Alternatives to Acetaminophen for Children

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It is probably safe to say that almost everyone has taken an acetaminophen product like Tylenol at some point in their life. Since it is available over the counter and often self-prescribed, it is one of the most commonly used drugs.

Acetaminophen is known as a pain reliever and fever reducer. It’s used as a standalone product and as an ingredient in over 150 other combination products, like Excedrin or Dayquil, for cough, cold, headache, muscle pain, etc. Plus, it’s specifically marketed in products for children.

It’s many people’s go-to, but there are some precautions to consider.

The Dangers of Acetaminophen Use

Since acetaminophen is available over the counter, I have seen it self-prescribed by many of my patients to relieve symptoms of a common cold or flu, or daily aches and pains. I’ve also seen it given to kids for teething pain, earaches, bumps and bruises, post-vaccine reactions, and to reduce fevers.

The problem is, when you take acetaminophen, it is quickly absorbed by the body and then metabolized by the liver into toxic metabolites.

To decrease these toxic metabolites, you need a lot of glutathione, which is essential for detoxifying substances from the body. Glutathione is our body’s master endogenous antioxidant. It reduces free radicals and the cellular damage they can create. This is especially true in our liver where glutathione is found in high concentration.

In fact, in both the US and the UK, acetaminophen accounts for more than 50% of overdose-related acute liver failure and approximately 20% of liver transplant cases.

  • 56,000 ER visits
  • 26,000 hospitalizations
  • 458 deaths, 100 of these were unintentional

Considering the number of ER visits and hospitalizations, it has a relatively low death rate. That’s because when treated promptly, the damage can be reversed. Treatment is given by ingesting mega doses of IV acetylcysteine, which is the precursor to glutathione. It helps to restore glutathione and minimizes the damage to the liver cells.

For the average healthy adult, the generally recommended maximum daily dose is no more than 4 grams of acetaminophen. The lethal limit is 10 grams, only 2.5 times higher than the maximum dose. This does not give much wiggle room if you accidentally decrease the interval time between doses or take more than one product with acetaminophen in it on the same day.

When giving your child acetaminophen, it is especially important to follow the dosing guidelines based on WEIGHT and not just relying on age guidelines to avoid the risk of overdosing.

Sometimes, a Fever Is Okay

When we are sick, the body’s response to fight the infection is a fever. When we reduce the fever, we are limiting our body’s ability to do this efficiently.

When a child is sick, we want to make sure they are as comfortable as possible so they can rest. I’ve found there are more effective ways to help keep a child comfortable instead of just working to reduce the fever.

Alternatives to Acetaminophen

In all the times our children have been sick, I have, thankfully, never felt the need to reach for acetaminophen. I attribute this to my knowledge of the effectiveness of other supportive therapies. Here are some of my favorites.

1. Hydrotherapy

I love using water (hydro) as a therapy to support our health. Water is amazingly therapeutic and has been used as a healing modality by many cultures for centuries!


For the acute and immediate pain and inflammation that results from an injury such as a sprain, strain, bump, or bruise, ice can be very helpful to reduce swelling and minimize pain.

After 48 hours, however, I recommend the application of heat alternated with a cold application to assist with healing. This technique is known as Contrast Hydrotherapy.


        1. Apply HOT for 3 minutes (in the form of a wet hot towel or hot water bottle application, or hot bath submersion) followed by.
        2. Apply COLD for 30 seconds (in the form of a wet cold towel application or cold ice bath submersion.)
        3. Repeat these alternating applications 3 times, ending with the cold application.

How it works:

The contrast facilitates a pumping action that helps to speed the healing. The hot water causes dilation of the blood vessels that brings fresh blood and oxygen to the injured tissue and the cold causes constriction of the blood vessels that helps clear away the waste and inflammatory mediators from the injured tissue.


Allowing a child to chew on a wet washcloth, chew toy, or soother that has been placed in the freezer can help ease the pain.


Encouraging your child to rest their head, sore ear down, on a warm hot water bottle can help ease the pain immensely.


Placing a cool cloth on a child’s forehead or placing them in a cool bath or shower with their body against yours to keep their core comfortable can help them feel cooler and ease discomfort. 

2. The Warming Socks Treatment

My favorite technique that I have recommended countless times to my patients is the Warming Socks Treatment. It is safe for infants, kids, adults, elderly, and even safe during pregnancy and lactation. I am still always amazed at how effective it can be! I often recommend it to support the immune system at the first sign of a cold or flu. The warming socks treatment can help to:

    • increase the circulation of white blood cells and other immune factors
    • drain congestion from your nose, sinuses, throat, lungs, and ears
    • relieve headaches or migraines
    • support a healthy fever
    • provide deeper, more restful sleep

Materials you’ll need:

    • 2 thin cotton socks
    • 2 wool socks
    • Bath tub


    1. Preparation

Run 2 thin cotton socks under cold water, wring them out well (you can roll them in-between a folded towel) and place them in the freezer.

    1. Preheat

Draw a hot bath and get in. You can add Epsom salts and drink warm tea. This usually lasts up to 20 minutes or until you start to perspire.

    1. Application

Get out of the bath, dry off, and get dressed in your pajamas. Dress warmer than you normally would. Take the socks out of the freezer, give them 60 seconds or so to thaw, put them on your feet and cover them with wool socks.

    1. Treatment

Hop in to bed, bundle up, and try to go to sleep. The socks will gradually get warmer and should be dry in around 2 hours. I prefer to keep them on all night.

This treatment works because it supports your fever to work harder at getting rid of your sickness. It is best to start this at the first sign of a cold or flu and continue it until your symptoms have resolved, or one day after resolution for good measure.

3. Homeopathic Remedies

I love using homeopathic remedies especially with children and pregnant women. In my experience they have a great safety profile with a low risk of side effects. They are available in most health food stores and are often labelled by the condition (teething, cold and flu, fever, cough, etc.). Boiron is a well-known homeopathic company with a good safety record.


With 2 active boys, the homeopathic remedy I never leave home without is Arnica. When they get hurt, I turn the tube upside down and dispense 2 little white balls into the cap and place them directly into my injured child’s mouth. It is amazing for most injuries including bumps, bruises, sprains or strains! I also like to use a topical homeopathic cream that contains Arnica along with a combination of other homeopathic remedies including hypericum (indicated for nerve pain). These remedies help reduce pain and speed the healing time.

Cuts and scrapes

I like to use a healing salve that contains antimicrobial herbs and healing herbs such as calendula to treat mild cuts and scrapes that don’t require additional attention.


I’ve found the liquid ampules of chamomilla homeopathic very helpful for a fussy and inconsolable child who is uncomfortable from teething pain.

Fevers and Colds

I use homeopathic fever combinations that include belladonna, gelsemium, ferrum phos, aconite, and arsinicum.

4. Botanical Medicine

There are many great herbal medicines that help to support the immune system. Elderberry is one of my favorites for kids. It’s delicious, anti-viral, provides respiratory support and contains vitamin C. There are other glycerite immune formulas specifically for kids that are effective and taste pretty good.

Aches and Pains

Magnesium is a great muscle relaxant herb that is available in a tasty powder. It can be helpful for growing pains, muscle strains, and cramps. Turmeric is a wonderful anti-inflammatory that can easily be added to your cooking or mixed with cow’s milk or any non-dairy milk.

If you DO take acetaminophen, err on the side of caution and don’t push the upper limit. Be aware of the ingredients of all the products you are taking, and especially make sure acetaminophen is not an added active ingredient as this can accidentally lead to increased dose accumulation.



Dr. Briana Sinatra

Meet Dr. Briana Sinatra

Dr. Briana Sinatra is a board-certified naturopathic doctor with a vibrant practice in the Pacific Northwest. There she focuses on women’s and family health, taking a holistic approach to healthcare by empowering women with the knowledge and tools they need to live their best life now and protect their future wellness by looking at how all the systems in the body work together and how diet, lifestyle, and environment all influence health.

More About Dr. Briana Sinatra