The short answer
Check how your child looks before anything else: a child with a danger sign, such as a fit, fast or difficult breathing, a rash that does not fade under a glass, or being very hard to wake, needs a hospital now, night or not. Otherwise take the temperature with a digital thermometer, offer drinks or breastfeeds, dress them in light clothes, and check on them through the night. A fever that settles by morning and comes back at night is still a fever: arrange a malaria test, and see a doctor if it lasts five days or more.
See a paediatrician by videoMedically reviewed by Dr Debo Odulana, Founder and Chief Executive, Mezo. Last reviewed . This page is general information, not a diagnosis. Care is decided with you after an examination.
Go to a hospital now
Do not wait for the morning. Go straight to an emergency department, or call 112, if your child:
- Has a fit, or is very drowsy, floppy or hard to wake
- Is struggling to breathe, breathing very fast, grunting, or the chest sucks in under the ribs
- Has blue, grey, pale or blotchy skin, lips or tongue (on dark skin, check the palms and soles)
- Has a rash that does not fade when you press a glass against it
- Cannot drink or breastfeed, or vomits everything
- Has a stiff neck, or a bulging soft spot on the head
- Is a baby under three months with a temperature of 38°C or more
What to do at home tonight
If none of those signs is there, NICE and the NHS advise:
- Offer drinks often. If you breastfeed, breast milk is the best drink
- Dress your child in light clothes and use a light cover. Do not wrap them up, and do not strip them either
- Do not sponge them with cold or tepid water: NICE does not recommend it
- Medicine for fever is for a child who is distressed, not to bring the number down. It does not prevent febrile fits. Check the dose for your child's weight with a doctor or pharmacist, and do not give two fever medicines at the same time
- Check on your child during the night, and look for signs of dehydration: a dry mouth, sunken eyes, no tears, a sunken soft spot, few wet nappies
- Write down the temperatures, times and any medicine given
Why the fever seems to go in the morning
Body temperature normally rises and falls a little through the day, which is why NICE defines fever as a rise above that normal daily variation. A fever can look worse at some hours and better at others, and a dose of fever medicine given at night can make the morning reading look normal. A fever that keeps coming back is still the same illness and still needs its cause found.
The next morning
In Nigeria a child with fever should have a malaria test, a rapid test or a blood film, before any antimalarial is given, as the national malaria guidelines say. A negative test means a doctor should look for another cause. Be seen again if your child seems less well, you are more worried than before, or the fever lasts five days or more.
What it costs on Mezo
One fixed price, paid online.
Common questions
My child has a fever at night but is fine during the day. Should I worry?
Watch closely, but you do not need to panic if your child is playing, drinking and passing urine in the day. Arrange a malaria test, and see a doctor if the fever lasts five days, or sooner if anything on the hospital-now list appears.
Should I wake my child to give fever medicine?
Not just to lower the number. Fever medicine is for comfort. Do check on your sleeping child through the night, and wake them if you are worried about how they are breathing or responding.
Can I give an antimalarial at night and test tomorrow?
No. Malaria should be confirmed with a test before treatment. The national malaria guidelines say so, and the fever may not be malaria at all.
Can I talk to a paediatrician about tonight's fever by video?
Yes, if your child has none of the danger signs. Book a video consultation and have the temperatures, times and medicines ready. If any danger sign appears while you wait, go to a hospital.
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Worried about the fever, but no danger signs?
Talk it through with a paediatrician by private video call, with your child beside you. The fee is shown before you pay, and if your child needs to be examined or tested, the paediatrician tells you where and how soon.
See a paediatrician by videoSources and further reading
The guidelines and patient information this page is checked against. Care in Nigeria follows the same evidence; what differs is the price and where it is done.
- Fever in under 5s: assessment and initial management (NG143). National Institute for Health and Care Excellence (NICE). Clinical guideline.
- High temperature (fever) in children. NHS. Patient information.
- National Guidelines for the Diagnosis and Treatment of Malaria, 4th edition (2020). National Malaria Elimination Programme, Federal Ministry of Health, Nigeria, 2020. Official publication.
Links last checked 29 October 2026.
Medical disclaimer: This guide is general information and does not replace advice from your own doctor. Where your centre's instructions differ from this guide, follow theirs.