Fever Management in Children

Fever- one of the biggest concerns parents

have regarding children.

Use of Tylenol (acetaminophen) and Motrin/Advil (ibuprofen) on an Alternating Schedule to Reduce Fever in Children

Alternating between the two products, acetaminophen and ibuprofen, every three hours, is a treatment option for the reduction of fever in children.  As an example, the recommended dose of acetaminophen would be given, and then three hours later the recommended dose of ibuprofen would be used. This would be followed by another dose of acetaminophen three hours later and then continuing to alternate back and forth between the two every three hours. It is generally recommended to limit this type of use of these products to 24 hours unless directed to continue by a provider.

Important tips to keep in mind:

·        Carefully read labels for active ingredients as there are various over-the-counter products with Tylenol, Advil, or Motrin in their name which may contain additional active ingredients.

·        Store brands often save money and are usually located near similar brand name products.

·        Follow the dosing information on the product packaging based on the child’s age and/or weight.

·        Be sure to use the appropriate dose measuring device – either what is included in the medication package or provided by a pharmacist/provider for use with the specific product.

·        Professional dosing that is not on the packaging may be available from the provider/pharmacist.

·        It is not ideal to give Motrin to any child under 6 months of age.

·        Children should not be given aspirin or aspirin containing products as this can cause a serious life-threatening emergency called Reye’s Syndrome.

When to contact the provider:

·        If an infant under 2 months old has a rectal temperature of 100.4F or higher or for a rectal temperature of 102F or higher in a child between the ages of 2 to 6 months.

·        If the child is 7 months to 2 years and has a temp of 104F or higher.

·        Before alternating medications, especially for infants under 6 months.

·        If the child has severe abdominal pain, severe headache, stiff neck, or a fever beginning after prolonged sun exposure.

·        If the child has a chronic medical problem associated with an increased risk of infection, such as diabetes, cystic fibrosis, sickle cell anemia, does not have a spleen, etc.

·        If the child is unusually sleepy/difficult to wake, has rapid, difficult or labored breathing, has a convulsion/seizure, or is so irritable that he/she cannot be consoled/quieted.

·        If the child is not drinking and has signs of dehydration, such as not urinating, dry mouth, or sunken eyes.

·        Or if you are concerned about your child- remember your provider is always there for you!