To Treat or Not to Treat: Medical Help from Dr. Mom

It’s time for another Practical Moms Feature!

Melissa, or Dr. Mom as she’s also known, has been one of my favorite mom bloggers for quite some time now.  She is a pediatrician and mom of two, and her stories and advice always seem to be just what I need to read on any given day.  We seek each other’s counsel fairly regularly these days, and I enjoy her friendship as much as her expertise.  So please head on over to visit Dr. Mom after you soak up this very useful information on when to medicate and when to step back.  Leave her some love here, but then please go visit her over there…

To Treat or Not to Treat: Navigating the Use of Acetaminophen and Ibuprofen in Your Child

With all the news recently on when and when not to give pain and fever reducers, it’s completely understandable why parents may end up confused.

Should I treat my child’s fever? If so, do I use acetaminophen or ibuprofen?

How much should I give and how often?

Should I give my child a pain reliever before his vaccinations?

Is there any harm in giving my baby some Tylenol for her teething pain?

These are all common questions posed by parents, so I’m here today (thanks to the lovely Katie) to give you the lowdown on fever reducers and pain relievers when it comes to making your child feel better.

In general, I recommend the prudent use of any and all medications in children. This includes antibiotics, acetaminophen (Tylenol), and ibuprofen (Advil, Motrin). The reason is that for most minor viral illnesses such as colds and fevers associated with them, your child’s body is pretty darn good at fighting off that infection without us interfering so much.

And, with recent studies indicating a potential link between acetaminophen use and increased asthma symptoms, there’s even more reason to be as prudent as possible.

We also know that fever does a body good. So, while you may not like seeing that thermometer read 101.2 F, taking a hands off the medicine approach will actually aid in your child recovering more quickly.

With this in mind, I’ve created a DO and DON’T list for when to reach inside your medicine cabinet, and when to sit back, offer up plenty of liquids, TLC…and wait (the hardest part, I know!)

DON’T reach for acetaminophen and/or ibuprofen for:

  • Vaccination pre-treatment. Studies have shown that the use of acetaminophen can actually decrease the immune response to a vaccine. If your child has prolonged pain or high fever following her vaccinations, contact her doctor.
  • An infant less than 4 months old. If your baby has a fever (100.4 or higher), you should contact his pediatrician immediately and do not give him any medicine. Fevers in babies can signify potentially serious infections and should always be evaluated by a healthcare provider.
  • No ibuprofen for babies less than 6 months old.
  • Fever. As I said, fever really does a body good. It activates your child’s immune system and aids in recovery. However, if your child’s fever is climbing rapidly and is reaching 103 F or higher, then by all means, give her some acetaminophen or ibuprofen. Also be sure to keep her hydrated, and contact her pediatrician if the fever continues beyond 3 days.
  • Teething. Acetaminophen and/or ibuprofen should not be your first line of defense when it comes to teething. Offer other comfort measures like a cold washcloth and cold teething rings. If your child is having trouble sleeping at night and you think it’s from teething, some children will benefit from a pain reliever. Just be sure to check with your child’s doctor that nothing else is going on with your child.

DO treat for:

  • Pain. Whether it’s a headache, a raging ear infection, or a sprained ankle…pain relievers work. No need to be afraid to tackle the pain with either acetaminophen or ibuprofen.
  • High fever. As I mentioned above, a high fever that’s making your child miserable certainly warrants some fever control.

So, as you can see, there are plenty of reasons to resist the urge to treat minor fevers and/or minor pain. When you do reach into the medicine cabinet, keep in mind that acetaminophen recently underwent new formulation changes. The infant drops (80mg/0.8ml) are being phased out and will now be sold as a standard formulation of 160mg/5ml. This phase out is not complete and both can still be found in some stores. So be careful. Double check which concentration you have and always base your child’s dose on her weight. If ever in doubt, contact her doctor.

I like this chart for acetaminophen dosing, and this chart for ibuprofen dosing.

Another last word of caution, aspirin should never be used in children due to the risk of Reye Syndrome. I know it’s not marketed toward children, but it’s worth mentioning. Also, if you have a strong family history of asthma, or your child has asthma, it’s a good idea to avoid acetaminophen if you can until further studies elucidate this link between its use and increased asthma symptoms.

Does this help you navigate through the use of acetaminophen and ibuprofen? What questions do you have for me?


About Katie

Katie Hurley is a Child, Adolescent, and Family Psychotherapist and Parenting Expert in Los Angeles, CA. She works in private practice in the South Bay area of Los Angeles, writes for PBS Parents, Washington Post Parents, and the Huffington Post. She is the author of "The Happy Kid Handbook: How to Raise Joyful Children in a Stressful World" (Tarcher/Penguin, 2015) and "No More Mean Girls: The Secret to Raising Strong, Confident, and Compassionate Girls" (Penguin Random House, 2018)