First, know that it is usually not necessary to give your child a fever reducer. In most cases, fever is treated as a comfort measure. If your child’s fever is making them so uncomfortable that they are unable to stay hydrated or rest, then a fever reducer is recommended. Otherwise, the fever should be left alone. Treating a fever will not help your child get better any faster. If your child has a fever, but does not feel bad, then you don’t need to give her a fever reducer. Fevers may even help kids (and adults) recover from illnesses faster. It is a common myth that teething causes fevers. This is not true. Fever in children is almost always caused by an infection.
Safety and Effectiveness Studies
Tylenol (acetaminophen) and Motrin (ibuprofen) have been studied for both reducing fever and pain in children. A meta-analysis of 85 studies that directly compared the two drugs for the relief of fever and pain found that ibuprofen was as effective (or more so) as acetaminophen and both drugs were equally safe. A narrative literature review found that in low-risk childhood fever where the child had no underlying health issues, ibuprofen seemed to be more effective in reducing the child’s distress. But both ibuprofen and acetaminophen had the same safety profiles for these children. But one review of the pediatric literature cautioned that the adverse events reported for ibuprofen were more likely to occur when it was used for fever or flu-like symptoms. As such, it concluded that ibuprofen might not be the first choice for fever, but it should remain the first choice for treating inflammatory pain in children.
Benefits of Motrin and Tylenol
Acetaminophen does have the benefit that it comes in a suppository form (Feverall), so you may be able to use it if your child is vomiting or is refusing to take any medications by mouth. Acetaminophen can be used in younger children, while ibuprofen is usually limited to children over 6 months of age. Motrin does last longer, though—6 to 8 hours, versus 4 to 6 hours for Tylenol.
Alternating Tylenol With Motrin
Another common question is whether it is safe to alternate acetaminophen and ibuprofen. In general, it is best to avoid this practice, because the risk of overdose is too great. If your child has a fever but is well enough to be at home (not in the hospital), they should not need two separate fever reducers. There is also no research to prove that alternating both medicines helps or is safe. If you are alternating two medicines, it is easy to get confused and give an extra dose of one or the other. And in some children, especially if they are dehydrated or have other medical problems, giving both medications can cause serious side effects, especially affecting the kidneys.
Deciding What to Use for Your Child
Motrin (ibuprofen) and Tylenol (acetaminophen) should never be given to a child younger than 2 years old without a doctor’s approval. If your child has a fever but no distress, no medication is needed. If your child has any underlying health conditions, discuss the appropriate use of these medications with your pediatrician to get a recommendation. For a normally healthy child, as long as you are following the age restrictions and dosage recommendations, you could choose either medication. If one worked better in the past without side effects, it might be the best one for your child. Remember that for both acetaminophen and ibuprofen, dosing is based on your child’s weight. Keep the child’s weight from their most recent pediatrician appointment handy in order to give the appropriate dose. If you do decide to give a medication, give the full dose, at the appropriate interval.
