Pediatric ibuprofen

[placebo_B12]

Does anyone use ibuprofen in kids < 6 months?

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[pedidoc]

In pediatrics, we don't use it in kids that age. Something to do with the relative immaturity of the kidney (they don't work so well in infants). Big taboo in our residency.

 

[roja]

Nope. Tylenol until 6months, then ibuprofen

 

[waterski232002]

I was always taught the same thing... no ibuprofen < 6 months. Assumed it was b/c of renal toxicity, but have never seen any literature to support it. Then again, I never really looked.

On a different note... Do you guys tell parents it's okay to give tylenol to children under 3 months old? I don't because I want the family to vigilant about checking for temps > 100.4 so that they return to the ER for a septic workup if the infant spikes a temp.

 

[Seaglass]

I generally don't but there's no good literature to support it. In one of the peds fever papers they looked at all infants who got ibuprofen - there was a not-statistically significant trend towards hospital admission, very few cases of renal failure.

 

[NateintheED]

Good timing. I was talking with one of our peds EM guys about this today. He was under the impression that there is actually a black box warning about ibuprofen in kids < 6mo. A thorough search of the FDA website, though, came up empty. All the other studies I looked at on a lit search today either mentioned a non-statistically significant number of complications or only included kids > 6 mo. Definitely still safer not to use it in those little ones, from what I've read.

 

[tkim]

Dr Sears' website makes mention that it's safe all the way down to 2 months:

http://www.askdrsears.com/html/8/T088900.asp

An Australian medical magazine mentions the safe age being lowered to three months:

http://www.australianprescriber.com/magazine/31/3/63/5/

 

[waterski232002]

I also did a search for peds ibuprofen < 6mo and I couldn't find anything strong to support it's exclusion.... hmmmm