Hello Neata, Thank you for describing your daughter’s situation. I understand how frightening it is. In young children, body temperature regulation is still immature, especially during sleep. After viral infections, some children develop a temporary disturbance of thermoregulation, leading to low nighttime temperatures.
Possible causes - Post-viral autonomic dysregulation, Physiologic Nocturnal Hypothermia, Effect of Anti-pyretics, Low-body mass + Sleep related heat loss.
It is appropriate to rule out: Endocrine causes, Neurological causes affecting thermoregulation. The tests ordered (TSH, FT4, cortisol, ACTH) are appropriate and sufficient as a first step.
Based on what you described: A nighttime temperature around 35°C during sleep, with a well child during the day, is not an emergency. True dangerous hypothermia would be associated with lethargy, altered consciousness, poor feeding, breathing problems, which your daughter does not have Waiting until Monday for hormone tests is safe.
What you should do right now- Keep her comfortably warm, but do not overheat. Use layers, socks, blanket, room temperature ~25°C. Avoid constant temperature checking unless she looks unwell. No need for hot water bottles if she is sleeping comfortably. Observe behavior, not just the thermometer.
Reasonable specialists in order of priority: Pediatric endocrinologist, Pediatric neurologist, Immunologist. A pediatric tertiary care center (children’s hospital) would be preferable if further evaluation is needed.
This pattern is rare but described, and in most reported cases: It resolves spontaneously. Leaves no long-term consequences. Does not affect development.
I know this is stressful, but based on the information provided, there is no indication that something dangerous is being missed.
Feel free to reach out again.
Regards, Dr. Nirav Jain MBBS, DNB D.Fam.Medicine
Your child’s symptoms are most consistent with transient autonomic (thermoregulatory) immaturity or post-viral hypothalamic dysregulation, which can cause exaggerated nighttime temperature drops while daytime activity and development remain normal. This condition is usually benign and self-resolving, and waiting for scheduled endocrine tests (cortisol, ACTH, TSH, FT4) is safe as long as she is alert, feeding well, and responsive during the day. For proper evaluation and reassurance, consult a pediatric neurologist (autonomic regulation), pediatric endocrinologist, and a pediatrician experienced in post-viral autonomic disorders, with emergency care only if temperature falls below 34.5°C or she becomes lethargic or unresponsive.
Hello dear It seems post viral response in children. It will improve with time. Following precautions can be taken Good hydration Night warming measures Adequate diet Protection from infection Hopefully improvement will occur Regards
Recurring post-febrile hypothermia in children, especially like you’re describing for your daughter, can be understandably concerning. Recognizing your worry, it’s important to ensure her safety and explore possible causes. You’re already doing the right thing by seeing multiple specialists. Here’s what might be helpful next. First, ensure she’s safe at night. Since her temperature is dropping, using warm water bottles, ensuring she’s appropriately dressed, and monitoring might prevent further drops. But since this happens post-fever, it makes sense to consider the body’s response to illness and temperature regulation. A drop in temperature after febrile episodes sometimes suggests a dysregulation in thermal set point—sometimes seen transiently in children post-illness. Reviewing endocrine results already on the path is essential, as thyroid issues or adrenal insufficiency could, in theory, contribute. Waiting for cortisol, FT4, TSH, and ACTH results seems appropriate—these can help rule out potential endocrine causes. In the meantime, maintain her well-hydrated and nourished to support her homeostasis. Consultation with a pediatric neurologist for autonomic dysregulation might be prudent—although less common, this could contribute if ongoing regulation issues arise. A pediatric immunologist could assess any unusual immune response if standard causes aren’t clear. If any result suggests a significant issue or her condition worsens, especially if she becomes less responsive, immediately seek emergency care. As for Dr. Cochino, if reaching him’s challenging, consider contacting IOMC directly to outline your urgency or contact your local healthcare administration to explore recommendations on alternative access routes. If available, use healthcare networks or platforms in Romania to get quick referrals; sometimes, discussing with your primary care provider can uncover alternative pathways to specialized care. Keeping detailed logs that document temperature changes, activities, dietary intake, and episodes could also provide valuable pieces of the puzzle when you consult specialists.
Analizele endocrinologice au ieșit normale, imunologul spune ca nu tine de imunologie, am vorbit și cu un neurolog dar spune că nu pare o problema neurologica. Medicul de familie nu știe unde sa ne mai îndrume. Nu știm unde sa mai cautam problema pentru a o rezolva
Hello Neata Thank you for sharing these details about your daughter. I understand how worrying it must be to see her temperature drop at night, especially when it happens repeatedly after viral illnesses.
What you described:
- Your daughter (2 years 8 months) has episodes of low body temperature (around 35°C) at night after viral illnesses, lasting a few nights each time.
- She is otherwise well during the day—active, eating, and playing.
- Routine lab tests are normal.
What this could mean:
- In young children, especially after viral infections, the body’s temperature regulation can sometimes be temporarily affected. This is called “transient post-infectious hypothermia.”
- Since she is well during the day and her labs are normal, this is reassuring and suggests there is no serious underlying illness.
- However, persistent or repeated hypothermia (low body temperature) is unusual and should be monitored closely.
What you can do:
- Continue to keep her warm at night, as you are doing, with warm water bottles or extra blankets.
- Monitor her temperature at night and note any other symptoms (shivering, lethargy, breathing changes, or if she becomes difficult to wake).
- Make sure she is not overdressed or overheated, as this can also affect temperature regulation.
Next steps:
- Since this has happened multiple times, it would be best to discuss this pattern with a pediatric neurologist or endocrinologist, to rule out rare causes like metabolic or hormonal issues.
- You can share your temperature logs and the pattern you’ve noticed with the doctor.
Hope she will get fine soon and nothing to Worry as of now .
Thank you
Mulțumesc mult. Am fost la Endocrinologie, analizele au ieșit normale, imunologul spune ca nu tine de imunologie , am vorbit și cu neurologil și spune ca nu pare ceva neurologic
Grozav. Nu-i nimic de care să-ți faci griji. Fiica ta se va face bine în curând. Dumnezeu să o binecuvânteze.
Thank you
