The Do’s and Don’ts of Fever medications in babies and children!

Can you give pain/fever medications to your new baby?

I always like to start with the fact that newborn babies should never be given any pain medications like Tylenol or Motrin. If your newborn is uncomfortable or has a fever (a temperature more than 100.4 measured rectally) you should contact your pediatrician. The pediatrician will probably send you to the ER for further testing to make sure your baby does not have a bacterial infection. Before the age of 2 months, if your baby gets a fever, they will need further testing. That is why we really encourage families to avoid crowded places or having visitors around who may be sick. We also recommend making sure that all family members or anyone that may be involved in the care of the baby be vaccinated for the Flu and Tdap to protect the baby who cannot get vaccinated yet. Once your baby is older than 2 months and had the first set of vaccines, it is at this visit that your baby will get a prescription and information on pain medications and dosages. This is provided as your baby may have pain or a low-grade fever for the first 24 hours after the vaccine. This fever is just a sign to show that your baby’s body is developing an immune response. It is nothing to be worried about and often parents do not medicate as most babies are not bothered by it and it often resolves on its own. We recommend families not premedicate their baby with pain medications before the vaccine visit.

What should you know about Pain medications like Tylenol (Acetaminophen) and Motrin (Ibuprofen)?

Firstly, there is no difference between Acetaminophen and Tylenol. One is the generic and less expensive version, and the other is the brand version. Families can use either formulation but just remember pricing may vary. Always make sure to check the dosing on the bottle as your pediatrician will give you dosing based on the weight of the child. Most Tylenol/Acetaminophen bottles are dosed at 160mg/5ml – the liquid version. I recommend Tylenol for babies younger than the age of 6 months old. Remember this medication can be given every 4 hours as needed for pain/fever.

Motrin or Ibuprofen are also the same thing but one is generic and the other is a brand version. Again, the pricing may vary but most liquid dosing formulations are 100mg/5ml. The dose your pediatrician will recommend is based on the weight of the baby. I recommend using this for fever and pain in children older than the age of 6 months. Remember this medication can be given every 6-8 hours as needed for pain/fever.

What does the pediatrician mean by “you can alternate the medications Tylenol and Motrin” if your child continues to have a fever?

This is recommended sometimes when your child may continue to have high fevers which make the child uncomfortable even though they have taken a fever medication. Remember Fever medications last for a certain duration (Tylenol 4 hours and Motrin 6-8 hours) so once the medication starts losing its effect the fever starts to rise again and it sometimes happens that there has not been enough time to give another dose of the same medication. So, if you have a child with a fever and you give a dose of Tylenol, and the fever starts rising again before the 4 hours are up you can then go and give your child a dose of Motrin. So, the pattern looks something like an alternating dose of Tylenol and then Motrin. I always recommend only one parent or caretaker be responsible for medication administration and they should write down the medication, dosage, and time it was given to prevent any overdosing.

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