Your baby is hot, miserable and not sleeping, and you are standing in front of the medicine cabinet unsure which bottle to reach for. Both medicines can help a feverish, uncomfortable baby, but they have different age limits and rules. Here is a clear comparison of acetaminophen vs ibuprofen for babies, and how to use each safely.
Quick answer: acetaminophen vs ibuprofen for babies
- Acetaminophen (paracetamol): can be used from 2 months in many countries (from birth with medical advice); gentle on the stomach.
- Ibuprofen: only from 6 months (or above a minimum weight, depending on the product and country); also reduces inflammation; give with food or milk.
- Dose by weight, using the syringe that comes with the medicine.
- Fever in a baby under 3 months needs a doctor first, not medicine at home.
Acetaminophen (paracetamol)
- reduces fever and pain
- usually given every 4 to 6 hours, with a maximum of 4 doses in 24 hours
- suitable for babies who are vomiting or have tummy problems
- avoid in babies with liver problems unless your doctor advises it
Ibuprofen
- reduces fever, pain and inflammation
- usually given every 6 to 8 hours, with a maximum of 3 doses in 24 hours
- give with milk or food to protect the stomach
- avoid if your baby is dehydrated, vomiting a lot, has chickenpox, asthma made worse by ibuprofen or kidney problems
Can you alternate them?
Health services usually advise using one medicine first. If it does not help and your baby is still distressed before the next dose is due, you can try the other. Do not give both at the same time, and keep a written record to avoid mistakes.
Giving medicine safely
- Check the strength on the bottle; infant and child versions differ.
- Dose by weight, or by age if weight is not known, following the leaflet or your pharmacist.
- Use the oral syringe provided, never a kitchen spoon.
- Write down the time and dose of every medicine.
- Never give aspirin to babies or children.
See how to give baby medicine safely and safe pain relief for babies.
Do you need to treat the fever?
Fever is the body fighting infection. Medicine is to make your baby more comfortable, not to bring the number down. If your baby is happy and drinking well, you may not need to give any. See baby fever: when to worry.
When to talk to your doctor
- any fever of 38°C (100.4°F) or higher in a baby under 3 months
- fever of 39°C or higher at 3 to 6 months, or lasting more than 2 to 3 days
- a rash that does not fade under a glass, breathing difficulty, a seizure or unusual sleepiness: seek emergency help
- you think you have given too much medicine: get advice immediately, even if your baby seems well
Frequently asked questions
Which works faster?
Both start working within about 30 to 60 minutes. Ibuprofen may last a little longer.
Can I give medicine before vaccinations?
Usually not needed. Follow your nurse’s advice; some schedules recommend paracetamol after certain vaccines.
What if my baby spits out the dose?
If most of it came straight back, ask your pharmacist whether to repeat it. Do not guess.
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Sources
- NHS: Paracetamol for children; Ibuprofen for children
- American Academy of Pediatrics, HealthyChildren.org: Medications Used to Treat Fever
- NICE: Fever in under 5s
This guide is general information, not medical advice. Always follow the product leaflet and ask your doctor or pharmacist before giving medicine to a baby.