Acetaminophen in concentrated infant drops will no longer be produced by manufacturers- and that’s a very good thing. There were dosing errors as people used concentrated infant drops on older children. It was easy to get it confused: if a child weighs twice as much as in infant, wouldn’t it make sense to give them twice the infant dosage? Of if you give one teaspoon of children’s Tylenol/Acetaminophen to your child- then couldn’t you give them one teaspoon of infant drops for the same result? With that understandable reasoning, the danger begins. Dr. Hugh Gilgoff of LICH Pediatrics explains, “if you use one teaspoon of the concentrated infant drops you will be giving 500mg! This is an adult dose, and this potential for confusion or a real overdose is the very reason they are now taking the concentrated drops off the market.” Now, there will be just one dose- 160/5 ml.
To clear it all up and explain how and when to use Acetaminophen and Motrin, our Expert Pediatrician for the blog, Dr. Hugh Gilgoff of LICH Pediatrics, clears it all up.
What is Fever?
Fever is a sign of an infection – either a virus or bacteria. Fever also comes at times as a reaction to vaccinations. Fever by itself is not dangerous, but you may want to bring your child to see the doctor if you are not sure where the fever is coming from. If there is a mild cough and cold, it is most likely a virus, and no antibiotics are needed. But if your child is acting very sick, and is not energetic and/or the fevers are getting higher and lasting many days, you should bring them in so we can diagnose the source of the infection and give medicines if needed. We usually say fever is any temperature above 100.4 if the baby is less than 2 months old, and then anything above 101. Higher fevers are not necessarily predictive of more serious diseases, as many viruses can cause high fevers. True lethargy or breathing fast is always worrisome regardless of the temperature. I encourage parents to bring down fevers mainly to make the child feel better, and therefore eat, drink and play more. With a bad bacteria, even when a fever is down, the child will often remain lethargic, but with a virus, they often perk up. There is not rule that is 100% – that is why computers will never replace a good pediatrician!
Fever medicines are safe if used in the right doses. The real reason to use a fever medicine is to make your child feel better, as they are usually not as happy with a real fever. You can use Tylenol, and after 6 months, you can use Motrin. The real name of Tylenol is Acetaminophen. The real name is Motrin is Ibuprofen. There may be different manufacturers, and the actual name brand of Tylenol and Motrin was actually taken off the market in certain ages/concentrations, so any generic version is fine to use.
There is confusion now because they are phasing out, or taking off the market a certain concentration of Tylenol/Acetaminophen. This concentration was stronger, and therefore you needed to give less of this liquid to achieve the same strength. This was called the infant version, and came 80mg/0.8ml and the dropper was graded as 0.4 or 0.8ml. The way that we dose all fever medicines – both in adults and children and infants, is by the medicines’ strength or milligrams. The newer infant Tylenol is in fact the same concentration as the children’s liquid. They are both 160mg/5ml, which means that IF you gave 5ml, which is one teaspoon, you will be giving 160mg. If you wanted to give 80mg, you would then give half that amount, or 2.5ml. This 80mg would the SAME 80mg as 0.8ml of the older infant Tylenol.
What was the big deal? What do we change?
If you have the older infant Tylenol dose, you can still use that medicine. Just make sure that you are using the correct dose. If you use one teaspoon of the concentrated infant drops you will be giving 500mg! This is an adult dose, and this potential for confusion or a real overdose is the very reason they are now taking the concentrated drops off the market .
Again, the children’s Tylenol, at 160mg/5ml is ok to give to babies, as long as you give the correct dose, and that dose is based on their weight and not age. After a 2 month old gets their shots, you can surely give Tylenol, and you can give the dose every 4 hours overnight. After 6 months old you can use motrin/ibuprofen, and you can use only Motrin, or only Tylenol or you can rotate the medicines every 3 hours. The Tylenol medicine can only be given every 4 hours, and the Motrin medicine can only be given every 6 hours, but you CAN give one medicine one hour after giving the other if the fever has not come down enough. You can check drgilgoff.com for doses of the medicines based on your child’s age/weight.
Is a Fever ever Dangerous?
There are situations where the fever shoots up very quickly and a young child can get a “fever seizure”. These are very scary, as your child is shaking and having a real convulsion for many minutes. If it is a straightforward, “simple” fever seizure, it is not dangerous.
We don’t give aspirin to children. Be careful of combination products, like those cold medicines that have Tylenol in addition to Sudafed, as you can’t use these AND give Tylenol on top of it, or you risk an overdose. We don’t recommend cold medicines in young children anyway, as they don’t work well and can have side effects.
Your child is bound to get some fevers! It is a right of passage, as kids just love to share their germs! But hopefully you now feel better equipped to assess and then help treat that fever.