What Pediatricians Wish Parents Knew About Giving Kids Medicine

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Young baby taking oral injection medicine When a child has with a cold, stomach virus or other common childhood illness, parents and caregivers suddenly have to wear many hats: family doctor, nurse and pharmacist.

Hugs and comfort food can go a long way toward making your child feel better, but sometimes you’ll need to administer medications — either prescription or over-the-counter (OTC). While these medications are generally safe and effective, they are still drugs and parents must take care to ensure they give their child the right medicine, at the right time and in the right amount. Too much of a good thing can have serious consequences for your child’s health and comfort.

Here, Katie Lockwood, MD, MEd, an attending physician at CHOP Primary Care, South Philadelphia, discusses the most frequent questions pediatricians get from parents and what pediatricians wish more parents knew about providing medication to their children.

Easily accessible medication isn’t necessarily safe for all uses

Just because a product is sold in your local drug store doesn’t necessarily mean it’s been FDA approved or otherwise regulated. For example, dietary and herbal supplements don’t fall under the FDA’s jurisdiction at all. Similarly, the FDA reviews the active ingredients in OTC medications but doesn’t formally approve them.

All medications can have potential side effects and should be used appropriately. Medications shouldn’t be used as a substitute for other healthy behaviors, such as healthy eating, regular sleep and dental care.

Some OTC medications can be abused. Especially for older children, if you have concerns about their mental health or they have a history of substance abuse, it may be smart to limit their access to certain OTC medications.

Know the right dose

Especially for younger children, it’s important to ensure your child is getting the right dose. Children’s medication dosages are usually based on their weight, so it’s important for all caregivers who may be administering medication to know the child’s current weight.

You should always use the measuring device that came with the medication. (If it doesn’t have one, check with your pharmacy.) A teaspoon from your kitchen is unlikely to be exact enough for measuring medication.

Giving too large of a dose of an otherwise very safe drug can cause potentially serious side effects for your child. 

Most fevers are less serious than you think

No parent likes to see their child uncomfortable as they deal with a fever. And let’s face it, anything above a very low-grade fever can look scary. Parents often want to give antipyretics (fever reducers, such as ibuprofen and acetaminophen) at the first sign of a fever. It's important to remember that fevers are our body's natural way of fighting an infection. Fever alone doesn’t always need to be treated.

If your child’s fever keeps creeping higher, they seem very uncomfortable or you have other concerns, call your pediatrician for advice on how to treat the fever. Just don’t be surprised if they advise you to stick with cold compresses, sponge baths and providing lots of fluids to drink.

Multi-symptom medications may not be a good choice

If your child has multiple symptoms at once, for example, a stuffy nose, fever and cough, a multi-symptom medication may seem like the most efficient way to tackle the situation. Not to mention a way to avoid giving multiple doses of medication to a child who’d rather not take any of it.

But multi-symptom medications may include active ingredients your child doesn't need for their particular symptoms. Plus, some decongestants in these medications are dangerous for children under age 2 or those who have certain health conditions. That doesn’t mean all multi-symptom medications are off the table, but you should check with your pediatrician first.

If your pediatrician OKs the use of a multi-symptom medication, be sure you write down the exact product name. Many OTC medications come in multiple versions. While they’re usually similar, they don’t all work the same or have the same ingredients. You want to make sure your child is getting the version your pediatrician recommended.

More vitamins aren’t necessarily better

Most kids with a healthy diet get enough vitamins and minerals from their food — which is the best way to get them anyway. Multiple vitamins aren’t necessary for most children and could even be harmful if doses of certain vitamins are too high. Check with your pediatrician before adding any vitamins or other dietary supplements to your child’s routine.

Store medications safely

You should always keep medications in their original containers. Many pills look similar, and for younger kids, pills may look like candy. Storing medications in child-safe containers with accurate labels can go a long way in preventing an accidental overdose.

Store medications as directed on the label. (Your warm, humid bathroom cabinet is likely not the best place to store most medications.) And always check the expiration date before administering a dose. Past-their-prime meds won’t be as effective and if they’ve degraded enough, they could even make your child sicker.

Make sure your child understands how to use medication responsibly. For younger kids, that can be as simple as discussing that different people need different medications and it’s not safe to take other people’s medications.

Keep your pediatrician in the loop

Your pediatrician needs to know what medications (prescription or OTC) and supplements your child is taking. But they rely on you to share that information with them. Remember to update your child's medication list at each appointment or mention any new medications if you’re calling with a question. That includes things you might not think of as “medicine” such as vitamins, melatonin and similar products.

What to do if there’s been a mistake

No matter how careful you and other caregivers are, there’s always a chance of making a mistake when giving your child medication. Mismeasuring the dose, grabbing the wrong bottle, handling a skipped dose, or discovering a young child got into a pill bottle are all common issues. 

When in doubt, you can always call your pediatrician with questions about medications and/or how to handle a mistake. If you think your child is in danger because of a medication they took or the size of the dose, call Poison Control (1-800-222-1222) for quick advice or go directly to the Emergency Department.

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