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Question
Hi, I have a 6 month old baby boy and he will be getting his 6 month shots this Friday. At his 4 month shots he was in soooo much pain, and we were told to give him Tylenol every 4 hours. Well he would throw it up sometimes, and then other times he would keep it down. Well he is starting to teeth so I started giving him Tylenol for the pain and gum inflamation, but he will NOT keep it down at all now. I've tried just giving it to him in the syringe very slowly, throws it up. I've tried putting it in his formula, throws it all up. I even tried the little melt away tablets, threw up as soon as it touched his tongue. Ive given it to him when he's full, I've given it to him when his tummy is empty, and I've given it to him in between empty and full. Nothing works! I've also tried Motrin and Ibuprofen as well, same thing. At his 4 month shots he was in a lot of pain and he got a fever from it so I am not looking forward to this Friday for his 6 month shots if I can't give him any pain meds. And it would be nice to give him something for his teething. I don't know what to do! Is there a different pain reliever that pediatricians can prescribe if the baby is allergic or wont keep the Tylenol down? Something without Aceteminophen? Could that be what he is allergic to? I know there are people out there that do not believe we should give our babies drugs, but I don't agree with them. Thanks for your time!

Answer
Hi Denee,

Tynelol and Acetaminophen is same. What you have described is not allergy, but just intolerance because of flavor/ smell/ sight of medicine. Tynelol is the mildest medicine and should be preferred over other medicines like Motrin (Ibuprofen). In India, we manage such cases by trying different brand of Acetaminophen as numerous brands (with different colour/ flavour/ consistency) are available here. Possibly this is not the situation in US where only one brand is available. Thus another option that can be tried is to give Acetaminophen as suppository: That is better tolerated and has better effect than oral Acetaminophen. I am not aware of the brand name of such formulation in US, so you would have to inquire about it from your doctor.

Another small point: Whenever there is such intolerance, you should preferably try giving the medicine empty stomach (except medicines like Motrin that are to be given only after feeds/ meals): so that if he vomits he vomits only medicine not everything else out.

Best wishes,
Dr. Puneet Kumar,
Kumar Child Clinic, Dwarka,
New Delhi, India

www.KumarChildClinic.com

+91-9818356846

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Dr. Puneet Kumar

Expertise

I would be happy to answer general queries on prevention and treatment of ailments in newborn, infant, toddler, child or an adolescent. Needless to say, it will not be possible to answer any query requiring specific diagnosis of a particular subject.

Experience

I have worked in various capacities (medical officer, resident, senior resident, consultant) in public as well as private sector in Pediatrics and Neonatology. Today, I have over 15 years of experience in the field.

Organizations
Currently, I am running my own clinic (Kumar Child Clinic) in Dwarka, New Delhi and am attached to Lifeline Hospital, Dwarka as consultant pediatrics and neonatology. I am also developing my clinic website into a comprehensive child health/ parenting website (http://www.kumarchildclinic.com)

Publications
(a) Chapter "National Immunization Schedule" in Frontiers of Social Pediatrics, Jaypee Publishers: 2nd edition, 2016. (b) Article, "All about Pertussis vaccines" in special issue of Indian Journal of Practical Pediatrics, July-Sept 2015 (c) Three chapters (DTP vaccines, Pneumococcal vaccines and Poliovirus vaccines) in "Textbook of Pediatrics for Post-graduates" First edition: 2015. (c) Chapter: "Alternative delivery methods of vaccines" in IAP textbook of Vaccines, First edition, 2014 (published by IAP/ Jaypee Brothers) (d) Special Article: "50 years of Immunization in India: Progress and Future" in January 2013 issue of Indian Pediatrics (e) Four chapters in "FAQ: Book on Vaccines and Immunization Practices" First edition, 2011 AND 2nd edition, 2015 published by Jaypee Brothers. (f) Three articles in special issue of Journal of Pediatric Sciences on “Controversies and Challenges in Pediatric Vaccination Today" in Sept, 2010. Co-edited the series also. http://www.pediatricsciences.com/issue/view/1050000010 (f) Regular column, “How do I treat” in Pediascene (www.pediascene.com) (g) Review article, “Role of Anti-Poliovirus Agents in Polio eradication and beyond” in Polio Pulse, April, 2008. (h) Chapter on “Acute Infectious Diarrhea” in Textbook of Infectious Diseases in Children. (An IAP Publication), 2007. 2nd edition in 2011. (i) Book-Review (IAP Pediatric Drug Formulary, 2004) in Pediascene, March 2005 (http://www.pediascene.com/page.php?cid=6&catid=9&id=132 ) (j) Case-report on Osteopetrosis. Jharkhand Journal of Pediatrics, Dec-2002.

Education/Credentials
After MBBS, I have done DNB residency in Pediatrics.

Awards and Honors
Winner of IAP practising pediatrician's quiz in 2001.

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