Cooling a Fever in the Middle of the Night

(First, I am not a doctor.  I am not trained in the medical profession at all, except for that one summer in college when I worked as a receptionist in Chris’ uncle’s surgical office.  But all I learned then about the medical profession was not to double-book appointments.  Any time your child is running a fever, please consult your pediatrician.  Then your mom.  Then your best friend.  Then your best friend’s mom.  Then Google.  Basically, talk to someone in real life.  These are just tips to use in addition to what the professionals tell you.  The end.)

In our house this week, we are all sick.  Bean has a respiratory infection.  I have something like the flu.  And Chris has a terrible head cold.  After an emergency clinic trip yesterday morning and a late night ER trip last night, it’s been fun.  Fortunately though, I think we’re all on the mend thanks to some strong prescriptions, freakish-like patrolling of our scheduled medicinal intake by Chris, and vegetable soup from my Mom.

One thing I had forgotten until this past weekend was how incredibly scary fevers are in little kids.  On Friday night, Bean’s shot up to 104 and stayed there for several hours.  He’s only had a fever that high once or twice before and it’s easy to forget how very helpless you can feel when your child is that sick.  But there are a few things you CAN do to help control the situation a bit and this weekend I found them particularly helpful.  Keep in mind, these are not medical treatments for an illness and you still need to consult your pediatrician about your child’s fever.  These are more like home remedies that help Bean feel more comfortable when he’s got a high fever.

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Pay attention to the type of fever that your child is having. I don’t know about your child, but Bean’s default mechanism for anything (teething, a head cold, over-tiredness, etc.) is to run a low-grade fever.  He runs them fairly often actually.  But those fevers are warm to the touch and usually hover around 99 degrees, though they may come up to 100 at night.  With that particular type of fever, Bean doesn’t miss a beat.  He’s still playing and having a good time.  He might be a little ornery, but that’s usually because of whatever is giving him the fever and not the fever itself.  Generally speaking, with that type of fever, we give him a little Motrin and then move on about our day.

The other kind of fever Bean runs stops all household activity.  It’s the one that he ran this past weekend.  And, trust me, you’ll know this kind of fever when it happens to your child.  It’s the kind that makes him cry – a lot.  A terrible, pathetic little wimper that at the peak of the fever becomes a screaming cry that makes you want to cry yourself.  But you can’t.  Because you’ve got to take care of this fever.  This kind of fever indicates something is really wrong, not just a head cold or teething.  This is the kind of fever that I call my doctor about in the middle of the night.  This is the kind of fever you watch the clock for and make sure it starts to fall within a certain amount of time.  This is the kind of fever that keeps you up all night, rocking your wee one with a cool washcloth on his head.  DON’T IGNORE THIS KIND OF FEVER.

So, be sure you pay attention to your child’s temperature when he’s well, as well as when he’s fussy or mildly ill.  Knowing their temperature patterns makes it a lot easier to recognize when something is different and needs medical attention.

Don’t be afraid to call the doctor. I hate calling the doctor after hours.  Especially in the middle of the night.  I worry about it for half an hour before I actually do it.  Can it wait?  Is it really something I can’t handle myself?  Have I tried everything I can?  But when it comes down to it, I usually go with my maternal instincts.  If I am really worried about something, I’m going to end up calling.  Even if it’s just to hear the doctor tell me in his sleepy, none-too-happy voice that everything is fine and it can wait until morning.  That piece of mind is worth a phone call to me.  Generally though, I have three rules for myself that I follow before calling the doctor after hours.  First, the fever must be 104 or above because that’s Bean’s rare fever.  That’s the temperature that tells me something is really wrong.  So, if we hit that fever in MY CHILD, I know that I need some help from a professional.  Secondly, I make sure I have tried everything I can to bring down the fever on my own.  I know he’s going to ask if we’ve tried all these things (which I’ll talk about in a minute), so I go ahead and do them AND THEN GIVE THEM TIME TO KICK IN before I call.  That way, when I’m talking to the doctor, I feel 100% certain that this is my last resort.  And finally, I check my watch.  If Bean’s fever hasn’t responded to Mortin or Tylenol in a reasonable time (which is several doses and hours), then I call the doctor.  If those three things are good to go, then I don’t feel as bad about calling.  Plus, I think about how much stinkin’ money we pay to have them give those stupid little vaccinations and I think, “They can handle a phone call…”

Use a pain reliever. Now, for this one, you definitely need to consult a pediatrician because medication type and dosage amounts vary from child to child.  But know how much, how often, and what pain reliever to give your child BEFORE they get sick.  Chris and I are not health nuts, but we really try to avoid medications as often as possible, especially with Bean.  If there’s another way to make him feel better that’s a little more natural, then we try that first.  But fevers are an exception.  We use Motrin or Tylenol to treat a fever.  We use both because sometimes Bean responds better to one than the other.  Our doctor says we should alternate them when he’s sick, but usually I stick with one until it doesn’t seem to be working well and then I switch to the other.  The point though is that you know what your child responds to the best BEFORE it’s a really serious situation and it leaves you guessing in the middle of the night as to what to give him.

Have a routine and stick to it as much as possible. When Bean spikes an unusually high fever, my head becomes mush.  All I see is the crying and the moaning and how pitiful he looks and it’s easy to become a big pile of mush that just wants to rock him in the rocking chair.  And there will be time for that rocking.  But first, I have to take action to bring that fever down.  I have found that a sick routine helps me in the middle of the night because it’s the same thing I do every time and so it doesn’t require too much on-the-spot thinking.  When Bean’s sick, we just go into action and start with our established routine.  Every family’s routine is probably different (and should be, to cater to the needs of your own child), but for Bean, here’s a step-by-step of what we do.

– Bean wakes up in the middle of the night with a very high fever.

– Chris and I both get up together and head into his nursery.  We try not to turn on too many lights or be too loud because the point is to eventually get him back to sleep after all this, so we want to keep him as dream-like as possible.  And we definitely try not to panic.  That’s why we both go in there.  It’s less scary when there’s someone with you and you can stop in the middle and whisper things like, “WHAT ARE WE DOING?!?!?” and having someone to respond back, “I have no idea, but keep doing it!” makes all the difference in the world.  It is for this reason (along with a million others) that I have such respect for single-parents.  I have no idea how they do it.)

– I take Bean out of his crib and begin undressing him.  We change his jammies for a couple reasons.  First, it gives him a chance to feel some cool air without jammies on. Also, it might be that the jammies are what’s making him just a little hotter and when you’re dealing with a high fever, every degree counts.  Lastly, when you’re sick, it just feels good to put on fresh jammies, doesn’t it?  I can remember my mom changing mine when I was sick and feeling clean, cool clothes on my hot body used to feel so good.  So, I change his clothes and usually put him into something cooler.  We do keep him in clothes though because we worry that the sudden change in body temperature might bother him even more (I think we learned that from Bear Gryllis…don’t judge…).  So, even if we just throw a t-shirt on with his diaper, we still keep some kind of clothing on him.

– While I’m changing him, Chris goes to get the medicine and he gives Bean whatever it is time to take.

– With Bean a little more comfortable in his clean, cool jammies and having taken a fresh round of medicine, we start cool compresses.  This part is getting harder the older he gets, but it is so effective for Bean.  We put a cold wash cloth on his face, his neck, and his back.  Just a little something to cool him down.

– If the fever is really high, our next step is a popsicle.  I keep a box of junior sized popsicles in our freezer for hot summer days and for hot, feverish nights.  Not only does it instantly start working to bring down that internal temperature, but it usually distracts or calms Bean down enough so that we can continue with the cold wash clothes without him getting too agitated.  For the popsicle, I sit in the rocking chair with him and hold the popsicle while he gnaws on it and Chris holds the wash cloths to him.

– After the popsicle (usually not the whole thing…), we keep rocking Bean right there until he either calms down enough to lay in his crib or he falls asleep.

– If neither of those things happen and if his fever is still alarmingly high, we might try a cool bath.  Not a freezing bath, but a cool bath.  And Bean HATES this part.  We really don’t do this one unless it’s been HOURS with a very high fever.  We run a cool bath, sit Bean in it and run a wet, cold wash cloth over him for about 10 minutes.  Then we dry him off, put him in clean jammies, and snuggle with him in the rocking chair.  Of course, this all sounds easy, but keep in mind Bean’s pissed and screaming bloody murder through this process.  But the point is not to make him happy, the point is to bring down that fever.

– Once we try all these steps, we put Bean back in his crib and let him sleep for another couple hours.  If in that time his fever doesn’t come down or his condition doesn’t improve, then we call our pediatrician.

    Remember that crying is just a communication tool. It is easy in the middle of the night to become frazzled or hyped up because of the crying.  Bean is a big crier when his fever is high and as much as I use that crying to tell me how bad the situation really is (he has certain cries when he’s just uncomfortable and certain cries when he’s really, really sick), I try to remember that the crying is just Bean’s communication tool.  It’s the only way for him to tell me what is wrong.  The fever itself is also a communication tool.  Until it gets up to the 105-108 range, the fever is not what is dangerous.  It is just the alarm that tells you something is wrong.  So, try not to panic or get overly worked up when the crying is loud and constant.  Be sympathetic and snuggly and do what you can to make them feel better, but remember the goal is not to make your child happier, it’s to make them healthier.  And sometimes, that might mean they’ll have to cry through something they don’t want to do (like a cool bath or a cold wash cloth) but the point is to lower that darn fever.  So, put everything else aside and make that your goal.

    As much as possible, try to keep your child in their own crib. This one will vary from family to family, so it might not apply to your child.  When I was growing up, when you were sick, you got to sleep with my mom and dad.  I remember that very distinctly.  With Bean though, he just doesn’t sleep well with us.  He doesn’t like to be cuddled when he sleeps and so as much as he (and Me!) might like the idea of snuggling in my bed until he feels better, what he really needs is a good night’s sleep.  And, for Bean, that comes in his own crib.  Plus, it’s cooler in there than in the big bed with all the covers and two other people’s body heat.  So, we try to keep him in his own room and his own bed when he’s sick.  (Though, I have been known to try bringing him into our bed when I’m too tired to sit up with him, but that never goes well for anyone…)

    You get more confident as your child grows up, but it scares us all. When Bean was little bity and he had this kind of fever, it would scare me to no end.  I was frantic with worry.  Now, after a couple of these episodes under my belt…well…it still makes me frantic and scared.  But at least I have a better understanding of what to do now.  So, if you’re a new parent, cut yourself some slack – call your doctor more if you need to, call your mom in the middle of the night, do whatever you need to get through it because when your baby is really little, first it can be more dangerous to them, but secondly, you don’t have any background yet to help you get through it.  You can’t tell yourself, “Well, the LAST time this happened…”  So, don’t worry about steps or routines or whatever.  Do what you need to do until you can begin to see patterns of sick behavior in your child – and that takes time.  But even for veteran moms (…of only 18 months…), it is still scary.  But as moms and dads, you just have to push past the scary and take action.  It’s the difference between a parent and anybody else.  Parents take action.  Be scared – that’s a good thing!  It’ll keep you working and trying different things.  But you have to get to the next level of taking action after the fear has come.  It’s what your child needs the most from you.

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    There are a hundred different ways to cool a fever.  These are just the ones that have worked in the past at my house and for Bean.  I’m sure when Gracie comes along, she’ll have her own set of needs and may require her own little fever routine.  Just try things out and see what works best for your child and your family.

    What about you?  What tricks do you use or have you used to cool a midnight fever in your house?

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    19 thoughts on “Cooling a Fever in the Middle of the Night

    1. Very good advice, actually. As a nurse and EMT I see the effects of high fevers all too often, especially this time of year. An unattended fever in a infant/toddler can lead to a seizure and that is the point most parents call 911. If that ever happens to your child don’t panic. Its the body’s mechanism to break the fever and usually not a sign of a disease (such as epilepsy). And Always, always consult your doctor, like you said.

      But I almost always agree…. moms seem to have the best advice.

      Cabin Fever in Vermont

    2. Jen C

      haven’t had to deal with this yet but i’m definitely bookmarking this page for future reference. its always good to have options on other things to try. hope you guys feel better soon! no fun being sick the week of christmas 🙁

    3. Sarah H.

      You’re such a good Mom Katie!
      I’m glad you are all on the mend!!

    4. Lisa

      Don’t have any tips for you since I’m not a mother yet, just wanted to say that I hope Bean, Chris and you are all feeling better soon!

    5. Ashley

      Good to know! Thanks so much for sharing.

    6. We haven’t had a fever with the little one yet, but I’m sure we will. Thank you for some great advice to keep in mind and give a try when the time comes. I’m happy to feel unexpectedly prepared for this now.

      Hope you all feel better soon!

    7. Great tips! Poor Bean…I hope he’s feeling much better, as are you and Chris!

    8. Hmmm…I never thought about this until now. My child is 19 months old and has never had a fever over 101, which came down within the day. He’s never woken up sick, he’s never had more than a stuffy nose. Wow, I’m lucky! Thanks for giving me ideas for when this happens in my house.

    9. Katie, I hope you know I’m bookmarking all of these didactic posts for when I become a parent. I love how you give solutions without being overly-authoritative. You experience has definitely served you well.

      I hope you guys are all feeling better! Sending warm (and cool for Beanie) thoughts your way!

    10. I have to say, we haven’t had any fever in the middle of the night. We have had fevers that show up during the day and in that case, the higher it is, the more lethargic P becomes. He had a terrible virus/bacterial infection during the summer and he was just sad and mopey 🙁

      We too do the alternating Tylenol and Motrin thing, as advised by our doctor. Not something I would have thought of on our own.

      We have, however, had projectile vomiting in the middle of the night and that is a whole different blog topic!

    11. Thank you! I also havent had to deal with that… yet. Does anyone have any good methods for getting an acurate temp?

    12. HeatherN

      Hi there, I’m a peds nurse, and I think all of your interventions are great suggestions. The only thing I would add is that these things should all be done when the fever hits the 101.5-102 range if the fever is just starting, 0r 100-101.5 if the child is fighting a persistent fever over a few days. A fever of 103-104 is dangerous in kids and they can end up with serious dehydration and seizures from it (and seizures can then cause brain damage too if they don’t stop quickly, not to mention they are terrifying for parents). A fever of 105-108 can cause brain damage or be fatal, which is why it’s best to prevent the fever from getting too high in the first place, and to treat it aggressively as soon as you notice it spiking.
      -Some signs that the child’s fever is starting to spike include: feeling HOT to touch (of course), increased heart rate, breathing faster than normal, being weak, that telltale whimper that just says “help me/ make it better,” fussiness/ irritability, listlessness (not wanting to play, just sit & veg)
      -One of the main goals in treating a fever is keeping the person hydrated. This is in part because when they are dehydrated their temp will be even higher, & in part because when they have a fever they are sweating off & breathing off more fluid, & need more fluids put into them to make up for these extra fluid losses. Popsicles, ice cream, those sugary juices that you don’t normally allow- all of these are allowed and encouraged regularly. Often you have to offer the baby a few sips every few minutes while they are awake. If baby is having fewer wet diapers than normal, then you need to go to the ER, because baby probably needs some IV fluids.
      -As far as taking temps, a rectal temp is the most accurate on a baby. If you use a pacifier temp remember it won’t be accurate for 10-20 minutes after the baby has had something to drink (especially popsicles), & an armpit temp is the easiest to get while they are asleep but the least accurate- if you do this, make sure the baby’s arm is folded across the chest so the elbow is touching the chest (it makes the temp more accurate).
      -As for medications: motrin can be given to babies over 6 months old, under 6 months, go with just tylenol. Motrin can be given every 6 hours, Tylenol every 4-6 hours. If the fever keeps coming back every time the meds wear off, don’t be afraid to give both tylenol & motrin around the clock for 24 hours. The easiest way to do this is to give each med every 6 hrs, but alternating, so that you would give tylenol at noon, then motrin at 3pm, then tylenol at 6pm, motrin at 9pm, etc. Honestly, if your baby is sick enough that they have fevers this high, they are not going to sleep through the night, and they should be offered extra fluids in the middle of the night for hydration, so sleeping through the night is not the goal here. It is often easier to give tylenol as a suppository to children under 3 yrs old (provided the dose is right- check with your pharmacist on the dose), because they can’t spit it back out at you. Honestly, it’s not that unplesant for them because they are used to people messing with their butts for diaper changes, and sometimes they even sleep through me giving a suppository. It is much more plesant on both you & baby then making them choke down gross tasting medicine when they are already cranky & uncooperative.
      Oh, and always put the child in one simple light weight t-shirt or even just a diaper, and sleep with one very light weight blanket and that’s it- no fuzzy fleece pj’s or blankets that will hold the heat in, you want the heat away from their bodies. Oh, and change their diaper more often than normal, because the liquid retains heat.
      -Of course, consult your pediatrician early and often, and all of these things are no substitute for talking with a doctor. And if the fever is in the 103-104 range (even 102), you definitely should go to the ER, because the child needs more tests & monitoring (such as blood tests & possibly a spinal tap to rule out meningitis if a culprit hasn’t been identified). And of course, if your mother’s intuition tells you something is truly seriously wrong, listen to it- I have seen many a mother saver her baby’s life because she knew something wasn’t right with her baby, & even though she couldn’t say exactly what, she sought out medical help right away. Sorry for the long post, but I hope it helps!

    13. HeatherN

      correction: if the fever is 102-104 AFTER tylenol and motrin, you definitely need to go to the ER

    14. Tawny

      When I was an infant I developed pneumonia and my fevre spiked. My mother and RN gave me a cool bath to try and break the dangerously high fever while the medics were enroute. My father a cop panicked and ripped me out of the tub, I went into shock and had a seizure. I was paralyzed on my left side only for a week.
      I am totally fine now but fevers are definitely not something to take lightly.

    15. I would never have considered having a sick plan. I think I should make one of those for myself, so I’m all prepared. Only I’m pretty good with normal colds, so I’ll have to plan around the bubonic plague and the like.

      Also?

      I totally shamed myself in the comments on Pioneer Woman’s jewelry post today. And then I thought of you. Because you’re BFFs, not because of the embarrassment. Clearly I’m who you’d think of when referencing stupid things written, not you.

      We all have our little marks of fame. Mine is just sadder than other peoples’.

    16. Deepa

      Thanks for the good advice, Katie! I have a question about popsicles – I want to start using them for teething (4 teeth and 4 molars at once… yeesh) but am worried about choking. What do you do to prevent Bean from taking too big bites? Thanks again!

    17. sue

      Is bean’s hair red or blonde!??

    18. Katie! Thank you so much for this post!!!!! I read it when you posted it and filed it away in my memory b/c I had never experienced a middle of the night fever. Then yesterday it happened. I woke up to my 5 month old screaming her head off with a pretty moderate fever. Somehow I managed to not completely panic (every ounce of willpower I have!!!) and walked through (most of) your steps. I felt like I almost knew what I was doing….almost. She’s still pretty sick and it’s still a guessing game 99% of the time, but your post really helped. So thanks for walking down this road first and then writing about it on your blog….have a great day!

    19. JennyB

      Thanks for the article. As the mom of a 16-month-old who doesn’t get sick very often, but has a fever right now, there was a lot of comfort here!

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