Managing a Child's Fever During the Night

Waking her up to take her temperature may not be the best way to treat her

Girl sick in bed
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If you're the parent of a baby or toddler, this may be a familiar scenario: A nasty cold has had your little one burning up with a fever all day. The pediatrician has assured you that with some TLC and perhaps a fever reliever, her temperature will drop back to normal as soon the infection clears up. Now that it's bedtime, though, you're not sure what to do. Should you monitor your child's fever during the night and wake her to give her medication?

Or is it better to let sleeping babies lie—even sick ones?

With few exceptions, it's almost always fine to let a small child who has a fever sleep. Here's why, and how best to manage a baby's or toddler's temperature during the night. 

A Symptom, Not a Disease

A fever is defined as a rectal temperature of 100.4 F or higher. In most cases, it's a symptom of a respiratory illness such as croup, flu, pneumonia, a bad cold, or an ear infection. In fact, it's a useful symptom: According to healthychildren.org, the American Academy of Pediatrics' (AAP) website for parents and other caregivers, a high temperature stimulates white blood cells and other immune defenses to attack and destroy the cause of an infection, such as bacteria or virus.

Helpful or not, a high fever can make a little kid feel absolutely miserable, so there's good reason to do all you can to relieve it. Here's what the AAP advises parents do to manage a baby or toddler's fever:

  • Keep her hydrated. A fever can cause a little one to lose fluids more quickly than usual. Offer her lots of water, but go easy on fruit juice, especially sugary ones.  If you're breastfeeding, nurse your child more often. If she shows signs of dehydration, crying without tears, a dry mouth, fewer wet diapers, ask your pediatrician about giving her a commercial electrolyte solution.
  • Don't overdress her. Yes, she has a cold, but as long as she's indoors where it's cozy and warm she'll just be doubly uncomfortable if she's bundled up. 
  • Give her an age-appropriate dose of a fever-relieving medication. Either Tylenol (acetaminophen) or Motrin (ibuprofen) is fine. If your child is under 2 or you aren't sure how to interpret the recommended dosages on the label, find out from your doctor or pharmacist how much medicine will be safe and effective for your little one.
  • Forget outdated fever-reducing practices. The AAP says things like alcohol baths, ice packs, and so forth aren't recommended and may even do more harm than good. 

Managing a Child's Fever During the Night

Although in most cases it's not necessary to wake up a baby or toddler (or even an older kid) during the night to take her temperature or give her medication, there are a few exceptions:

  • Your child is newborn or younger than 2 or 3 months old, at which age fever can be a serious symptom.
  • She has a chronic illness such as cancer, a problem with her immune system, or recurrent urinary tract infections.
  • She's sleeping, but restlessly, and you think she will get a better night's sleep if you give her a fever reducer.
  • Her temperature has been going up and down consistently throughout the day and you know she's due to a fever spike that's going to wake her and make her miserable anyway.
  • She has other symptoms, such as trouble breathing, that concern you. In that case, you might want to wake her and call the pediatrician even if she doesn't have a fever.

If your child has a history of febrile seizures you may want to wake her if she's running a temperature during the night. However, there's no research to show that this really prevents further seizures. Your best bet, in that case, is to follow your pediatrician's advice.

That way both you and your child can rest assured that you're doing all you can to help her feel better when she has a fever.

Source:

Healthychildren.org, "Fever and Your Baby." American Academy of Pediatrics, Aug 3, 2016.

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