Updated December 16, 2014.

Is it safe to alternate acetaminophen and ibuprofen?

If you are using the correct dosage of each medicine at the correct times, then it is probably safe in most children, although there is no research to prove that it helps or that it is safe. The problem is that it is easy to get confused and give an extra dose of one or the other medicines. And in some children, especially if they are dehydrated or have other medical problems, giving both medications can cause serious side effects, especially with the kidneys.

If you are alternating fever reducers, then write down a schedule with the times that you are giving the medicines so that the correct medicine is always given at the correct time.

Keep in mind that the AAP does not recommend alternating fever reducers.  In their report on "Fever and Antipyretic Use in Children," the AAP states that "Combination therapy with acetaminophen and ibuprofen may place infants and children at increased risk because of dosing errors and adverse outcomes."

Do you have to treat a fever?

Not necessarily. In most cases, fever is treated as a comfort measure. Treating a fever, especially if it is caused by an infection, will not help your child to get better any faster, but it may help make it feel better. If your child has a fever, especially if it is low grade, but does not feel bad, then you don't really need to give him a fever reducer.

Should you really starve a fever?

Yes, but only in the sense that you don't need to push your child to eat if he doesn't feel well and has a fever.

Instead, try and get him to drink extra fluids. If he is hungry and feels like eating, you can continue with his regular diet.
Things to avoid when your child has a fever include:

• Ignoring any fever in an infant under three months of age.
• Giving your child a sponge bath with alcohol.
• Using cold or hot water when giving your child a sponge bath for a persistent fever. Use lukewarm water instead.
• Forgetting that while most fevers are caused by infections, such as upper respiratory infections, ear infection, urinary tract infections, strep throat, and many types of viral illnesses, there are other causes of fever that aren't caused by infections. Some children with fever, especially if it is persistent, can have an inflammatory or immune system disorder, such as Juvenile Rheumatoid Arthritis, Kawasaki disease, etc. In many of these cases, treating the fever with an anti-inflammatory medicine actually treats the underlying illness and will make the fever go away.

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