A child’s fever is one of the most common reasons for doctor visits. There are only a couple of medicines that are safe for infants; ibuprofen (aka Motrin) and acetaminophen (aka Tylenol, paracetamol). Which one works best?

Recent studies show that ibuprofen 10mg/kg is slightly better than acetaminophen 10mg/kg in terms of more rapid effectiveness, as well as lasting a bit longer (over 6 hours). It also may being a high fever down more effectively. Perhaps it’s because ibuprofen is also anti-inflammatory, while acetaminophen is not. But both are so safe, and so commonly used, that you certainly should try both to see which may be more effective.

By the way, both medicines have very different chemical structures and can be used together — just make sure it’s the right dose. Some parents like to alternate every 4 hours, and that’s fine as well. Parents should use whichever they think works best, but consider trying ibuprofen first if they aren’t sure. It’s the same as in adults; most people know after trial and error which medicine works best for them.

Why Not Aspirin?

Doctors don’t recommend aspirin for children due to the rare but serious risk of Reyes syndrome.

Don’t forget that ibuprofen is generally very safe but can cause heartburn symptoms if used many times, or for many days (same problem as in adults). Tylenol does not have that stomach problem; large overdoses can cause liver problems.

Do You Even Need To Treat A Fever?

An important point for parents, especially nervous first-timers, is that you do not need to treat your child’s low grade fever. For a typical common cold low fever , anti-fever medicine certainly isn’t directly killing the virus, and it doesn’t speed up healing the infection; it’s only for comfort. There is data to suggest that a light fever (under 40 celcius, 104 fahrenheit) is an effective germ fighter, and taking anti-fever medicine (especially ibuprofen) may slightly inhibit that natural healing process. On the other hand, no good studies show that taking anti-fever medicines will prolong a common cold. So, if your child seems otherwise well and isn’t too irritable, you don’t have to constantly monitor your child’s temperature and automatically give medicine every time their temp is over 38 celcius/100.4 fahrenheit. It’s much more important to keep up a healthy diet, to rest and stay hydrated.

A higher fever is a different story; the body’s immune system starts to deteriorate at temperatures over 40 celcius/104 fahrenheit. At those temps, you should definitely use fever medicines. You don’t have to obsess over brining it down 100% to normal; a few degrees is usually beneficial. This may be the time to use both medicines at the same time. Also, at this high temperature, you need to be evaluated by a doctor.

By the way, you  should not avoid these pain/fever medicines for any condition just because you’re coming in to see your doctor because you think they may diagnose it better; a good doctor can diagnose anything even while you’re taking pain/fever medicine; so, please, there’s no need to suffer — take your pill!

Where To Buy

These are both generic and OTC, available in all expat and local pharmacies, at the same doses as in your home country.