How to Handle Your Toddler’s Midnight Fever

Fevers in young children are very common, but can still feel very scary for parents, especially when they happen in the middle of the night. Imagine that your 2-year-old child awakens in the night with a fever of 102F. How would you respond? 

  1. Panic and call 911. 
  2. Panic and call the on-call provider. 
  3. Stay calm and gather more information. 

I am sure you have already determined that panicking is not the right answer! However, when faced with this scenario in the middle of the night, many people react quickly instead of gather more data and responding appropriately. 

A fever of 102F degrees is generally not considered harmful for a child of this age. So, we have time to gather more information while being mindful of emergency symptoms.  

Gather More Information 

If your child has a fever, here are some questions to consider: 

  • Had the child seemed ill during the day at all? 
  • Are they having any other symptoms now? 
  • Is the child showing any symptoms that may indicate a medical emergency? 

It’s always important to know signs or symptoms that would indicate a medical emergency. These include but are not limited to difficulty breathing, any uncontrolled bleeding or a change in the color of their skin, lips or tongue (especially blue or extremely pale). If your child is unresponsive or showing signs of a seizure, emergency care is needed. 

Monitor the Fever 

It’s important that you know how to take and monitor your child’s temperature. Skin scanners and ear/tympanic thermometers work well, but it’s a good idea to take three readings to make sure you are getting readings that are close together to assure an accurate temperature. 

A child has a fever if there’s a reading over 100.5F. Children generally have higher temperatures than adults because their immune systems are gaining exposure and building strength against many common viruses that adults have already been exposed to. Fever is our friend! It fires up our child’s immune system to help it conquer viruses and other infections.  

Children generally do not run fevers high enough to hurt themselves unless it’s a very serious infection. In these cases, the child’s behavior will usually indicate before their temperature does that they need immediate care. They will act confused, inconsolable or unresponsive. Temperatures over 105F generally indicate a serious infection of this nature. 

Use Medicine When Needed 

Not every fever requires treatment with medication. If your child is happy, drinking well, playful and sleeping well, no treatment is required. But if your child is uncomfortable because of their fever, medication may be used if they have not had any in the recent past. Acetaminophen is available in liquid form, and can be given every 4 hours as needed for fever. Children over 6 months of age can receive ibuprofen. It is also available in liquid form and can be given every 6 hours as needed for fever. It is important to have an acetaminophen/ibuprofen dosing chart available in your home so you can determine how much medication your child can safely receive based on their current weight.  

Medications to reduce fever will start to work in 30-60 minutes, so wait one hour to recheck your child’s temperature. The medication is a success if it decreases the temperature by a degree or degree and one half. So if a child started at 102F and after one hour of giving acetaminophen they are 101F, then the medicine has succeeded! If after an hour the child is still miserable and crying uncontrollable, then it would be a good idea to call their primary care provider for more specific advice on how to care for your child. 

Avoid Tepid or Alcohol Baths 

Tepid and alcohol baths have been used in the past to decrease a fever, but they are not recommended today. Alcohol baths can actually be fatal. The child absorbs the alcohol through their skin and this can cause fetal alcohol toxicity. So they should never be used as a tactic to reduce a fever. 

Tepid baths may sound like a good idea to cool of your child when they are so hot, but they don’t work as you think. When you apply tepid water or put a child in a tepid bath, this causes them to shiver. The cooler water alerts the body that they need to raise the temperature, and causes the body to shiver to produce heat. This then will actually raise the child’s temperature. This is not what we want! Instead, try a cool rag on your child’s forehead to help them cool them down safely. 

Fevers in young children can seem scary, but are very common. Have thermometers, fever-reducing medication and dosing charts on hand. Having resources at the ready will go a long way towards helping you feel confident if something were to happen. Stay healthy, everyone!  

Amy Spangler, CNP, is a certified nurse practitioner at ProMedica Urgent Care for Kids, located in Perrysburg. 

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