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Ibuprofen, Tylenol, or a Popsicle? A Parents’ Guide to Kids Pain Relief

No parent wants to see their child suffer. But sometimes, the safest way to treat aches and pains may not involve medication at all.

The tricky thing about pain is that it is, to some degree, subjective. It is emotional as well as physical and, even the most competent adults probably have trouble putting that pain on a scale. My pain is, um, at a 7? With kids it is usually even less clear. You’re lucky if they can even articulate which area of the body is causing distress. This leaves parents in a bind. Should you reach for the ibuprofen or try to tough it out?  Should you trust that their arm hurts so bad they need Tylenol or some other kids medicine? Or do you just try to distract them?

“The big picture is that we don’t want kids to feel pain if they don’t have to, and over-the-counter pain medication is part of the solution,” says Andrew J. Bernstein, M.D., a clinical assistant professor of pediatrics at Northwestern University and spokesperson for the American Academy of Pediatrics. “But in many situations, it’s good to try other methods of relief first.”

Why? Because getting rid of pain with medication can hurt kids. According to a report from the consumer watchdog site ProPublica, acetaminophen-associated overdoses account for approximately 78,000 emergency room visits, 33,000 hospitalizations, and more than 300 deaths annually. The drugs can also cause liver damage if taken for too long. So it’s prudent to be cautious, but that’s easier said than done when it’s 3 AM and your little one is sobbing for you to “make it better.” Now what? Here’s your guide for three common situations.

The Situation: Kids Headache

The solution: It seems logical to reach for pain meds when your child has a headache. For occasional cases, child acetaminophen is fine, says Dr. Bernstein, “but with chronic head pain, you risk your child getting a rebound headache by overuse.” It’s also possible for a child to develop a reliance on the medication — not a physical addiction, says Dr. Bernstein, but a psychological one. Before heading for the medicine cabinet, consider natural alternatives first. “You can say, ‘Let’s have a big glass of water or let’s go out in the fresh air,’” he suggests. Other remedies include:

  • Resting in a dark room (light can exacerbate headaches)
  • Using a cold compress on the forehead
  • Eating sliced fruit and a cheese wedge (low blood sugar can trigger headaches)
  • Drinking fluids (dehydration is a major head pain contributor)
  • Gently massaging your child’s forehead

The Situation: Flu Shot Arm Pain

The solution: It’s that season again. Flu shots may result in soreness or fever for a day or two, but some research suggests holding off on giving kids pain meds because they can block the production of certain antibodies, making the shot less effective. Dr. Bernstein isn’t convinced. The research is theoretical, he says, and treating your child’s pain should always come first. If your child is hurting, it’s OK to give them a dose of Tylenol. When it comes to the sting of the shot itself, choose distraction over medication. “The shot is over so quickly, you are better off taking your child’s mind off it by playing music or using a toy that vibrates against the skin and grabs their attention,” he says.

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If your infant or young child develops a post-shot fever and you’d rather skip the meds, try placing a cool washcloth on the forehead to help bring the temperature down. If the fever is exceptionally high or lasts more than 24 hours, talk with your pediatrician.

The Situation: Baby Teething Pain

The solution: Pain from teething is typically caused by inflammation of the gums, so nonsteroidal anti-inflammatories (NSAIDs) can help. The problem, though, is that teething can go on for weeks or even months. “You don’t want to get in the habit of turning to pain medication every time your child has teething pain or you will be overusing it,” says Dr. Bernstein. Tricks like giving them a frozen washcloth or cold spoon to mouth on can provide relief, as can teething toys that apply pressure to the irritated areas. For older children with adult teeth coming in, rinsing with a lukewarm glass of water mixed with salt can help, as can pressing an icepack against their cheeks.

The bottom line, says Dr. Bernstein, is kind of common sense. “There is no reason for kids to suffer from pain if a medication can ease it,” he says. “Just don’t use it for chronic conditions, and be sure to try other approaches like distraction and soothing first.”

Ibuprofen, Tylenol, and the Kid Pain Reliever Cheat Sheet

These basic rules can keep your child safe.

  1. Always check the label for dosing instructions. Never give a child medication that’s for adults.
  2. Stay away from aspirin for kids under 18 months. In a rare number of cases it can cause Reye’s syndrome, a serious condition involving swelling of the liver and brain.
  3. Check with your pediatrician before combining meds — even over-the-counter ones. They may have the same active ingredient, meaning you are giving a double dose.
  4. Use the dose cup that comes with the medication. Kitchen “teaspoons” can vary drastically in size resulting in accidental overdoses.
  5. Use your child’s weight as a final gauge of dosage. Many labels provide age guidelines, but those are really determined by an average weight per age. If your child is heavier or lighter than most, talk with your doc about adjusting the dosage accordingly.