Pain relief medicines for children

A while ago I was contacted by Hannah who I’d met at the BritMums Live! conference back in June. She works for Nurofen for Children, who have recently launched a campaign to help parents use pain relief medicines more effectively to treat their child’s pain and fever symptoms. As part of this, they sponsored a small poll involving 500 mums (MumPoll, Mums Study, April 2012) which asked various questions about pain relief for children. Within the email that Hannah sent me were some results from this poll, and I was quite surprised by them, in that many mums did not seem to know as much about pain relief for children as I thought was general knowledge. I guess I take it for granted that my parents are pharmacists and therefore, along with working in their pharmacy myself as a teenager, I’ve grown up knowing quite a bit about medicines and how/when to take them (or not!)

So I thought I would do my bit in helping to dispel some of the myths surrounding pain relief medicines for children, by writing a blog post about how we use paracetamol and ibuprofen for Andrew (and will do for baby). First, I should say that I’m a firm believer in buying generic (pharmacy-own brand) medicines if they are cheaper than the brands like Calpol and Nurofen, because I don’t believe there is any difference in how they work, despite having heard, either directly or via Facebook or other such media, that various people’s little ones apparently had some kind of reaction (e.g. sickness, runny nappy) after they used own-brand medicine – we’ve never experienced such things with Andrew. I should also say that so far we’ve been very blessed with a child who has hardly ever been ill, had a raised temperature, or suffered much from teething pain. So our use of pain relief medicines has been quite rare, and we’ve only recently started on our second bottles of paracetamol and ibuprofen since he was born 21 months ago. I know this is not the case for all children, some of whom need pain relief more often than others, as is the case with us adults (I know I take paracetamol, and ibuprofen when I’m not pregnant, more often than Tom, for example).

We first used paracetamol when Andrew had his tongue tie snipped at 10 weeks. This was a one-off dose of 2.5ml, as he was still under 3 months old (but he was over 4kg and wasn’t premature – 2 things that need to be the case to give it to a less than 3-month old). He didn’t seem to be too affected by pain after the snip, and calmed down much faster with a feed than he did for his vaccinations, but I thought we’d give him a dose just in case. We didn’t give ibuprofen at this age, because it should only be used from 3 months in babies over 5kg. According to the MumPoll survey, over a quarter of the 500 mums didn’t realise that you can give ibuprofen even as young as 3 months, and I’d say that anecdotally amongst mums I know, this seems to be the case, with paracetamol (or rather ‘Calpol’) being the name that rolls off the tongue in conversation when talking about what they have in for pain relief in young babies.

I’d also say that in general amongst mums, of babies or toddlers, paracetamol is the medicine that I’ve heard mentioned most often when we’re talking about what their child has for pain relief and/or fever. This is supported by the results of the MumPoll survey, which showed that paracetamol is a preferred treatment among mums, with almost two thirds choosing it over ibuprofen to reduce a fever. Maybe it’s because that’s what we remember having as a child ourselves – I know I for one liked the taste of the paracetamol suspension I was given for pain relief, especially for all my bouts of tonsillitis before my tonsils were whipped out. But these days ibuprofen is also an option, and it’d be great if more parents knew about it and what it can do.

Since Andrew was 3 months old, we’ve used both paracetamol and ibuprofen for two main reasons: a raised temperature and teething pain. He’s never had en extremely high temperature, but the times that he has been at 37 or 38 degrees, one or two doses of both medicines (with the correct timing between doses) have helped to bring it down very quickly. That’s another thing that I’ve been surprised by: not everyone knows that doses of paracetamol and ibuprofen can be given at exactly the same time, because the two drugs work in different ways. (It’s the same for adults – taking the correct doses of paracetamol and ibuprofen at the same time is fine.)

The MumPoll survey showed that nearly 60% of mums chose paracetamol with the belief that it provides the fastest relief from fever, but in my experience, I’d say that both paracetamol and ibuprofen work at speeds that aren’t distinguishable from one another, and apparently (according to Nurofen for Children) there is evidence that ibuprofen works faster to reduce fever, in as little as 15 minutes (Pelen et al (1998) Treatment of fever. Monotherapy with ibuprofen. Ibuprofen paediatric suspension containing 100mg per 5ml, muliti-centre acceptability study conducted in hospital. Annales de Pediatrie 45(10):719-728. I don’t have access to this journal, so I can’t comment on their research, and the title doesn’t mention a comparison with paracetamol, but Nurofen’s claim seems to be based on something more than my anecdotal evidence that ibuprofen works pretty quickly!)

In my (again, anecdotal) experience, it seems that a fairly common belief amongst parents of young children is that paracetamol is for reducing fever and ibuprofen is an anti-inflammatory and therefore is for relieving pain like teething and earache that might be accompanied by inflammation. Whilst it is true that ibuprofen is an anti-inflammatory, it also works to reduce a high temperature, similarly to (but not in the same way as) paracetamol. And the great thing is, as I said above, you can use them both at the same time! However, you should always read the label on the bottle and check that you’re giving the right dose of each for the child’s age and leaving enough time between doses.

Finally, there’s a handy (if slightly cheesy 😉 ) summary of paracetamol and ibuprofen use for pain relief and fever in children given by Dr Hilary Jones on youtube. I know I’m technically a ‘Dr’, but I guess you’re more likely to take on board what a medical doctor says about pain relief than what I’ve written here, which is based on our own experience. If you’re a parent of a young child, I hope you found this post useful and informative.

Disclaimer: All personal views expressed in this post are my own, based on my own experience. I was given no incentive for writing this.

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