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Discussion in 'Emergency Medicine' started by placebo_B12, Dec 14, 2008.
Does anyone use ibuprofen in kids < 6 months?
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.
Nope. Tylenol until 6months, then ibuprofen
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.
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.
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.
Dr Sears' website makes mention that it's safe all the way down to 2 months:
An Australian medical magazine mentions the safe age being lowered to three months:
I also did a search for peds ibuprofen < 6mo and I couldn't find anything strong to support it's exclusion.... hmmmm