Childrens Analgesics

INFANT ANALGESICS

Many OTC analgesic medications are not suitable for use by infants and children. Some can be dangerous as children’s organs such as their liver and kidneys are still developing and are unable to break down medicines as efficiently as adults. The most commonly used analgesics for infants and children for the treatment of pain and fever today are Paracetamol and Ibuprofen. Both analgesics are safe and effective for common childhood illnesses. OTC analgesics are available in drops or syrups for babies and young children. Parents should always read labels carefully to minimize the risk of overdose.

Identifying Pain in Babies and Toddlers

Babies may be crying to communicate many things which may be mistaken for pain, such as: hunger, trapped wind, soiled nappy, tiredness or overheating. It is important to rule out any of these causes before administering pain relief. Toddlers may be able to communicate using words, or they might hold or rub the part of the body that is causing them pain, for example they may poke or pull their ears if they may have an earache.

Causes of Pain

Colic: may start within weeks of birth and symptoms peak around two to three months of age. Parents can be reassured that it should resolve by three to four months. Babies may have periods of intense crying, often in the early evening, pull up their legs and arch their backs. They should still feed and gain weight. Teething: first teeth can start appearing in babies around six to nine months of age. Symptoms may appear from as early as three months, before teeth are visible. Teething causes pain and discomfort around the gums, swollen gums, excessive saliva production and an increased tendency to chew on objects for relief. The child may also have red, hot cheeks. Colds and flu: caused by many different viruses, colds are normally mild and resolve within a couple of weeks. Symptoms include sneezing, sore throat, runny nose, mild fever and a cough. Flu symptoms may come on more quickly, and make the child feel more poorly. They may complain of aching muscles. Ear infections: children are more susceptible to ear infections and these often follow a cold. Symptoms include ear pain, fever, vomiting, hearing loss and lethargy. Children may pull or tug at their ear and have a cough or runny nose. Ear infections should resolve within a few days. Sore throat: often caused by a viral illness, a sore throat can be alleviated with pain relief.

Paracetamol and ibuprofen for babies and children

Paracetamol and ibuprofen are safe for treating pain and fever in babies and children. Both are available as liquid medicines for young children. A sugar-free version should be recommended as medicines that contain sugar can a child’s teeth.

Paracetamol is safe to use for babies over 2 months onwards. Paracetamol works by blocking pain messages - the source of the pain is still present, it’s just not noticed as much. It can be taken on an empty stomach or with food or milk, and takes approximately 30-60 mins to work fully. Its effect lasts up to 4 hours. Ibuprofen can be given to children who are aged three months or older and who weigh more than 5kg (11lbs). Ibuprofen has a similar effect to aspirin, but is more potent and better tolerated. It can be taken for pain and fever in children of three months and over who weigh more than 5kg (11lbs). Ibuprofen is not recommended for children who suffer with asthma, reflux, tummy, kidney, liver or heart problems. Ibuprofen takes effect in 1 to 2 hours, and can last up to 8 hours. Ibuprofen should be taken with milk or food to reduce the risk of gastrointestinal side effects.

Guidelines for Safe Use

Given the high risk for overdose, parents should: • Only use analgesics for clearly defined symptoms of illness • Not give more than one type of analgesic to their baby • Give liquid medicine using a special spoon or liquid medicine measure. Never use a kitchen teaspoon, as they vary in size. • Not give more than the recommended dose. • Not give baby analgesics for longer than 24 hours.

• Check labels carefully. Caution needs to be taken with the wide variety of different strengths of oral preparations available. • Monitor the effectiveness of the treatment.

Medicines to avoid

Aspirin is no longer recommended for use by babies and children due to the risk of Reye’s Syndrome, which is a rare but dangerous disease (most cases have occurred in children and young adults recovering from a viral infection and they had taken aspirin to treat their symptoms). Other analgesics containing opioids and medications containing narcotic drugs can have potentially serious effects for babies and children because they produce a sedative effect that may impair breathing function.

WWho? Paracetamol can be given to children aged two months or

older for pain or fever. Ibuprofen can be given to children who are aged three months or older and who weigh more than 5kg (11lbs)

WWhat are the symptoms? Complaining of pain, soreness and crying. It is

important to rule out other causes of distress in babies before administering pain relief

HHow long have they had the symptoms? Babies should not be given

analgesics for more than 24 hours

AAction already taken? Parents may have tried pain relief. They should

not give the child paracetamol and ibuprofen at the same time, unless advised to by a healthcare professional

MMedication? If the child has asthma, get advice from a GP before

giving them ibuprofen