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Pain relief for children

Lets talk meds. What do you do if your child is unwell and has a fever? What if they are teething? What if they have injured themselves?

Do I use Paracetamol or Ibuprofen?


This is a common question, and one I get asked in almost every session I teach. They are both great forms of pain relief, but do work in different ways and are dependent on a number of things.


Paracetamol (panadol, dymadon, panamax)

  • For infants and children older then one month

  • Can be given 4 -6 hourly, maximum of FOUR times in 24 HOURS. {Dose is 15mg/kg, but always follow the guidelines on the packet of medicine, as there are various strengths sold depending on the brand}

  • Metabolised by the liver

  • Reduces pain and fever

  • works by blocking the pain messengers (prostaglandins) in the brain thus reducing the amount of pain the child is feeling

  • Infections can also increase the production of prostaglandins, but the ones that actually work on the hypothalamus (the “thermostat” so to speak, located in the brain) which in turn make us hotter and result in a fever. This is how paracetamol also works at reducing a fever.

Ibuprofen (nurofen, brufen, advil, dimetapp)

  • Reduces pain, fevers and inflammation

  • For infants and children older then 3 months

  • Can be given 6 - 8 hourly, no more then THREE times in 24 hours. {Dose is 10mg/kg, but always follow the guidelines on the packet of medicine, as there are various strengths sold depending on the brand}

  • is also an anti-inflammatory

  • is metabolised by the kidneys

  • reduces prostaglandins in the WHOLE body, and not just in the brain like paracetamol does.

  • Needs to be given with food or milk (however a one off dose is fine on an empty stomach)


As paracetamol and ibuprofen are different classes of medication and work differently in the body, this allows the two medicines to be given together at the same time if needed. Remember to always write down what medicine you gave and what time to avoid any mistakes from happening - the tired brain at 3am with a sick baby can often lead to forgetting which drug you gave and at what time.

Do not go more then 48 hours of needing paracetamol or ibuprofen consistently without seeing a GP.


Pain

  • if the pain is a result of a head injury, give paracetamol only unless advised by a doctor otherwise.

  • Both paracetamol and ibuprofen work well. If the pain is a result of teething or another inflammatory cause however, ibuprofen would be my suggestion as it works on both the pain receptors as well as reducing the inflammation.

  • If the pain is occurring without inflammation, then offer paracetamol first as it is gentle on the little tummies. This is especially true if they are not eating or drinking as a result of their pain (#HFM hello mouth ulcers from the super common childhood illness - Hand foot and mouth!)

  • Paracetamol and ibuprofen do work well together when managing pain, so if needed, you can alternate between the two or give together when required.


Fever

  • Both are great options as both reduce a fever.

  • There is no added benefit to combining the two/alternating in between, so it is often best to choose one of the medications and give as required to avoid becoming confused and risking overdosing the child on the medicine.

  • Remember there is no need to give medicine to reduce a fever unless the child is irritable with it. Treating with medicine will not prevent a febrile convulsion from happening either which is one of the most common reasons behind trying to reduce a fever.


Inflammation

  • Ibuprofen.

  • This includes inflammation as a result of an injury (likely suggested to give by your doctor), teething, or infections such as tonsillitis or ear infections.



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