Suppositories for a Child's Fever: What They Are and How to Give Them
A suppository is a small dose of fever medicine inserted into the back passage, useful when your child is vomiting or refusing medicine by mouth. Here's what they are, which medicines come this way, how to give one step by step, and what to do if it comes back out.
What is a suppository, and when does it make sense?
A suppository is a small, solid dose of medicine that is inserted into the back passage (rectum), where it dissolves and is absorbed into the bloodstream through the lining of the rectum. For fever, it is the same medicine as the syrup or tablet version, just given by a different route.
It is most useful when the usual route is not working: your child is vomiting and cannot keep oral medicine down, refuses to take medicine by mouth, or is asleep and you do not want to fully wake them for a dose. It is not a stronger or faster version of the medicine, just an alternative way to give it.
Which fever medicines come as suppositories
- Paracetamol suppositories, the most commonly used option, available in a range of strengths for different ages and weights.
- Ibuprofen suppositories, less commonly stocked but available.
- Diclofenac suppositories, an anti-inflammatory option usually reserved for higher fevers and not used in children under 1 year old.
Check the packaging for storage instructions. Many suppositories are kept at room temperature below a certain limit and can soften in Singapore's heat. If one feels too soft to handle, a few minutes in the fridge in its wrapper firms it up without affecting the dose.
Before you use one
- Do not use a suppository for a baby under 3 months unless a doctor advises it.
- Do not use a diclofenac suppository for a child under 1 year old.
- Do not use a diclofenac or ibuprofen suppository if dengue is possible. Use paracetamol instead.
- Do not use a diclofenac or ibuprofen suppository if your child is vomiting repeatedly or not drinking well. Use paracetamol instead.
- Check the strength on the pack against your child's weight with your pharmacist.
How to give it, step by step
- Wash your hands, then unwrap the suppository.
- Lay your child on their side with their knees drawn up slightly toward their chest. For a baby, lying on their back with knees gently lifted also works.
- Gently push the suppository into the rectum, pointed end first, just past the muscle ring at the entrance.
- Hold your child still and keep their buttocks gently together for a minute or two, so the suppository stays in place while it begins to dissolve.
- Wash your hands again afterward.
Suppository and oral medicine: still the same total dose
If your child has had a paracetamol suppository, any paracetamol given by mouth afterward still counts toward the same daily limit and the same minimum gap between doses. The form changes, the active ingredient and the clock do not.
This matters most when one caregiver gives a suppository, often overnight, and a different caregiver gives oral medicine later without knowing a dose was already given. Note down, or log in an app, the time, medicine, and form of every dose so whoever is caring for your child next can see the full picture. If you think too much has been given across forms, see what to do about a possible overdose.
What if it comes back out
If your child passes the suppository within a few minutes and it still looks mostly whole, it likely was not absorbed. Even so, do not give a replacement straight away. Some of the dose may have been absorbed before it came out, and a second dose on top of that risks giving more than intended.
Call your pharmacist or GP to ask whether a replacement dose is appropriate, and mention what time the original suppository was given and roughly how long it stayed in. If you cannot reach anyone, do not give another. Wait for the next dose time.
If your child vomits straight after a suppository, you do not need to give another dose. The suppository still works.
→ Paracetamol dosage calculator
→ Fever at night: when should parents worry?
When to get help now
Call 995 now if your child has a fever and any of these:
- !A seizure lasting more than 5 minutes (give rectal diazepam if a doctor has prescribed it, and still call)
- !Struggling to breathe (skin pulling in under the ribs, nostrils flaring, or grunting), pauses in breathing, or lips turning blue or grey
- !Cannot be woken, or floppy and not responding to you
- !A rash of small red or purple spots that does not fade when you press a glass on it
- !Swelling of the lips, tongue, or face, with any difficulty breathing
- !Cold, clammy, or mottled skin, with drowsiness or restlessness
Go to the nearest 24-hour A&E or children's emergency now if:
- !A baby under 3 months with a temperature of 38.0°C or above
- !A first febrile seizure, even if it has stopped
- !After a seizure: confused, still drowsy after 30 minutes, or more than one seizure in a day
- !A stiff neck, or crying in pain when bending the head forward
- !Unusually drowsy or hard to wake, but can be woken
- !Dengue warning signs as the fever comes down: tummy pain, repeated vomiting, bleeding gums or nose, or very tired
- !No urine or wet nappy for 12 hours or more
- !No tears when crying, sunken eyes, or a very dry mouth
- !Cannot keep any fluids down
- !Green vomit
- !A temperature above 40°C that is not coming down, and your child seems unwell
Frequently asked questions
Does a suppository work faster than medicine by mouth?+
Not necessarily. It works on a similar timeline to oral medicine, it is simply a different route into the body. The main reason to use one is that your child cannot take, keep down, or be woken for medicine by mouth, not because it acts faster.
Can I cut a suppository in half for a smaller dose?+
Do not do this without checking first. The medicine is not always evenly spread through a suppository, so cutting it can give an uneven or unpredictable dose. Ask your pharmacist if a smaller size is available instead.
My child passed it within a few minutes of insertion. Do I need to give another one?+
Not automatically. If it came out quickly and looks mostly whole, it likely was not absorbed, but giving a second one risks a double dose if some was absorbed after all. Call your pharmacist or GP to ask before giving a replacement. If you cannot reach anyone, do not give another. Wait for the next dose time.
Is it normal for my child to be upset during this?+
Yes. It is a brief, unfamiliar sensation and many children cry or wriggle. This does not mean anything is wrong. A calm voice, a cuddle afterward, and keeping the whole thing quick usually helps.
My child had an oral dose a few hours ago. Can I still give a suppository now?+
It depends on the medicine, not the form. A suppository and a syrup of the same medicine share one clock and one daily total. Wait for the minimum interval since the last dose of that medicine, whatever form it was given in. A different medicine runs on its own schedule. Ibuprofen, diclofenac and naproxen are one class of medicine, so they count as the same medicine here. Never give a diclofenac suppository within the dosing window of ibuprofen, or the reverse.
Do suppositories need to be kept in the fridge?+
Check the packaging. Many fever suppositories are stored at room temperature below a certain limit, often around 25°C, and can soften or melt in Singapore's heat if left out. If yours feels very soft, a few minutes in the fridge in its wrapper can firm it up before use.