Motrin or Tylenol: The Great Debate for Treating Fever in Kids

                            Motrin vs Tylenol: The Great Debate for Treating Fever in KIds

 

As a pediatrician, I am asked on a daily basis from worried parents about what they should give their child with a fever,  Motrin (Ibuprofen) or Tylenol (acetaminophen) to bring down the temperature.

 This question always requires more than a one word response to the choice between antifever medications .  An explanation about if medication is even necessary for the fever and to clarify many long standing fever phobia misconceptions.  Mainly, it is not necessary to treat the number on the thermometer, nor is it always necessary to bring the temperature down.

 What is important is to address how the child is feeling and behaving regardless of their temperature. Are they happy, playful drinking fluids or are they cranky, irritable and uncomfortable? If the former then no fever reducing medicine is even necessary.  What pediatricians want parents to know is to not be scared of fever, it’s the body ‘s way of fighting off the infection. The goal of a fever reducer is to make a kid feel better so they can rest and recover.  The over the counter medicine does treat the illness nor make them better or less contagious any faster. The take home message is to use fever reducers for added comfort not just because your child has an elevated temperature documented on the thermometer.

 

Now that you have come to the decision that a fever reducer is warranted, here is some information on helping you decide which one to use Motrin or Tylenol.

Fever reducer tips by Dr. Jen

Fever reducer tips by Dr. Jen

 

Efficacy and Safety - Both Tylenol and Motrin are effective in bringing fever down in otherwise healthy kids over the age of 6 months.  From my longstanding experience with patients, the fever does tend to decrease  faster and remain lower a bit longer with Motrin than with Tylenol. But choosing which to give when your child is sick often comes down to what you have on hand in your kitchen or bathroom cabinet when your child needs it. Always use the measuring device that comes with the bottle or a measuring spoon or syringe. A kitchen spoon is not an accurate measure and can lead to under or even overdosing.

Length of Action- Tylenol can be given at 4 hour intervals as needed where as Motrin is every 6 hours. As a parent, it’s nice to have less dosages to administer, especially if it’s a struggle because your child does not like to take medicine in the first place.  An all to common practice in my opinion is alternating Tyenol and Motrin. Parents often do this to keep the fever “down” or suppressed. In most cases this is not needed especially if you remember treatment is for comfort and not trying to get the thermometer to read 98.6F. In addition alternating medication every 3-4 hours leads often to medication errors and overdoses which can potentially be severe. So if you are giving both,( a practice I rarely recommend) please make sure to write down which medicine, the dosage and what time it was given, so all caregivers are aware to avoid errors.

Dosing is Key- Regardless of whether you are giving Ibuprofen (Motrin) or acetaminophen (Tylenol), make sure you know the correct dosage for your child. Dosage is always based on their weight NOT on their age. This will help to ensure the medication works as weight is much more accurate than a child’s age (so keep their weight from their last check up visit handy). A common mistake I hear when a parent tells me that a fever reducer “didn’t work” is not giving the full recommended dosage. Often parents are scared of over medicating so they give a reduced or lesser amount than indicated and then are surprised it didn’t help the symptoms adequately.   Tip, if you are going to give a medication always give the correct full dosage each time.

Pros and Cons - Tylenol can be administered to infants under 6 months of age. It does not cause stomach upset and can be used for pain or for fever reducing and lasts about 4 hours. An added perk about acetaminophen is that it also comes in suppository form if your child is vomiting or refusing to take anything by mouth, often this is the easiest route to deliver the medicine in a sick infant/toddler.  The downside to Tylenol it can cause liver toxicity if given in excess or accidental overdose,  so give as directed and keep it stored high up and out of range when not in use.

Motrin is also great for fever reduction but has added benefit for reducing inflammation likes sports and muscle injuries. It keeps fever down longer and the dosing is less often at every 6-8 hours as needed. Remember Ibuprofen is for children over the age of 6 months of age, it may cause more stomach upset so avoid if your child is vomiting or not eating.

Lastly which fever reducer to give may ultimately come down to your child’s preference. Neither fever reducer will be helpful if they just won’t take it. Because both are safe and effective when taken correctly, opt for the one your child will take without a major meltdown or tantrum. This may be based on its flavor, consistency or even form ( liquid vs chewable)  And remember lots of extra TLC , added fluids to drink to avoid dehydration and even a tepid bath or cool compress on their forehead for added comfort and relief.

 

How To Say “NO” So Your Child Will Listen

Do you feel like you’re always saying No to your child and not getting the response from them that you are looking for? Do you end up repeating yourself over and over, so frustrated you begin to yell or just given in to your toddlers demands? Unfortunately, I hear this way too often from moms so I wanted to give some tips on the art of saying No that will get your child to cooperate, understand and be safe.

 To begin with, kids do much better when there are clear boundaries, routines and structure to their day. Consistency is key, not only with what you say but what you do. Your child is always watching you. The goal of discipline especially in a young toddler is to teach them to understand in order to get a desired result, it is not a punishment. So here’s my advice and strategies to making ‘NO” count.

How to say No

 

Tips on Saying NO to Your Child

 

Say NO less often- Really?? (yup its true) Use it only when you mean it and when necessary, for example to avoid dangers such as your toddler touching a hot stove, running into the street, hitting or biting.  They will quickly learn that “No” mean “No”, so don’t overuse it. Saying it all the time just dilutes its effectiveness and confuses kids as to its importance.

 

Distractions work – Instead of repeating “No” over and over when they want something they just can’t have, try distracting them with another item or engage them in a new activity.  Be sure not to get into a battle with them (most toddlers are great at manipulation, until we lose our patience and cave in to their whining.)

 

Catch them Being Good- So you probably think you do this and you probably do use praise but you know what most parents don’t realize it but they tend to more often tell their child what not to do or what they are doing wrong rather than praising accepted good behavior. So I recommend accentuate the positive way more often than the negative.  Give a lot of attention and praise to the good behavior and efforts. So if your child is playing nicely with his toys. Give her a shout out, that you noticed how attentive she is with her dolls. It also doesn’t haven’t to be verbal praise but just a touch or squeeze on their arm with a smile. Yes, this is called positive reinforcement and it works!

 

Ignore Bad Behavior – I know this seems counterintuitive but it really works. Attention around a child’s misbehavior increases the unwanted behavior. At every age kids like attention and sometimes they will even try to push your buttons to engage with them even if you’re yelling, making idle threats or seem angry. Their goal is to be heard, get their way and to pay attention to them. So how should you respond? I suggest “Planned ignoring” but it will only help to shape a child’s behavior if the child is getting positive attention most of the time. (see tip above) In addition once the undesired “bad” behavior stops, step in with the positive attention. Here is an example.

If your child is dropping food onto the floor from their high chair, instead of saying “NO don’t do that”, ignore the action, and as soon as she returns to eating appropriately, point it out and give some positive attention. With a smile say “I love the way you use your spoon” or “how clever you are to feed yourself” rather than focusing on your child throwing the food on to the floor. By doing this, you continuously shape the behaviors you want to see more of and the negative behaviors disappear.

 

Consistency is Key – One of the hardest things is being consistent, especially when you are a mom with 1001 things to do before the day ends.  I advise to pick your battles and don’t make idle threats (follow through is very important) If you have house rule that you only want kids eating in the kitchen and not in the tv room, you need to enforce it daily not every once in a while or your little one won’t be clear on the rules. In addition be a role model for your kids because kids are always watching and your actions speak louder than words.

 

Parenting is hard, as a mom of three I truly get it. (and one with special needs). I know how chaotic days can often be, but try your best to keep positive. Your children will definitely make mistakes and test your limits. They will be loud at times, whine, stomp their feet and want everything their way. This is part of child development and it’s an ongoing learning process. Fill most of the day with love, affection and consistency. Shaping behaviors, just like healthy habits takes time, energy and patience, but I guarantee it does work. Good Luck Mamas! Questions? Comments? Let me know how its going. – Dr. Jen

How to say NO