Pain Reliever Guide for Babies

Chances are, you’re familiar with your pain reliever options. Maybe you take an Excedrin when the telltale migraine throb starts, an ibuprofen to help quell your post-Pilates soreness, or an Aleve for period pain. But when it comes to babies and pain relievers, there are so many questions! Not only can babies not tell you what hurts, their small and sensitive bodies are more prone to drug reactions. For help navigating the nail-biting path to baby pain relief—including the recommended dosage of Tylenol and ibuprofen for babies—follow our guide.

Baby Tylenol vs. Baby Ibuprofen

There are two primary over-the-counter pain relievers for infants and toddlers: acetaminophen and ibuprofen. While both are used to help relieve fever, aches, and pains, the mechanics behind acetaminophen and ibuprofen are different. Acetaminophen reduces pain signals from the body’s nervous system, while ibuprofen blocks the formation of substances that trigger the sensation of pain stemming from swelling or inflammation. For the most part, they work equally well, but a 2020 analysis in JAMA Network Open did find that ibuprofen was associated with slightly better fever reduction within the first 24 hours compared with acetaminophen. Here are the basic differences between OTC baby pain relievers:

Infant and Children’s Acetaminophen

• Other names: Infant and Children's Tylenol, Feverall, Tempra, Actamin, and Panadol
• How it works: Reduces pain signals from the body’s nervous system
• Formulations: Available in a liquid and chewable tablets, and rectal suppositories
• Who can take it: Safe for babies over 6 pounds, however it’s not recommended for babies under 12 weeks old, regardless of weight, unless your pediatrician tells you otherwise.
• Timing: You can give acetaminophen every 4 to 6 hours, if needed.
• Warnings: Check with your pediatrician before giving acetaminophen to a child under 2 years old. Do not give more than 4 doses in 24 hours.

Infant and Children’s Ibuprofen

• Other names: Infant and Children's Motrin and Advil
• How it works: Blocks the formation of substances that trigger the sensation of pain stemming from swelling or inflammation
• Formulations: Available in a liquid, concentrated drops, chewables, and tablets for older children
• Who can take it: Safe for babies over 12 pounds, however, if your baby is less than 6 months old, do not use ibuprofen unless your child’s doctor tells you to.
• Timing: You can give ibuprofen every 6 to 8 hours, if needed.
• Warnings: Do not give ibuprofen to babies under 6 months old. Always call your pediatrician before giving ibuprofen to a child under 2 years old. If your child has kidney disease, asthma, an ulcer, or another chronic illness, talk to your pediatrician before giving ibuprofen.

Are ibuprofen and Tylenol safe for babies?

If used correctly, over-the-counter infant and baby pain relievers are very safe. But if you accidentally give your baby too much, your child can become very sick. For instance, too much acetaminophen can lead to liver damage and, even death in rare cases, while an excess of ibuprofen can cause stomach issues, confusion, and possible kidney problems. Early symptoms of an acetaminophen or ibuprofen overdose include nausea, vomiting, stomach pain, pallor, and tiredness. If you suspect your child has consumed too much medicine, call your child’s physician and/or poison control at 800-222-1222.

To ensure the safest possible dosing, use your child’s weight instead of their age when figuring out how much medicine to give. And follow pediatrician-approved dosage charts for acetaminophen and ibuprofen.

Is aspirin safe for babies?

No. Never give aspirin to a baby unless your child’s doctor says it’s safe. While aspirin is another medicine used to quell pain, fever, and swelling, the American Academy of Pediatrics (AAP) strongly recommends that you don’t give aspirin—or any medications containing aspirin—to your child or teenager when they have any viral illness, particularly chickenpox or influenza. Aspirin can cause a rare but very serious illness called Reye syndrome that most often strikes children younger than 15. It can gravely affect all organs, hitting the brain and the liver the hardest. Aspirin is also called acetylsalicylic acid, so always read all medicine labels carefully.

Tylenol (Acetaminophen) Dosage Chart

Check with your pediatrician before giving acetaminophen to a child under 2 years old.

Infant Tylenol Drops Dosage

Baby’s Weight: 6 to 11 pounds (0 to 3 months, but not recommended for babies under 12 weeks)
Infant Drops Dose: 1.25 milliliters (mL)

Baby’s Weight: 12 to 17 pounds (4 to 11 months)
Dose: 2.5 mL

Baby’s Weight: 18 to 23 pounds (12 to 23 months)
Dose: 3.75 mL

Children’s Liquid Tylenol Dosage

Toddler’s Weight: 24 to 35 pounds (2 to 3 years old)
Dose: 5 mL

Toddler’s Weight: 36 to 47 pounds (4 to 5 years old)
Dose: 7.5 mL

Children’s Tylenol Chewable Tablet Dosage

Toddler’s Weight: 24 to 35 pounds (2 to 3 years old)
Dose: 1 tablet (160 milligrams)

Toddler’s Weight: 36 to 47 pounds (4 to 5 years old)
Dose: 1.5 tablets (240 mg)

Ibuprofen (Motrin, Advil) Dosage Chart

Check with your pediatrician before giving ibuprofen to a child under 2 years old.

Infant Ibuprofen Drop Dosage

Baby’s Weight: 12 to 17 pounds (6 to 11 months, ibuprofen is not recommended for babies before 6 months, regardless of weight)
Dose: 1.25 mL

Baby’s Weight: 18 to 23 pounds (12 to 23 months)
Dose: 1.875 mL

Toddler’s Weight: 24 to 35 pounds (2 to 3 years old)
Dose: 2.5 mL

Toddler’s Weight: 36 to 47 pounds (4 to 5 years old)
Dose: 3.75 mL

Children’s Liquid Ibuprofen

Baby’s Weight: 12 to 17 pounds (6 to 11 months, ibuprofen is not recommended for babies before 6 months, regardless of weight)
Dose: 2.5 mL

Baby’s Weight: 18 to 23 pounds (12 to 23 months)
Dose: 4 mL

Toddler’s Weight: 24 to 35 pounds (2 to 3 years old)
Dose: 5 mL

Toddler’s Weight: 36 to 47 pounds (4 to 5 years old)
Dose: 7.5 mL

Children’s Ibuprofen Chewable Tablets

Toddler’s Weight: 24 to 35 pounds (2 to 3 years old)
Dose: 2 tablets (100 mg)

Toddler’s Weight: 36 to 47 pounds (4 to 5 years old)
Dose: 3 tablets (150 mg)

What’s the difference between infant ibuprofen and children’s ibuprofen?

Because babies may not be able to swallow large amount of medicine, liquid ibuprofen for infants (dubbed “infant drops”) is a more concentrated formula than ibuprofen for children. That means infants take less because the medication is stronger, making it super important to always read the label of your child’s medication. If a parent or caregiver were to accidentally give a child between the ages of 2 and 11 the more concentrated infant’s ibuprofen, an overdose might occur. Alternatively, if an infant gets the less concentrated children’s ibuprofen, the baby might not get enough medicine to be effective.

What’s the difference between infant Tylenol and children’s Tylenol?

There is no difference. Infant and children’s acetaminophen is the same strength. For decades, infant Tylenol was stronger than the children’s version. Then in 2011, the Food and Drug Administration recommended all children’s acetaminophen formulations be one strength.

Concentrated infant drops are no longer available. Interestingly, Infants’ Tylenol is more expensive than the children’s version, reportedly because of the sturdier bottles and the inclusion of a dosing syringe. No matter which version you opt for, the most important thing is to get the dosing right.

Should I alternate between Tylenol and ibuprofen for fever?

When a little one is dealing with a persistent fever, it’s sometimes advised to alternate between acetaminophen and ibuprofen as symptom-soothers. But the AAP stated that there’s “insufficient evidence to support or refute the routine use of combination treatment with both acetaminophen and ibuprofen.” And a 2019 report in the journal Frontiers in Pediatrics affirms this stance, noting that while alternating meds is slightly more effective at reducing fever than the one-drug-and-done method, the benefit is “not clinically relevant,” and the practice should not be encouraged. The main reason: The meds’ varying doses and drug strengths makes combo treatment more complicated and can contribute to accidental overdose. That said, alternating between acetaminophen and ibuprofen might be a good option if your child’s pain or fever is not helped by monotherapy. Be sure to check in with your child’s physician before embarking on this strategy.

Can I use a spoon to give my baby liquid Tylenol or ibuprofen?

No. Never use a kitchen spoon to measure medicine! Instead, the AAP notes that it’s very important to use a dosing tool with markings on it that came with your child’s liquid medication. Dosing tools include oral syringes, special dosing spoons, droppers, and dosing cups. If a dosing tool was not included with your medicine bottle, ask your pharmacist for one. And please know that medicine can be measured in different ways. While you may see teaspoon (tsp) or tablespoon (tbsp) on a dosing tool, the AAP encourages you to only measure meds with a dosing tool that uses milliliters (mL). To further ensure you dose your child correctly…

• Always use an oral syringe when you’re measuring less than 5 mL of medicine.
• Gently squirt the medicine between your child’s tongue and the side of their mouth when using a dropper or syringe. Don’t put the medicine in the back of your little one’s throat (this can cause choking)!
• Wipe excess medication off the syringe. Dipping the dropper inside the bottle can leave residue on the outside of the syringe.
• Consider a bottle adapter, also called a spill-proof stopper. Using one allows you to insert the oral syringe into the medicine bottle, tip the bottle, and get the proper dosage without any lingering residue. Ask your pharmacist for one or buy online.

Should babies take medicine for fever?

That depends. According to Dr. Harvey Karp, a fever on its own isn’t necessarily concerning. In fact, the AAP states that fever in children over 6 months old probably don’t require meds…unless the child is uncomfortable. To help keep feverish kiddos get comfy:

• Ensure their room is cool enough.
• Offer a lukewarm bath.
• Dress them in loose, light clothing.
• Encourage them to drink water or a store-bought electrolyte solution
• Have them rest.

However, if your baby is younger than 12 weeks and has a temperature of 100.4 degrees Fahrenheit or higher, call your pediatrician for advice. The same holds true for any child whose temperature repeatedly rises above 104 degrees Fahrenheit. Also, reach out to your child’s physician if their fever is coupled with listlessness, an increase of fussy or irritable behavior, dry mouth, no tears, fewer wet diapers than normal, severe sore throat or ear pain, and/or has an underlying condition, like cancer.

More on Baby Pain and Medicine:

• What’s the Best Teething Pain-Reliever?
• How to Relieve Shot Pain Without Meds
• Toddlers and Growing Pains
• The Truth About Baby Cold Medicine

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• American Academy of Pediatrics (AAP): Acetaminophen Dosing Tables for Fever and Pain in Children
• Children’s Health of Orange County (CHOC): Acetaminophen vs. ibuprofen: A guide for parents
• AAP: Ibuprofen Dosing Table for Fever and Pain
• Comparison of Acetaminophen (Paracetamol) With Ibuprofen for Treatment of Fever or Pain in Children Younger Than 2 Years: A Systematic Review and Meta-analysis. JAMA Open Network. October 2020
• Neumors KidsHealth: How to Safely Give Acetaminophen
• AAP: Fever and Pain Medicine: How Much to Give Your Child
• Neumors KidsHealth: How to Safely Give Ibuprofen
• AAP: Reye Syndrome
• Stanford Medicine Children’s Health: Reye Syndrome in Children
• MedlinePlus: Ibuprofen dosing for children
• AAP: Using Over-the-Counter Medicines With Your Child
• org: Don’t mix up concentrated “ibuprofen infant drops” with “children’s ibuprofen”
• National Public Radio (NPR): Tylenol For Infants And Children Is The Same. Why Does 1 Cost 3 Times More?
• Fever and Antipyretic Use in Children. Pediatrics. March 2011
• Prescribing Controversies: An Updated Review and Meta-Analysis on Combined/Alternating Use of Ibuprofen and Paracetamol in Febrile Children. Frontiers in Pediatrics. June 2019
• Alternating acetaminophen and ibuprofen for pain in children. Canadian Family Physician. June 2012
• AAP: How to Use Liquid Medicines for Children
• Intermountain Healthcare: Getting the Right Medication Dose for Your Baby
• Nationwide Children’s Hospital: How to Give Medicine by Mouth
• AAP: Fever: When to Call the Pediatrician

Disclaimer: The information on our site is NOT medical advice for any specific person or condition. It is only meant as general information. If you have any medical questions and concerns about your child or yourself, please contact your health provider.