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Midnight Fever!? Now what?


What to do about a fever in your child

Anyone who has had small children dread the random, middle of the night fever.


What should you do? Take them to the ER? Give them a cold bath? Let them ride it out till morning? Wake them up and give them medicine?


There isn't a magical answer to this question but often a combination of these is best.


In this post, we cover 4 topics:

  1. What is a fever and what to do about it

  2. What medicines to use and does it need to be brand name

  3. What else you can do

  4. Special advice for new moms


WHAT IS A FEVER? AND, DO I TREAT IT RIGHT AWAY?


Lets start with, what is a fever? A fever is generally a temperature over 101 degrees Fahrenheit.


Even so, the American Academy of Pediatrics suggests that what is more important is the comfort of the child. Are they restless? Do they seem tired or irritable? If so go ahead and treat the fever.


However, any child less than 2 months with a fever, should be seen by a Provider right away. Why? Because the first symptom of illness is often a fever.


It’s important to your Provider to know how high the fever is, how long it’s lasted, and what medications you’ve used to treat it. It’s very hard to diagnose fevers that have just begun before any other symptoms show up - eg., runny nose, rash, sore throat, diarrhea, vomiting, etc.


If you feel comfortable in doing so, you can manage the fever at home and see if your child improves before going to the doctor.


WHICH MEDICINE TO USE? BRAND NAME OR NOT?


Which medicine do I give? How much? Should I buy brand name? Brand name medication is not necessary, but often comes in multiple flavors which can be beneficial to a picky child.


A child less than 6 months should only receive acetaminophen/Tylenol, but children over 6 months can take either acetaminophen/Tylenol or Ibuprofen/Motrin.


Never use aspirin in children unless instructed by a Provider.


Be sure to know your child’s weight and give medications as instructed on the box. If the child’s fever comes back before the next dose you can alternate between ibuprofen and acetaminophen every 4 hours as needed.


If the child’s fever lasts more than 2 days or does not improve with the medications, your child should be seen by a Provider. Seek emergency care if the fever is over 104 and does not improve with medications.


WHAT ELSE CAN I DO?


What else can I do to reduce my child’s fever while I wait for the medicine to work?


You can always give your child a lukewarm bath. Especially if the child is congested, get in to the shower with your child and let the warm water run over their back while you hold them. If this isn’t possible, cool rags on the back of the neck and forehead can be soothing.


In addition to bath or shower, removing the blankets, cooling the room, and using a fan can all be very effective.


There is no need to seat out a fever - so do not pile up blankets or rub alcohol on the skin. Doing those things can cause heart problems or seizures, and you surely don't want that.


SPECIAL ADVICE FOR NEW MOMS


My advice to all new moms is this: follow your mom gut.


If you feel like there is something more than a simple illness going on, speak up and advocate for your child. You really are the expert after all.


All pediatric providers expect to receive worried parent calls at all hours of the day so please don’t hesitate to call or seek help.


Fevers can be very scary. But I hope now, you can feel a little more reassured about what to do next.


Bridget Heard,

BS, MS, RN, FNP-BC

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