If your baby or toddler is sick with another cold or virus and needs more than the usual cuddles, fluids and rest, medication may be in order. But before you head to the drugstore, you'll want to make sure you're getting medicine that's safe for your little one and know the right doses to dole out.
To prepare you, here are some handy medication safety guidelines and tips for babies and toddlers.
How to give a baby or toddler medicine
Here are some tips on giving your little one medication:
- Never give a baby under 2 months old any medication, not even an over-the-counter one, that's not recommended or prescribed by a doctor.
- Only consider two pain and fever medications for both babies and toddlers and always check with your pediatrician first for any child under 2 years old: acetaminophen (like Tylenol) for babies 3 months and older, and ibuprofen (such as baby Motrin or Advil) for those 6 months and older.
- Always use the infant or toddler formulations. Never give your baby or toddler a medication intended for older kids or adults.
- Don't get physical. To prevent choking, don't squeeze your little one's cheeks, hold her nose or force her head back when offering her medicine.
- Make sure your child is propped up. If your baby is old enough to sit up, dispense the medicine with your baby in a sitting position. If your baby can't yet sit up, aim the dropper to the inside of her cheek while propping her up slightly to prevent choking.
- Aim the dropper to prevent gagging. Don't point the dropper to the back of your little one's mouth, since that can trigger gagging.
- Have a few tricks up your sleeve. If your baby resists taking medicine, try gently blowing on her face, which triggers the swallow reflex in young babies. Or offer a pacifier to suck on immediately after offering medicine, as the sucking action will help the medicine get where it needs to go.
Medications to avoid giving babies and toddlers
When it comes to medication safety for babies and toddlers, certain drugs may be harmful. These include:
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Cough and cold remedies
Studies have shown that cough and cold remedies don't stop the sniffles or silence the hacking, and they may even cause young kids to develop serious side effects such as a rapid heart rate and convulsions.
That's why the American Academy of Pediatrics (AAP) says cough and cold medicines should only be used in children who are at least 4 with their pediatrician's approval.[1] Otherwise, the AAP recommends waiting until children are at least 6 years old to give them cold medicines specifically designed for them, and again only with the doctor's approval.
Aspirin (and anything containing salicylates)
Doctors have warned parents for years against giving their kids aspirin, but the message bears repeating: Don't give aspirin to children younger than 19 years old because it has been linked to the onset of Reye's syndrome, a rare but very serious illness that affects the liver and brain.[2]
Although research comes down hardest on aspirin, the National Reye's Syndrome Foundation advises against giving children any medication that contains any form of salicylate, so read ingredient lists on drug labels carefully.
Questions to ask your pharmacist
Getting medication for your child requires more than just picking it up from the pharmacy: you need to know the dose, how and when to give it and what the side effects are, among other details. Your pediatrician should give you most of this information, but you'll also want to talk to the pharmacist to be on the safe side.
If you're giving your child an OTC drug, check out the back label. For prescription medications, read the pamphlet that comes inside the box. Either way, bring any questions up with your pharmacist. Here are a few you'll want to have answered before you head home:
- Are there any generic (i.e. less expensive) equivalents to this brand-name medication?
- What is the drug supposed to do?
- How should the medication be stored?
- Should it be given before or with meals? Can I mix it with food or milk?
- Are there alternatives that require fewer daily doses (if it's given three times per day)?
- If my child spits up a dose, should I give another one?
- If I miss a dose, should I double up the next time?
- How soon should I expect to see an improvement? When should I call the doctor if I don't see an improvement?
- Does my baby have to finish the full prescription?
- Are there any common side effects I should look out for?
- If my baby is taking another medication, should I be worried about any interaction?
- Could the medication affect my baby's chronic health condition (if applicable)?
- How do I get my toddler to take liquid medicine?
- Would you be able to divide the medication into two bottles, each with its own label, so that one can be kept at home and one can be kept at day care (if applicable)?
Common safety tips for giving your child medicine
When giving your child medicine, follow these tips:
- Always talk to the doctor first. You shouldn't give a child of any age any medicine (OTC or even an old prescription written for your child) without getting a specific okay from a doctor for every illness, unless your doctor has given you standing instructions (e.g. whenever your baby has a fever of 102 degrees Fahrenheit, give acetaminophen, or use asthma medicine any time wheezing begins).
- Treat herbal remedies like any other medicine. No one really knows whether many herbs are safe for babies and toddlers. Herbal supplements aren't fully regulated by the Food and Drug Administration (FDA), which means you might be getting more of an active ingredient than is advertised on the label, or it may contain other contaminants.[3] All of which means herbal remedies should be treated just like any other drug, only to be dispensed to your child with an approval from your doctor. This includes herbal remedies that claim to treat colic, teething and gas.
- Only use medications made for kids. Children are not mini-adults who can take smaller doses of adult medication. Children's bodies are less developed, and an adult medication (which is formulated specifically for an adult body) could not only work very differently on them, but could also cause serious side effects. When choosing meds for your baby or toddler, limit yourself to medicine found in the pharmacy's children's aisle and to the medication your pediatrician prescribes.
- Read the directions carefully. Read the medication insert and/or label carefully. The rule of thumb when measuring the dose is to follow the weight recommendation — even if the package suggests one dose based on your child's weight and a different dose based on her age. If the instructions conflict with your doctor's instructions or aren't specified for your baby or toddler's age, call the doctor or pharmacist first. Follow the instructions about timing, shaking and giving with or without food.
- Use as intended. Unless otherwise recommended by your doctor, only use a medication to treat the indications listed on the label or insert. And don't administer the medicine longer than prescribed.
- Avoid double-dosing and keep records. Never give your baby or toddler more than one medication at a time without checking with your doctor or pharmacist first. Some combinations are unsafe, and many parents accidently give double doses. Always document when and how much medication was given to your child so you don't accidentally offer up a double dose or skip one. Try using a piece of paper on the refrigerator door or a shared document (think notes or tasks or reminders) with any other caregiver to keep track. If you do give your child a dose a little late, don't stress — just get back on schedule with the following dose.
- Check the ingredient list. Know the active ingredients in the medication you're dispensing to avoid accidentally giving your baby or toddler two medications with the same active ingredient at the same time — possibly causing an overdose. Reading the ingredient list also clues you in to whether the medication contains anything that your child may be allergic to.
- Steer clear of expired meds. Drugs that have expired are not only less potent, but they may also have undergone chemical changes that can render them downright dangerous. This applies to prescription meds you may have hanging around from a previous illness, too. Look at the expiration date before you buy a drug to make sure it isn't outdated or about to expire. Recheck expiration dates periodically — otherwise you may end up making a pharmacy run in the wee hours. Time to clean out your medicine cabinet? Learn how to safely dispose of expired medications.
- Never give your child a prescription medication intended for someone else. While it may be tempting to skip the trip to the pediatrician and give your tot her older sib's leftover antibiotics in a pinch, don't do it. Just because your 5-year-old benefited from a medication doesn't mean your 2-year-old will. Plus, taking someone else's meds could be very dangerous to your child. Only give her a prescription medicine that's been written specifically for her by the pediatrician.
- Turn on the lights. If you're doling out medicine in the wee hours of the morning, make sure you can see — and think — clearly (not always easy when you've been up all night with a sick toddler). Read package labels in good light (under a night-light when you're exhausted doesn't count) so you don't mistake "tsp" (teaspoon) for "tbsp" (tablespoon), or "every four hours" for "every two hours."
- Measure with care. Once you've nailed down the correct dose, dispense the medication in the cup that comes with it, or use a calibrated medicine spoon, dropper or cup. Don't use spoons from your flatware — you can't count on them to equal a true teaspoon or tablespoon (and that's how many dosing mistakes happen). Make sure the pharmacy doses your medicine in milliliters for your child's age and size.
- Only mix with food if recommended by your doctor. Also be sure your child will finish the whole bottle or cup (and therefore the whole dose of medicine).
- Be conservative after any medication meltdowns. If your baby or toddler spits or vomits up a medication, it's best not to give a second dose without checking with your pharmacist or doctor first, since under-dosing is less risky than overdosing. Definitely be sure to check with the doctor about antibiotics, since taking the full dose as recommended is especially important.
- Take the full course of antibiotics. On that note, if your pediatrician does prescribe antibiotics for your toddler, be sure she takes the full course, even if she appears to be better. Stopping antibiotics midcourse can give lingering bacteria the opportunity to grow back. The end result? A sick child all over again and, maybe, the need for yet another (possibly stronger) course of antibiotics. Nip the illness in the bud the first time around and finish off the antibiotics.
- Store meds safely. Keep medicine for babies and toddlers (as well as those for the adults in the house) out of kids' reach and in a cool, dry place. That means you'll want to avoid stashing them in bathroom cabinets, where humidity from the bath and shower can damage the drug's potency. Also, while it's easy to get distracted with your sick baby or toddler when you're giving her medication, remember not to leave the drugs out and unattended after dispensing them. Put them away quickly so they don't end up in the wrong hands. That goes for your medications too, including those in the pill-a-day dispensers that can look like an enticing toy or box of candy to a child.
- Re-read the label every time. That way you're sure to get dosing, timing and other important information correct.
- Update other caregivers. If your child will be at day care or staying with another caregiver, be sure they have clear instructions on how to use the medication. Licensed child care facilities require special forms to administer any prescription and nonprescription medication (including vitamins). Ask your day care about the policy so you know what to expect should your child need to finish out a prescription for something like an ear infection while in their care.
- Don't call medicine "candy" or a "treat." While doing so might temporarily make your baby or toddler cooperate, that kind of association could lead to an overdose if your child later finds the medicine and decides to try out the "treat." Vitamins and medicines often look like candy to a child, further adding to the confusion.
- Ask questions. If you're ever unsure whether to give your baby or toddler a medication, or if your child seems to be having an adverse reaction, call the doctor.
Getting your baby or toddler to take medicine
Where's Mary Poppins when you need her, right? Unless you're lucky enough to have a baby or toddler who happily opens up wide at the sight of a medicine dropper, having these tricks in your back pocket to "help the medicine go down" can help (spoonful of sugar not included):
Try giving the medication to your toddler before meals
Unless you're instructed to give medicine on a full stomach or after eating, try offering it before breakfast, lunch or dinner. Your child may be more likely to accept it when she's hungry.
Avoid taste buds
Taste buds are located in the front and center of the surface of the tongue. Bypass them by placing a medicine behind the rear gum and inside the cheek, where it will glide down the throat without hitting the taste buds as much. (Yes, this requires a bit of skill, and maybe an extra set of hands to keep your toddler still while you perfect your dunk shot.)
Keep medicine cool
If your pharmacist says chilling the medicine doesn't affect potency, try sticking it in the fridge to make the taste less pronounced. Otherwise, offer a cool bottle, a mesh feeding bag with frozen fruit or a Popsicle first to slightly chill and numb baby's tongue so it doesn't taste as strong.
Look for fun flavors
Ask your pharmacist for an FDA-approved child flavoring (like FLAVORx) that can combat the icky-tasting flavor of many medicines. Sometimes these do have a small up-charge, but it can be totally worth it.
Offer a bribe
Okay, last resort. Offer a treat, a small prize, stickers or extra time watching a show in exchange for taking medicine without a fuss. Pull out all the stops if it helps!
Side effects of infant and children's medicine to look out for
Some children may experience side effects when taking certain kinds of medications. Here's what to watch for in your baby or toddler:
- Diarrhea
- Change in activity or mood (e.g. increased fussiness or drowsiness)
- Sweating or flushing
- Unexplained rash
- Swelling
- Rapid heart rate
If you notice your baby having any trouble breathing or showing other signs of distress, call 911.
Though you should use medication sparingly when your baby or toddler is sick, take heart in knowing that if at-home remedies aren't helping her feel better, there are safe prescription and OTC options for infants and young children. Be sure to follow these guidelines and your pediatrician's advice when giving your little one medicine, and rest assured that she'll soon be on the mend.
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