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Is it better to give my 3-year-old acetaminophen or ibuprofen for pain or fever?
Q: My son is 3 years old. If he has a fever or is in pain, which is better to give him: acetaminophen or ibuprofen?
A: When children are uncomfortable with an illness or injury, the medications most commonly used to treat fever and pain are acetaminophen and ibuprofen. These are known as “anti-inflammatory” medications because they can reduce the inflammation in the body tissues that leads to fever and pain.

A recent study compared the safety and efficacy of acetaminophen and ibuprofen in children. The study found that both medicines were equally effective for pain relief, but the study didn’t examine their use for different kinds of pain (e.g., headache vs. illness vs. injury). The study did find that ibuprofen was slightly more effective than acetaminophen at reducing fevers, but acetaminophen was generally adequate as well. The study found that acetaminophen and ibuprofen were equally safe. But it is important to note that ibuprofen has never been tested in babies under 6 months of age, so when treating young infants, only give acetaminophen.

Although both acetaminophen and ibuprofen can be helpful in reducing children’s discomfort with fever or pain, don’t automatically reach for the medicine. Remember that it’s always safest to use non-medical ways to relieve children’s fever and pain—giving them plenty of attention and hugs, fluids to drink, and massages. These can calm their discomfort and avoid the rare risks of side effects of medications. It also teaches them that you don’t always need to treat discomfort with a drug. See the articles on this web site, “Children’s Illnesses: Is Medication Always Necessary?” and “Fevers: What You Need to Know.”
Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician