Acetominophen and Ibuprofen |
It should go without saying that none of us want to give our kids medication unless it is necessary. I also always like to see if there are some natural remedies that can help us out. Many low grade temps will resolve with some cool compresses and a tepid bath. Of course there will be times that we need to move to plan B and break out the standard over the counter fever medications. There are several options available for infants and children. Acetaminophen is most often found under the brand name Tylenol, ibuprofen manufactured under the names Motrin or Advil. Generic brands are acceptable. At the end of this post you will find a dosage chart to refer to as your child grows. The charts tell you how many milligrams of each medication your child needs. This is usually based on the child's weight. The different concentrations can be confusing. Let's go back to school for a moment for a quick review. If you take a 500 mg Tylenol tablet, crush it and then dissolve it in a teaspoon (5 ml) of water, you will have 500 mg of Tylenol. If you take the same 500 mg tablet and dissolve it in a cup of water (240 ml). You will still have 500 mg. It is simply in a different concentration. The first step is to see how many milligrams are appropriate for your child. Your next step is figuring out what volume of fluid will deliver the proper dose. That will depend on the concentration of the medicine. Infant and Children's Tylenol have the same concentration of 160 mg/5ml. The only difference is that the infant bottle comes with a handy syringe for accurate dosing. The infant Tylenol used to be more concentrated but that formulation is no longer on the market. It is still important to read the label to make sure you know exactly what you are giving. For kids over 6, there is a fairly new dissolving powder pack that works well. Acetaminophen is usually given every 4-6 hours. Too much Tylenol can be toxic to the liver, so it is important not to exceed the recommended dose. Ibuprofen still has both infant drops and children's liquid. These are NOT the same concentration. It is important to pay attention to which medication and dose you are giving. The infant formulation is about twice as concentrated. Ibuprofen is usually given every 6-8 hours. It can cause tummy upset if given on an empty stomach. This is challenging for sick kids with poor appetites. Ibuprofen is an anti inflammatory, so it is a better choice for treating an injury. For fevers, I don't have a strong preference between acetaminophen or ibuprofen. Ibuprofen does tend to last a little longer which makes it a good choice for a night dose. Both of these medications come in a variety forms. Liquid is the easiest choice for the youngest kids. As they get older, many prefer chewable tablets. Acetaminophen also comes in a suppository form. This is very useful for a child who won't cooperate with oral medications. It is also a valuable option for someone who is vomiting. For kids over 6, there is a fairly new dissolving powder pack that is easy to give. Eddie, from the Feel Good Pharmacy, offers options that you can't get in a standard drugstore:
Compounded products need a prescription even though the medications are over the counter. He also can only ship within California. If a fever is lasting longer than a few days in a row, it is worth getting seen by your doctor. If you are dealing with a stubborn fever and have a diagnosis, it is okay to alternate the medications. An example of this would be: 9 am Tylenol 12 noon Advil 3 pm Tylenol If the fever is staying under control, spread out the doses: 9 am Tylenol 1 pm Advil 5 pm Tylenol Medication errors happen more often than you can imagine. Consider putting a piece of masking tape on the bottles and mark off times and dates of dosages. This can help sleep deprived parents keep track of when they gave what. It also alerts partners if a dose was recently given by another caregiver. This is a good habit with antibiotics as well. Another option is to keep a notebook nearby and document your doses there. Figure out which method works best for you and make sure that all the caregivers stick with the plan. It is worth having a syringe on hand for accurate measuring. These are easily available at any pharmacy or online. When it comes to medicine, some folks are under the assumption that less is better and try to give partial doses. This doesn't usually do the trick. I like to use an analogy here. Imagine that you are trying to fix something on the roof. To get up there you need to climb a ladder. You must climb high enough to actually get on the roof. Climbing halfway gets you nowhere aside from hanging on a ladder. With medicine, you need to give enough to be efficacious (enough to get you all the way up to the roof.) In some cases your child might respond to a smaller dose. If that is the case, by all means give the smallest amount that you can get away with. In my experience, most kids need the full dose to achieve relief. The correct dose adjusts with your child's weight. That dose that the Dr. gave you when your infant came in for their first shots? It is not going to cut it for your 25 pound toddler! Keep in mind that neither of these medications work instantly. It is common to have to wait at least 30 minutes or so before you notice any relief or decreased fever. Most of the time, acetaminophen and ibuprofen are safe to give with other medications. Be careful if you are giving any of the multi-symptom cold remedies. Many of these already have the fever reducer as one of the ingredients; you don't want to double dose. A little bonus tip is that the benadryl dose is generally the same volume as Tylenol. If your child is under 3 months of age, and you feel that they need any medication, check with your doctor's office. Any young infant with an elevated temperature needs to be evaluated. If your child is teething,those symptoms can linger for weeks at a time. I try to reserve Tylenol and/or Advil for occasional use. Getting a good night's sleep if your child is having a ridiculously fussy day seems reasonable once in a while. There are many other comfort measures to try first. |
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