are relatively harmless, those that recur or last for more than 10 minutes should be seen without exception
• You have difficulty waking the child
• Your child is under two years old and has had a temperature of at least 100.4 degrees F for more than 24 hours
• Your child is over two years old and has had a temperature of at least 100.4 degrees for more than 72 hours

A Word From Verywell

When your child has a fever, it's easy to feel overwhelmed and question your decisions. You should absolutely feel free to call your pediatrician with any questions or concerns, regardless of what your child's temperature is or how long they've had a fever. Fevers can be stressful for parents and for kids, and sometimes seeking out advice from your doctor is exactly what you need to do to feel better and be confident in your care decisions for your child.