Can I Alternate Tylenol and Motrin for My Baby's Fever?
Medically reviewed by Dr. Michael Okonkwo, MD, FAAP · Board-Certified Neonatologist
Content reviewed against published AAP, Mayo Clinic, NIH guidelines
Last reviewed:
If your baby has been diagnosed with or you suspect can i alternate tylenol and motrin for my baby's fever, here is what the evidence says.
The short answer
Alternating acetaminophen (Tylenol) and ibuprofen (Motrin) is sometimes recommended by pediatricians for stubborn fevers in babies over 6 months, but it carries a risk of accidental overdosing. If your doctor recommends alternating, give one medication, wait 3 hours, then give the other, and keep a written log of every dose to avoid confusion.
Key takeaways
- Alternating acetaminophen (Tylenol) and ibuprofen (Motrin) is sometimes recommended by pediatricians for stubborn fevers in babies over 6 months, but it carries a risk of accidental overdosing. If your doctor recommends alternating, give one medication, wait 3 hours, then give the other, and keep a written log of every dose to avoid confusion.
- Usually normal when: Your baby's fever responds to a single medication and alternating is not needed
- Call your doctor if: You think you may have accidentally given a double dose of either medication, or your baby shows signs of overdose such as nausea, vomiting, abdominal pain, or excessive drowsiness
- Varies by age — see the age-by-age breakdown below
“Fever itself is not an illness — rather, it is a sign or symptom that the body is fighting an infection. Fever stimulates certain defenses, such as the white blood cells, which attack and destroy invading bacteria.”
Thousands of parents search for this exact thing. You are not alone.
What Parents Should Know
According to AAP, Mayo Clinic, NIH guidelines, alternating acetaminophen (Tylenol) and ibuprofen (Motrin) is sometimes recommended by pediatricians for stubborn fevers in babies over 6 months, but it carries a risk of accidental overdosing. If your doctor recommends alternating, give one medication, wait 3 hours, then give the other, and keep a written log of every dose to avoid confusion. At 0-3 months, alternating medications is not appropriate for this age group. Only acetaminophen may be used, and only after consulting your pediatrician. Any fever in a baby under 3 months requires immediate medical evaluation rather than home management with medication. It is generally considered normal when your baby's fever responds to a single medication and alternating is not needed. However, you should contact your pediatrician promptly if you think you may have accidentally given a double dose of either medication, or your baby shows signs of overdose such as nausea, vomiting, abdominal pain, or excessive drowsiness.
Normal vs. Concerning
By Age
What to expect by age
0-3 months
Alternating medications is not appropriate for this age group. Only acetaminophen may be used, and only after consulting your pediatrician. Any fever in a baby under 3 months requires immediate medical evaluation rather than home management with medication.
3-6 months
Only acetaminophen is safe at this age since ibuprofen cannot be given before 6 months. Alternating is therefore not possible. If acetaminophen alone is not controlling your baby's fever, contact your pediatrician for guidance rather than looking for additional medications.
6-12 months
Alternating is now technically possible since both medications are safe. However, the AAP cautions that alternating increases the risk of dosing errors. If your pediatrician recommends it, write down the name of each medicine, the dose, and the exact time given. A typical schedule might be acetaminophen at noon, ibuprofen at 3 PM, acetaminophen again at 6 PM.
12-24 months
Some pediatricians recommend alternating for persistent high fevers that do not respond well to a single medication. Keep a detailed log and use a timer or phone alarm to avoid doubling up. Remember that the goal is comfort, not getting the temperature to perfectly normal. A slightly feverish but comfortable toddler does not necessarily need more medicine.
2-3 years
Alternating can be helpful for high fevers during more significant illnesses. Continue to track all doses carefully. If you find yourself alternating medications for more than 48 hours, contact your pediatrician to ensure the underlying illness does not need further evaluation or treatment.
What to Tell Your Pediatrician
- Describe when you first noticed can i alternate tylenol and motrin for my baby's fever and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if a single fever reducer does not seem to bring your baby's temperature down at all.
- Mention if you are confused about the timing or dosing schedule for alternating medications.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Your baby's fever responds to a single medication and alternating is not needed
- The fever returns when medication wears off but your baby is comfortable and drinking well between doses
- Your pediatrician specifically recommended alternating and you are keeping a written log of all doses
- A single fever reducer does not seem to bring your baby's temperature down at all
- You are confused about the timing or dosing schedule for alternating medications
- Your baby has needed alternating medications for more than 2 days
- You think you may have accidentally given a double dose of either medication, or your baby shows signs of overdose such as nausea, vomiting, abdominal pain, or excessive drowsiness
- Your baby's fever remains above 104°F (40°C) despite alternating medications, or your baby shows signs of serious illness such as difficulty breathing, persistent vomiting, rash, or extreme lethargy
What You Can Do at Home
- Keep track of when you notice can i alternate tylenol and motrin for my baby's fever — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that your baby's fever responds to a single medication and alternating is not needed — this is generally within the range of normal.
- At 0-3 months, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Follow any care instructions from your pediatrician. Keep a written log of symptoms to bring to appointments.
- While monitoring at home, seek immediate care if you think you may have accidentally given a double dose of either medication, or your baby shows signs of overdose such as nausea, vomiting, abdominal pain, or excessive drowsiness.
Related Conditions
Should I Give Acetaminophen or Ibuprofen for Fever?
Acetaminophen (Tylenol) can be used from birth (with doctor guidance for babies under 3 months), while ibuprofen (Motrin/Advil) is only safe after 6 months of age. Both are effective fever reducers. Acetaminophen works for about 4-6 hours and ibuprofen for 6-8 hours. Always dose by weight, not age, and use the measuring device that comes with the medicine.
My Baby's Fever Won't Go Down with Medicine
Fever-reducing medicine does not always bring the temperature back to normal, and that is okay. The goal is to improve your baby's comfort, not to reach a specific number. A temperature drop of 1-2 degrees after medication is considered a response. If your baby remains uncomfortable and the fever stays above 104°F despite proper dosing, contact your pediatrician.
Infant Tylenol Dosing Concerns
Infant acetaminophen (Tylenol) is generally safe when dosed correctly by weight. The most important rules are to dose by weight rather than age, use the measuring device that comes with the product, never give more than 5 doses in 24 hours, and always use infant-concentration products for babies. When in doubt, call your pediatrician before giving the first dose - they can give you the exact amount based on your baby's current weight. Never give acetaminophen to babies under 2 months without consulting a doctor first.
Ibuprofen and Acetaminophen Dosing Safety
Acetaminophen (Tylenol) can be given to babies 2 months and older. Ibuprofen (Motrin/Advil) should NOT be given to babies under 6 months. Dosing is based on your child's WEIGHT, not age - always use the dosing syringe that comes with the product and follow the weight-based chart on the packaging. Never give aspirin to children under 18 (risk of Reye syndrome). When in doubt about dosing, call your pediatrician. Alternating acetaminophen and ibuprofen can be effective for fever but increases the risk of dosing errors - only do this under your pediatrician's guidance.
Related Resources
Fever Decision Tree
Step-by-step guidance for evaluating your baby's fever by age and temperature.
Medicine Dosage Calculator
Calculate correct Tylenol and Motrin doses by your baby's weight.
Month-by-Month Development
Detailed monthly development guides from birth through 24 months.
When to Call the Doctor
General guide on when to call the pediatrician, visit urgent care, or go to the ER.
Frequently asked questions
Is can i alternate tylenol and motrin for my baby's fever normal?
When should I call the doctor about can i alternate tylenol and motrin for my baby's fever?
When is can i alternate tylenol and motrin for my baby's fever normal?
What causes can i alternate tylenol and motrin for my baby's fever?
What should I mention to my pediatrician about can i alternate tylenol and motrin for my baby's fever?
Is can i alternate tylenol and motrin for my baby's fever normal at 0-3 months?
Is can i alternate tylenol and motrin for my baby's fever normal at 3-6 months?
Should I go to the ER for can i alternate tylenol and motrin for my baby's fever?
Does can i alternate tylenol and motrin for my baby's fever go away on its own?
References
- [1]American Academy of Pediatrics. Alternating Acetaminophen and Ibuprofen for Fever. Pediatrics, 2011. AAP
- [2]Mayo Clinic. Fever treatment: Quick guide to treating a fever. Mayo Clinic
- [3]National Library of Medicine. Combined and alternating paracetamol and ibuprofen therapy for febrile children. Cochrane Review. NIH
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Can I Alternate Tylenol and Motrin for My Baby's Fever?.
Things to mention
- Describe when you first noticed can i alternate tylenol and motrin for my baby's fever and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if a single fever reducer does not seem to bring your baby's temperature down at all.
- Mention if you are confused about the timing or dosing schedule for alternating medications.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- A single fever reducer does not seem to bring your baby's temperature down at all
- You are confused about the timing or dosing schedule for alternating medications
- Your baby has needed alternating medications for more than 2 days
Urgent signs to report immediately
- You think you may have accidentally given a double dose of either medication, or your baby shows signs of overdose such as nausea, vomiting, abdominal pain, or excessive drowsiness
- Your baby's fever remains above 104°F (40°C) despite alternating medications, or your baby shows signs of serious illness such as difficulty breathing, persistent vomiting, rash, or extreme lethargy
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of can i alternate tylenol and motrin for my baby's fever are normal. Talk to your pediatrician if you think you may have accidentally given a double dose of either medication, or your baby shows signs of overdose such as nausea, vomiting, abdominal pain, or excessive drowsiness.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
Was this page helpful?
Related Medical Concerns
Should I Give Acetaminophen or Ibuprofen for Fever?
Acetaminophen (Tylenol) can be used from birth (with doctor guidance for babies under 3 months), while ibuprofen (Motrin/Advil) is only safe after 6 months of age. Both are effective fever reducers. Acetaminophen works for about 4-6 hours and ibuprofen for 6-8 hours. Always dose by weight, not age, and use the measuring device that comes with the medicine.
My Baby's Fever Won't Go Down with Medicine
Fever-reducing medicine does not always bring the temperature back to normal, and that is okay. The goal is to improve your baby's comfort, not to reach a specific number. A temperature drop of 1-2 degrees after medication is considered a response. If your baby remains uncomfortable and the fever stays above 104°F despite proper dosing, contact your pediatrician.
Infant Tylenol Dosing Concerns
Infant acetaminophen (Tylenol) is generally safe when dosed correctly by weight. The most important rules are to dose by weight rather than age, use the measuring device that comes with the product, never give more than 5 doses in 24 hours, and always use infant-concentration products for babies. When in doubt, call your pediatrician before giving the first dose - they can give you the exact amount based on your baby's current weight. Never give acetaminophen to babies under 2 months without consulting a doctor first.
Ibuprofen and Acetaminophen Dosing Safety
Acetaminophen (Tylenol) can be given to babies 2 months and older. Ibuprofen (Motrin/Advil) should NOT be given to babies under 6 months. Dosing is based on your child's WEIGHT, not age - always use the dosing syringe that comes with the product and follow the weight-based chart on the packaging. Never give aspirin to children under 18 (risk of Reye syndrome). When in doubt about dosing, call your pediatrician. Alternating acetaminophen and ibuprofen can be effective for fever but increases the risk of dosing errors - only do this under your pediatrician's guidance.
My Baby's Head Shape Looks Abnormal
Many babies develop temporary head shape irregularities that are completely normal. A cone-shaped head from vaginal delivery reshapes within days. Mild positional flattening (plagiocephaly) from sleeping on the back is very common and usually improves with repositioning and tummy time. However, head shape changes involving ridges, a persistently bulging fontanelle, or rapid head growth changes should be evaluated to rule out craniosynostosis.
Achondroplasia (Dwarfism) in Babies
Achondroplasia is the most common form of short-limbed dwarfism, affecting about 1 in 15,000 to 40,000 births. It is caused by a mutation in the FGFR3 gene and is usually apparent at birth with characteristic features including short limbs, a larger head, and a prominent forehead. Intelligence is normal. With monitoring for specific complications and supportive care, children with achondroplasia lead full, active, and independent lives.