Ibuprofen or Paracetamol? What Parents Really Need to Know

This blog only provides tips, tricks and hints and does not replace a doctor visit. For severe symptoms, always consult a doctor.

It's the middle of the night. Your child is burning up, the thermometer reads 39.7 °C. You're standing in front of the medicine cabinet with two options – paracetamol suppositories and ibuprofen syrup. Which one do you give? And can you alternate between them?

The most important thing upfront: Both medications are safe and effective at the NHS dose for your child's age, with the right gap between doses. What guides the choice is how they differ in action, and how young your child is — and that's exactly what we'll cover.

Important note: This article does not replace professional medical advice. If in doubt or in an emergency, always contact your GP or emergency services.

What Is the Difference Between Ibuprofen and Paracetamol?

Both medications reduce fever and relieve pain — but ibuprofen also has anti-inflammatory properties and works slightly stronger. Both are safe first choices for a feverish child at the right dose. Paracetamol can be given earlier in life than ibuprofen, which is what usually decides it for the youngest babies.

	Paracetamol	Ibuprofen
Takes effect	~30–60 min	~30–60 min
Duration	4–6 hours	6–8 hours
Fever reduction	good	slightly stronger
Anti-inflammatory	no	yes
Pain relief	good	slightly stronger
Minimum age (NHS)	2–3 months, if over 4kg and born after 37 weeks	3 months and over 5kg
Forms	syrup, suppositories, tablets	syrup, suppositories, tablets

When to Use Paracetamol

For the youngest babies — from 2 to 3 months, where ibuprofen is not yet an option
When your child has a sensitive stomach
When your child hasn't eaten or won't drink

When to Use Ibuprofen

When there's also inflammation involved (ear infection, sore throat, teething pain)
When paracetamol alone isn't enough, after checking with your GP or pharmacist
For children from 3 months and over 5kg who are drinking well

⚠️ Important: Your child can eat and drink normally while taking ibuprofen; for tablets the NHS suggests giving them with or after food. If ibuprofen seems to upset your child's tummy, ask your pharmacist or GP before the next dose.

How Do I Dose the Right Medication for My Child?

NHS dosing for children goes by age band, not by a milligram-per-kilo calculation. You look your child's age up in the table on the pack, measure that many millilitres with the syringe or spoon supplied, and count the doses. Weight matters at one point only: whether the very youngest babies may have the medicine at all.

The tables below are the NHS ones. Check the strength on your bottle first — the same medicine comes in more than one concentration, and the millilitres differ.

Paracetamol dosing

From the NHS page on paracetamol for children (last reviewed 2 October 2025), infant liquid at 120mg/5ml:

Age	Dose
3 to 5 months	2.5ml (60mg)
6 to 23 months	5ml (120mg)
2 to 3 years	7.5ml (180mg)
4 to 5 years	10ml (240mg)

For older children the "six plus" liquid at 250mg/5ml applies: 5ml (250mg) at 6 to 7 years, 7.5ml (375mg) at 8 to 9, and 10ml (500mg) at 10 to 11 years. In every band the NHS rule is the same — "Do not give more than 4 doses in 24 hours", and "Wait at least 4 hours between each dose."

Ibuprofen dosing

From the NHS page on how and when to give ibuprofen for children (last reviewed 21 August 2026), infant liquid at 100mg/5ml:

Age	Dose	Maximum in 24 hours
3 to 6 months (weighing more than 5kg)	2.5ml (50mg)	up to 3 times
6 to 12 months	2.5ml (50mg)	3 or 4 times
1 to 3 years	5ml (100mg)	up to 3 times
4 to 6 years	7.5ml (150mg)	up to 3 times
7 to 9 years	10ml (200mg)	up to 3 times

From 7 to 12 years there is also a "Seven plus" liquid at 200mg/5ml: 5ml (200mg) at 7 to 9 years and 7.5ml (300mg) at 10 to 12 years, with no more than 3 doses in 24 hours.

The same page is explicit about the gap: "Doses can be given every 6 to 8 hours", and "Do not give your child more than the recommended dose in 24 hours." It also limits how long you give it without advice: for babies aged 3 to 6 months, not more than 24 hours, and for children aged 6 months or older, not more than 3 days without speaking to a doctor or pharmacist.

💡 Tip: Write your child's date of birth and current weight on the medication box, and keep the syringe that came with that bottle. Syringes are calibrated to one strength — the 5ml mark on the wrong syringe is not the same dose.

When did she last have paracetamol?

The question that drives everyone crazy at night. Mona tracks doses and intervals automatically, so no one doubles up.

What Intervals Must I Keep Between Doses?

Giving doses too close together is one of the most common — and most dangerous — mistakes with children's fever medication. The two medicines have different gaps, and that is exactly what slips at three in the morning. The clock runs from the last dose you gave, not from the last reading on the thermometer.

Medication	Gap between doses	Maximum in 24 hours
Paracetamol	at least 4 hours	4 doses (babies aged 2 to 3 months: 2)
Ibuprofen	every 6 to 8 hours	3 doses (babies 6 to 12 months: 3 or 4)

The NHS states the paracetamol rule plainly: children aged 3 months and over can have it "up to 4 times a day", and "Wait at least 4 hours between each dose." For ibuprofen the dosing page says "Doses can be given every 6 to 8 hours", with up to 3 doses a day for children aged 1 to 9.

Why this matters: The body needs time to break down the active ingredient. If you give the next dose too early, it can accumulate — with serious consequences:

Paracetamol overdose can damage the liver
Ibuprofen overdose can harm the kidneys and stomach

🚨 Warning: Never exceed the maximum daily dose. When in doubt, skip a dose and contact your GP rather than giving too much. The German S3 fever guideline notes that paracetamol and ibuprofen are among the top ten medicines that prompt calls to poison centres about children.

Is It Safe to Alternate Both Medications?

Alternating ibuprofen and paracetamol is something to do on advice, not on your own. The NHS is explicit that the two must not be given at the same time, and that alternating is for cases where a health professional has told you to. The risk is not the medicine — it is losing track of what went in when.

The NHS page on paracetamol for children (last reviewed 2 October 2025) puts it in one line:

"Do not give ibuprofen and paracetamol at the same time. But you can alternate between them if a health professional such as a doctor or nurse tells you to."

The same page adds why the writing-down matters: if a health professional advises alternating, "it can help to write down when you gave each medicine to make sure the doses are spaced evenly and to avoid giving too much".

Why Caution Is Needed

Mix-up risk: At night, under stress, sleep-deprived – when did you give which medication? The error rate goes up significantly.
Overdose risk: If you lose track, both medications can be given too frequently.
No clear advantage: The temperature may drop slightly faster, but lowering fever isn't the goal — your child's comfort is what matters.

When Your GP Recommends It

If a health professional does advise alternating — because your child is still uncomfortable before the next dose of the same medicine is due — then:

Follow the exact schedule the health professional gives you
Never give both at the same time
Each medication keeps its own gap: paracetamol at least 4 hours, ibuprofen every 6 to 8 hours
Document exactly what you gave and when

💡 Tip: This is exactly where it gets stressful – keeping track of two medications with different intervals in the middle of the night. With Mona, you log every dose precisely and instantly see when the next one is earliest possible.

This is also where the article stops and a clinician starts. Recording what you gave and when is your part. Which medicine your child should have, at what dose and at what interval, is a decision for your GP or pharmacist — dosing and treatment belong with a clinician, not with a guide like this one. What this text can do is help you keep the record that makes that conversation accurate.

What Else Parents Should Know About Fever Medication

Fever medication doesn't fight the infection — it relieves discomfort. This matters: you're not giving medication because the thermometer reads 38.7 °C, but because your child is visibly suffering. Is your child drinking, active, sleeping reasonably? Then no medication is needed.

The NHS page on high temperature in children (last reviewed 3 January 2024) sets the threshold at "38C or more" and describes what a temperature is for: "A high temperature is the body's natural response to fighting infections like coughs and colds." The frequency cap sits on a different NHS page — paracetamol for children, which says children aged 3 months and over "can have paracetamol up to 4 times a day if they need it". That is a ceiling, not a schedule.

Lowering Fever Isn't Always Necessary

Fever is a defence mechanism. The body raises its temperature to fight off pathogens. Don't automatically reach for medication the moment the thermometer hits 38.5 °C. What matters is: Is your child drinking? Are they responsive? Are they maybe even playing? A child with 39 °C who's still active doesn't necessarily need medication. A child with 38.5 °C who's lying listlessly and won't drink, does.

Suppositories or Syrup?

Syrup: More precise dosing, usually better accepted
Suppositories: When the child is vomiting or refuses the syrup
Important: Don't use suppositories during diarrhoea — the active ingredient won't be absorbed

Aspirin Is Off-Limits

🚨 Never give aspirin to children under 16 (risk of Reye's syndrome). It can trigger Reye's syndrome — a rare but life-threatening condition affecting the liver and brain. Not even "just this once" or if nothing else is available.

When to Seek Emergency Care?

Some warning signs mean no fever medicine will help — those need action straight away, whatever the thermometer says. They apply to any feverish child, including one whose temperature is not especially high.

In babies under 3 months, a temperature of 38°C or above needs urgent medical advice — contact a GP or call NHS 111 straight away (call 999 or go to A&E if your baby seems seriously unwell). That age cut-off comes straight from the NHS guidance on high temperature in children, which also says to call 111 if a high temperature "has lasted for 5 days or more".

🚨 Call 999 or go to A&E immediately if your child:

has a febrile seizure (convulsions, loss of consciousness)
has a stiff neck or is bothered by light
has a rash that doesn't fade under pressure (the glass test)
has difficulty breathing or very rapid breathing
is unresponsive, lethargic or hard to wake
has bluish lips or skin

Don't wait — see your GP, call NHS 111, or go directly to A&E. If the fever persists for 5 days or more, see your GP even without other warning signs.

Frequently Asked Questions About Ibuprofen and Paracetamol

From what age can my child take ibuprofen?

From 3 months, provided your child weighs more than 5kg. The NHS dosing page covers babies aged 3 to 6 months weighing over 5kg: "They should usually only be given 2.5ml up to 3 times in a day" of the 100mg/5ml liquid. Below that, paracetamol is the option. For a premature or very small baby, ask your GP or pharmacist first.

What if the fever doesn't come down despite medication?

A fever reducer typically lowers temperature by about 1–1.5 °C. If the fever barely responds after 1–2 hours, this signals a strong infection — not that you've underdosed. Wait out the full dosing interval. If the fever doesn't drop at all or spikes right back up very high, contact your GP.

Can I give paracetamol and ibuprofen on the same day?

Yes — but not simultaneously, and only if each medication respects its own minimum intervals. Alternating between the two should be done on your GP's recommendation, not on your own initiative. The main risk isn't the medications themselves, but losing track of timing and accidentally giving too much.

How long should I give fever medication?

Only as long as your child is visibly suffering, and within the NHS limits: do not give paracetamol for more than 3 days without speaking to a doctor or pharmacist, and do not give ibuprofen for more than 3 days (more than 24 hours for babies aged 3 to 6 months) without speaking to a doctor or pharmacist. Fever medication treats symptoms — it's not an antibiotic or a cure. Once your child is drinking, active, and the fever is subsiding, you can skip doses. If fever persists for 5 days or more even without other warning signs, see your GP.

Why does the dose go by age rather than by weight?

Because in the UK the dose itself is set by age band, not calculated from weight. The NHS tables give you millilitres per age, and weight enters at one point only — whether the very youngest babies may have the medicine at all: over 4kg for paracetamol, over 5kg for ibuprofen. Always check the strength printed on your bottle first.

Does it matter whether I use syrup or suppositories?

Both forms contain the same amount of active ingredient when correctly dosed. The difference: syrup works slightly faster (first effect in ~20–30 min); suppositories are absorbed a bit more slowly (~30–60 min). Choose suppositories if your child is vomiting or refuses the syrup. During diarrhoea, don't use suppositories — the active ingredient won't be absorbed.

Summary: Which Medication When?

Situation	Recommendation
Infant under 3 months with fever	Urgent — NHS 111 / GP straight away (999 if seriously unwell). No medication on your own.
Baby from 2–3 months, sensitive stomach, won't drink	Paracetamol
Child from 3 months and over 5kg, with inflammation (ear, throat)	Ibuprofen (drinking well)
Paracetamol not helping enough	Ask your GP or pharmacist before switching or alternating
Alternating both medications	Only on GP's advice + document everything
Fever 5 days or more, or warning signs	See your GP today or call NHS 111
Child drinking, playing, sleeping reasonably well	No medication needed — observe