Dr. MJ Bazos MD,
A Guide to
Cold medicines, allergy medications,
antibiotics, and other prescriptions, syrups, creams,
Ever get confused over
which medicines are made for children, when your child may need a prescription,
or how much medicine to give your child? You are not alone. There are many
medications that your child may need at one time or another. Some medications
require a prescription from your pediatrician or other health care professional.
Others, called over-the-counter medications, can be bought without a
prescription. The following information will help you sort out the differences
between prescription medications and over-the- counter medications, and when and
how to use them.
must be ordered by a doctor. If your child needs a prescription medication, it
is very important that you understand the pediatrician’s and
following list of questions will help you find out all you need to
- What is the name of the medication?
- How will this medication help my
- Do I need to do anything before giving
this medication to my child?
- How much of the medication do I give my
- At what times of the day should I give the
medication to my child?
- How long does my child have to take the
- Should my child avoid certain foods or activities
while using this medication?
- Should my child avoid other medications while
using this medication?
- Are there any side effects that I should know
- Is there anything unusual about how my child is
taking this medication (for example, is it a larger than usual
- Does this medication come in other forms that may
be easier for my child to take, such as chewable tablets or liquid?
- Can this prescription be refilled? How many
- Is there any written information you can give
- What do I do if my child misses a dose?
- What do I do if I give my child too
- What if my child spits out the
- Can you show me how to use this medication?
Many medications come in
less expensive forms. These are called generics. Often a generic can be used
instead of a brand name. Other times it is more important to use the brand name.
Talk to your pediatrician about the difference in using a generic instead of a
Ask as many questions as
you need. If more questions come up after you leave your pediatrician’s
office, call the office or ask the pharmacist for clarification. If your child
is old enough, make sure he understands what he must do as
If your child goes to the
hospital do the following:
- Bring your child’s health
- If your child is taking any medications, bring
them to the hospital in their original containers. Bring a record of when your
child last took the medications.
- Ask about any medications your child is given
while in the
Almost half of all parents do not
correctly follow the directions on drug labels. However, labels have a lot of
important information that you need to know. The illustration below shows the
different parts of the label and what they
a) Prescription number (you will need
this number when calling the pharmacy for a refill or for insurance
b) Doctor’s name and phone
d) Your child’s name - this
medicine is only for the child whose name is on the label. Do not give
medications to another child even if the other child has similar
e) Name of the medication or the
main ingredient - make sure this matches what your pediatrician told you. There
may also be information on the strength of the medication (ie, 10 mg
f) Pharmacy name and phone
g) Refills - the label will show a
number of how many refills are permitted. The label may also state "no refills
– Dr. authorization required," which means you have to talk to your
pediatrician if you need more.
h) QTY -
"quantity" or how much is in the package
MFG -"manufacturer" or who makes it
Expiration date - do not use the medication past this date. Do not save unused
prescriptions. If your child gets sick again, talk to your pediatrician.
k) Instructions - this is information
about how often and when your child needs to take the medicine. Instructions on
labels can be confusing. Talk to your pediatrician for specific instructions and
make sure they match what is on the label.
The following are some common instructions
you may find on a label:
- "Take full course" - means that your child should
finish taking the entire contents of the prescription even if she is feeling
better. This is especially true if your child is taking antibiotics. The
infection can come back if you stop too soon.
- "Take with food"- means that you should give the
medicine to your child after she has eaten a meal. Some medications work better
when the stomach is full.
- "Take four times a day" - means to take the
medicine four times throughout the day (for example, at breakfast, lunch,
dinner, and before bed). This is different than "Take every four hours," which
adds up to 6 times in a 24-hour period (for example, 6 AM, 10 AM, 2 PM, 6 PM,
10 PM, and 2 AM). If you are confused about when to give your child’s
medications, talk to your pediatrician or pharmacist. Most medicines do not
have to be precisely timed in order to be effective, but some do.
- "Take as needed as symptoms persist" - means the
medicine can be taken when symptoms are
The package may
also have brightly colored warning labels with additional information. The
following are examples:
- Safe storage instructions, such as "keep
- Instructions for use, such as "shake well before
- Possible side effects, such as "may cause
prescription medications for
used for bacterial infections like strep throat, some types of ear
infections, sinus infections, urinary tract infections, and skin infections.
Antibiotics are very safe but can have some side effects including skin rash,
loose stools, stomach upset, staining of urine, or even mild to severe allergic
reactions. Be sure to tell your pediatrician if your child has any side effects
from antibiotics. Antibiotics (such as penicillin, amoxicillin, sulfas, and many
others) can cure bacterial infections. Viral infections like colds and flu are
not treated with antibiotics. New strains of bacteria have become resistant to
some antibiotics because the antibiotics have been overused. When your child is
sick, antibiotics are not always the answer. Your pediatrician will let you know
if an antibiotic would help your
Ear preparations -
commonly used for infections of the ear canal, like swimmer’s ear.
They may cause minor side
Eye preparations - for
conjunctivitis (pink eye) or allergies. Some children may get puffy eyes from
using these medications.
preparations - for skin infections, burns, lice, rashes, and acne. When used
correctly, these medicines usually have no side effects. Certain lice
medications can be toxic. Talk to your pediatrician if using a medication for
Analgesics - used to
relieve pain. Analgesics can have many side effects including stomach upset,
ringing in the ears, dizziness, irritability, and nervousness. Since young
children cannot always tell you if they are feeling these symptoms, talk to your
pediatrician if your child acts unusual after taking these medications.
Inhalers - used to treat
asthma. Include bronchodilators, inhaled steroids, and a drug called cromolyn
medications (OTCs) can be bought at your local drug store or grocery store
without a doctor’s order. This does not mean that OTCs are harmless. Like
prescription medications, OTCs can be very dangerous to a child if given
incorrectly. You need to read and understand the instructions before giving OTCs
to your child.
Common OTCs for
The following list
describes some common OTCs for children. Talk to your pediatrician before giving
any medications to your child.
reducer or pain reliever (ie, acetaminophen,
If your child has a mild
fever but is playing, drinking fluids, and generally acting well, there is no
reason to treat the fever. However, if your child complains of headaches, body
aches, or seems irritable, there are fever reducers such as acetaminophen and
ibuprofen that may help him feel better. They can also help relieve minor pain
from bangs and bumps, or tenderness from an immunization.
Given in the correct dosage,
acetaminophen and ibuprofen have few side effects and are quite safe. They come
in drops for infants, liquid ("elixir") for toddlers, and chewable tablets for
comes in suppositories for the child who is vomiting and cannot keep down
medicine taken by mouth. Remember, the infant drops are stronger than the
liquid elixir for toddlers. Too many parents make the mistake of giving higher
doses of the infant drops to a toddler thinking the drops are not as strong. Be
sure the type you give your child is appropriate for her weight and age.
Ibuprofen tends to be more effective
than acetaminophen in treating high fevers (103F or higher). However, never give
it to a child who is dehydrated or vomiting continuously. Also, children who are
sensitive to aspirin, have a kidney disease, asthma, or an ulcer should not take
ibuprofen. Ibuprofen should not be used with any other pain reliever or fever
reducer, unless directed by a doctor. Read the instructions and talk to your
pediatrician about dosage to avoid giving your child too much for too long.
A warning about aspirin
Never give aspirin to your
child unless your pediatrician specifically instructs you to use it. Aspirin has
been linked to Reye’s syndrome, a serious and sometimes fatal liver
disorder, especially when given to children with the flu or chicken pox.
can relieve runny noses, itchy eyes, and sneezing due to allergies (but not
colds). They also relieve itching from chickenpox or insect bites and may even
control hives or other allergic reactions. They can make some children sleepy.
In other children they may cause irritability and nervousness. For that reason,
avoid giving an antihistamine for the first time at bedtime. If you do, your
child may have difficulty sleeping. If your child has asthma, check with your
pediatrician before using antihistamines.
Insect bites, mild skin rashes,
poison ivy, or small patches of eczema usually respond to cortisone cream. Never
use it for chickenpox, burns, infections, open wounds, or broken skin. Check
with your pediatrician before using it repeatedly or using it on your
Coughing helps the lungs clear
out germs. A cough is "productive" if it sounds like mucus is being brought up.
You can best relieve it by humidifying the air in your child’s bedroom to
loosen mucus. Be sure to clean the humidifier frequently to prevent mold and
bacteria buildup. Some cough medicines, called expectorants, may also help
loosen mucus. Sometimes, a cough may be dry and annoying, and may keep your
child awake. However, avoid using cough suppressants, as coughing is necessary
to clear the lungs. Check with your pediatrician before giving your child cough
medicines or expectorants, especially for use in infants. Cough syrups may not
relieve cough caused by asthma.
Combinations of antihistamines
and decongestants can have side effects such as hyperactivity, sleeplessness,
and irritability. Giving your child more than one cold medicine to treat
different symptoms can be dangerous. Some of the same ingredients may be in each
product. Also, many cold medicines contain acetaminophen. If you are already
giving your child acetaminophen in addition to the cold medicine, this can lead
to overdose. Read labels carefully. Check with your pediatrician before giving
your child any cold medicines.
toddlers cannot sniffle or blow their nose. If your child is sleeping well and
eating happily, there is no need to treat her stuffy nose. But if your child is
unable to sleep or eat because of thick mucus, saltwater nose drops can help
clear the nose. Put a drop or two into a nostril at a time. Using a bulb
syringe, squeeze the bulb, put the tip gently into your child’s nostril,
then let go. This will suction out the drops, along with the mucus. Be careful,
overuse of a bulb syringe can be irritating to a child’s nose.
Decongestant nose drops
can shrink the membranes in the nose and make breathing easier. However, they
should never be given to an infant because too much of the medication can be
absorbed through the membranes of the nose. Also, the more they are used, the
less effective they become and symptoms can return. If your older child
can’t eat or sleep because of nasal stuffiness, use decongestant nose
drops only for a brief time. Talk to your pediatrician if your child’s
symptoms do not improve.
used for common GI problems
many OTC medications for heartburn, gas, constipation, and diarrhea. Most of
these conditions usually go away by themselves or by a temporary change in diet.
Before using any medicine for constipation or diarrhea, talk to your
pediatrician. Repeated bouts of diarrhea or chronic constipation can be due to
serious underlying problems.
medicines come in liquid form because they are easier to swallow than pills. But
they must be used correctly. Too often parents misread the directions, giving
children several times the recommended dosage. This can be very dangerous,
especially if given over a period of several days. Read the instructions
carefully. Call your pediatrician if you are not sure how much, how often, or
for how long to give medicines to your child. When giving your child a liquid
medication, do not use standard tableware tablespoons and teaspoons because they
usually are not accurate. Instead, use one of the measuring devices listed below
(many children’s medications come with one). These can help you give the
right amount of medicine to your
Syringes and oral droppers -
These can be very helpful when giving medicine to an infant. Simply squirt
the medicine between your child’s tongue and the side of his mouth. This
makes it easier for him to swallow. Avoid squirting the medicine into the back
of your child’s throat - he is more likely to gag and spit the medicine
out. If you have a syringe that has a plastic cap, throw the cap into the trash
so that it does not fall off in your child’s mouth causing a choking
hazard. You do not need to re-cap the syringe.
Dosing spoons - These can be
useful for older children who will open their mouths and "drink" from the
Medication cups - These
often come as caps on liquid cold and flu medicines.
You can help prevent
overdose or poisoning by following these tips:
- Always use good light. Giving medicine in the
dark increases the risk that you will give the wrong medicine or the wrong
- Read the label before you open the bottle, after
you remove a dose, and again before you give it. This routine can ensure your
- Always use child-resistant caps and lock all
medications away from your child.
- Give the correct dose. Children are not just
small adults. Never guess how much to give your child based on her
- Never play doctor. Do not increase the dose just
because your child seems sicker than last time.
- Always follow the weight and age recommendations
on the label. If it says not to give it to children younger than age 2,
don’t. Check with your pediatrician.
- Do not confuse the abbreviations for tablespoon
(TBSP or T) and teaspoon (tsp or t).
- Avoid making conversions. If the label calls for
2 teaspoons and you have a dosing cup labeled only with ounces, do not use it.
Use an appropriate measuring device.
- Be sure your pediatrician knows if your child is
taking more than one medication at a time.
- Supervise your children if they are old enough to
take medicine by themselves. Never let young children take medicine by
- Before using any medication, always check for
signs of tampering. Do not use any medicine from a package that shows cuts,
tears, or other
Keep a small
bottle of syrup of ipecac on hand in case of poisoning. Store it with your other
medicines, out of the reach of children. This is available without a
prescription at most drug stores.
Syrup of ipecac is used to
induce vomiting and empty the stomach. However, sometimes vomiting causes more
harm than good. Do not make your child vomit unless your pediatrician or the
poison center tells you to do so.
If you suspect your child has
swallowed any substance that might be harmful, call your pediatrician or a local
poison control center (post this number on your phone) first to find out whether
and how to use syrup of ipecac.
is not always easy to give medicine to a child. You may find your infant or
toddler hates the taste and spits out the medicine or refuses to swallow it. Try
adding a little sugar or juice to the dosing device to make it taste better.
However, do not mix medications into a bottle of milk or a bowl of cereal. Your
child may only eat part of it, or it may settle to the bottom and never get into
his mouth. Older children may be more willing to take chewable tablets over
liquid medicines. Although most children’s medicines are flavored to make
them taste better, avoid calling them candy. It might make your toddler decide
to take them on his own.
Talk to your
pediatrician if you have any questions or concerns about giving your child
medications. Keep your pediatrician informed about any changes in how your child
is feeling or if your child has any reactions to the medications.