Acetaminophen (Tylenol is one brand) is a good product for the treatment of fever and pain. It comes in a variety of brands and fruity flavors and has a medicine applicator inside the bottle marked with 0.4 ml and 0.8 ml. It is best to take a couple of bottles overseas. Acetaminophen works great for relieving the pain of teething, which is commonly demonstrated by excessive drool, fingers or fists in the mouth, and/or fretful behavior. Teething is associated only with very low-grade temperatures of less than 100 degrees. If the baby has a cold or a viral infection, a dose of acetaminophen will relieve muscle aches and discomfort, which usually occur with a temperature of 101.5 degrees and above. Acetaminophen may also be used to relieve the painful inflammation of an ear infection for the first 48 hours after initiation of antibiotic therapy. Note: Acetaminophen and ibuprofen are medications for fever and/or pain for teething, colds, ear infections.

One may substitute ibuprofen for any of these indications.

• Acetaminophen(infant 80mg/0.8ml; children's 160mg/5ml**) Dose: 10 mg per kg* of weight every 4 hours (i.e. child weighs 8 kg; multiply 8 X 10 =80mg which is one infant dropper of acetaminophen)
• Ibuprofen (Motrin, Advil) (100mg/5ml) Dose: 5mg per kg of weight every 6-8 hours (i.e. child weighs 10 kg; multiply 10 X 5 =50 mg, which is 2.5 cc of ibuprofen)

*To convert pounds to kilograms, divide the pounds by 2.2 (i.e. 22 pounds divided by 2.2 equals 10 kilograms).
**5 cc or 5ml equals one teaspoon.

Teething begins about 4-6 months of age, but there may be no teeth until after one year! When a child's mood changes and they are inserting their fingers or fist, mouthing everything in their environment, or drooling to beat the band, think of teething. A dose of acetaminophen or ibuprofen at bedtime for the obviously teething infant is a gift to the baby. Remember that the fever of teething is low grade and is rarely above 100 degrees.

Parents frequently ask about the management of ear pain from the changes of pressure in the airplane especially if a child has a cold or an ear infection. Having the child sucking on a bottle or a sippy cup on take off and landing can be helpful. A dose of acetaminophen or ibuprofen before the take off or before landing is also useful. Decongestants have not been proven to be effective. As mentioned above, it is not advisable to use antihistamines to control or prevent changes in behavior on an airplane. Good old-fashioned distraction with walking up and down the aisles, a visit to the bathroom, snacks, drinks, and play are in order. Some parents claim that inserts for the ear canals called "earplanes" are useful; they are available for adults and children.