Painkillers specifically formulated for children include flavoured suspensions containing paracetamol or ibuprofen. Current advice is that paracetamol or ibuprofen can be used for a child with a fever who is also distressed and unwell. These can be given using an oral syringe or a medicine spoon. Some may contain sugar and/or colourings.

1. Paracetamol suspension is indicated for the treatment of mild to moderate pain and to reduce fever in children aged over two months. It is available in different strengths: 120mg/5ml for younger children and 250mg/5ml for children over six years of age. For children over six years of age, melt-in-the-mouth tablets are also available (e.g. Calpol SixPlus Fastmelts). Parents should be advised to leave four to six hours between doses and not to give more than four doses in 24 hours.

2. Ibuprofen 100mg/5ml suspension is available for children aged over three months and weighing at least 5kg to relieve mild to moderate pain, post-immunisation fever and general fever. For children over seven years of age, there are also chewable capsules (e.g. Nurofen for Children Chewable Capsules). Ibuprofen may not be suitable for children with asthma, and should not be taken by children who have chickenpox. Parents should be advised to leave four to six hours between doses and not exceed three doses in 24 hours. 

For children under 16 years of age, paracetamol and ibuprofen should not be given at the same time if one medicine hasn’t worked and the child is still distressed, parents can try the other medicine at the next dose. Parents should not keep switching between the two medicines, unless advised to do so by a pharmacist or GP. Advise parents to check pack dosage instructions carefully and to check with the pharmacist if they are unsure.

3. Oral painkillers and/or teething gels may relieve teething pain. Teething products containing calming agents such as chamomile (e.g. Nelsons Teething Gel) are also available. Some products for oral pain contain salicylate salts and shouldn’t be used by children under the age of 16 (e.g. Bonjela). Every baby is different, so a few different products may need to be tried until parents find something that works for their baby.

4. Drops containing simeticone (e.g. Infacol) or lactase (e.g. Colief Infant Drops) may help to improve colic. These should be tried for a week to see if they are effective. Parents and healthcare professionals can also discuss nutritional solutions such as specialist infant formula milk.