This is surprisingly very confusing – especially if you read the back of a box. So let’s walk through this step by step
Starting rules for giving Acetaminophen and Ibuprofen
1. Any child less than 3 months with a fever (100.4 F or 38.0 C) measured rectally needs a call to your pediatrician
2. A child should be 6 months or older to receive Ibuprofen (MotrinⓇ)
3. We dose Acetaminophen and Ibuprofen based on WEIGHT – but the box of medicine usually doesn’t help (they only give tips on age)
4. Weigh your child. You can even do this by weighing yourself and then holding your child.
5. Write down the weight in pounds to the nearest tenth OR write down the weight in kilograms (if it is available on your scale)
6. Make sure you have the correct “strength” of (TylenolⓇ) or Ibuprofen (MotrinⓇ)
7. Use the table to figure out the correct dose of (TylenolⓇ) or Ibuprofen (MotrinⓇ) (Double check the concentration of the medicine you have on the box with the concentration listed below.
8. The recommendations below are for
Acetaminophen (TylenolⓇ) 160 milligrams per 5 ml (160 mg/5ml)
Ibuprofen (MotrinⓇ) 100 mg per 5 ml (100mg/5ml)
Above image from Children’s Hospital Of Minnesota Patient Education
How Often do I give (TylenolⓇ) or Ibuprofen (MotrinⓇ)?
Acetaminophen (TylenolⓇ) can be given every 4 hours
Ibuprofen (MotrinⓇ) can be given every 6 hours
Can I give them "at the same time"?
This is confusing! People tell me to “alternate” or “rotate them” or even give them at the same time. What do we recommend?
Combining or alternating Acetaminophen (TylenolⓇ) and Ibuprofen (MotrinⓇ) just doesn’t do much extra and in my opinion makes it very easy to make a mistake in dosing and more stressful for parents.
Remember, there is no need for FEVER phobia. Fever is the body’s response to infections, and the reason we treat fever is so kids can be more comfortable. Fever will usually always come back so long as the infection is still around.
The Fever Chart
In our house – we have a simple paper chart we keep on the fridge, so that everyone knows the last time a child got some medicine.
Let’s look at an example below:
So in this example our child had a fever at 8am so we gave Acetaminophen (TylenolⓇ). She got better and then a new fever spiked at 11am. Since that was less than 4 hours from the last dose of Acetaminophen (TylenolⓇ) we gave Ibuprofen (MotrinⓇ)
(We could not give Acetaminophen because it was not 4 hours since the last dose)
Now if the next fever is at 6pm – we can give whatever we want! (it’s been more than 4 hours from the last Acetaminophen and more than 6 hours from the last Ibuprofen)
What else can we do? (or avoid)
The goal here is comfort. We can not magically make it so the fever never comes back (it’s going to come back so long as they are sick).
- Put children in loose comfortable clothing. Not excessively bundled or wrapped. If the child is having the “chills” – please put a blanket on them so they are comfortable.
- What are chills? When a child has a fever, their thermostat has reset so that their body wants to be at high temperature. Chills are involuntary shaking of their muscles that actually help increase their temperature (it’s why a lot of kids say they feel cold right before their chills or shakes start)
- Cool wash clothes are fine, but make sure they are not too cold. Take them off if your child starts to feel cold
- Yes – drink plenty of fluid. When your child has a fever they do need more fluids
- You don’t need to wake up your child to give fever medicine on a schedule. Let them rest
NEVER do any of the following
- Give your child aspirin
- Never use alcohol baths
- Treat a fever for a child less than 4 months without calling or talking to your pediatrician
- We care more in this age because these infants don’t have their full set of vaccines yet, have an immature immune system to fight illnesses and because signs of them being more sick can be subtle
When should I go straight to the ER?
- A child who can not keep down or drink any liquids
- A child who is so sleepy all day that it is hard to wake them up
- A child who describes severe neck pain and can’t move their head even after you’ve given them medicine for fever and pain
- A child who is having trouble breathing, even after you treat the fever
- Seizure with fever:
- Although relatively common in the ages between 6 months and 5 years (3% of all kids less than 5 will have one) – we recommend a visit to the ER and calling 911 when you see and are dealing with your first one.
- Your parent “instinct” says they are not acting right even after you’ve done all the things above
