The Do's and Don’ts for Children's Meds

Johnnie or Janie wakes complaining of a headache. You don't want to call your pediatrician at 3 a.m. What do you do?

There are some simple rules for using over-the-counter (OTC) medicines for children. The first and most important: NEVER give any OTC medicine to children 2 years and under without consulting a health care provider, says the FDA.

But what about older children, those between 2 and 12? Here is some advice:

Aspirin

Don't give aspirin to a child under the age of 19 without a doctor's advice. Use of aspirin in sick children has been associated with Reye's syndrome, a potentially fatal illness.

Acetaminophen

Acetaminophen and ibuprofen are usually safe alternatives to aspirin for children. They relieve pain and reduce fever as effectively as aspirin. Both are available under various brand names. Some brands are available in baby and junior strengths. Be sure to follow the dosages on the container because the strength of each preparation is different. The doses for children under 2 are not given on the package and you should consult your child's doctor before giving any nonprescription medication. Researchers have determined that alternating acetaminophen with ibuprofen provides the best fever control and reduces the total dosage of each drug.  

Decongestants

Decongestants can shrink swollen mucous membranes, relieving stuffy noses and clogged ears. They're sold as tablets, liquids, nose drops and nose sprays. Be sure to check with your child's doctor before giving a decongestant. In any case, don't give a child decongestants by mouth for more than five to seven days. Permanent damage to mucous membranes is possible with longer usage. Sprays and drops should not be used for more than two or three days because a "rebound effect" may occur. When the effect of a decongestant spray wears off, membranes swell to even greater levels. The nose and ears become severely clogged.

Cough medicines

A cough is the body's way of clearing mucus secretions from the throat and bronchial tubes, so you should encourage your child to cough rather than suppress it. But OTC cough medicines can temporarily reduce discomfort, especially at nighttime and may help with nonproductive coughs. OTC cough medications contain dextromethorphan as the active ingredient. Always consult a doctor or pharmacist to determine which preparation is best for your child's condition. Expectorants are used to help clear mucoid secretions from the airway by liquefying secretions and making them easier to cough up. The only available OTC expectorant is guaifenesin. To be effective it should be taken with plenty of water.

Anti-diarrheal preparations

• Fluids. Over-the-counter medications are no-nos for young children. Instead, give them an oral rehydration solution or clear liquids to replace any fluids they are losing. Most diarrhea disappears without treatment. If it does not improve in a few day, or your child's behavior changes, or he or she has bloody stools or a high fever, consult your doctor.

Anti-diarrheal agents:

• Kaopectate. Though Kaopectate is not recommended for children younger than 12 years, it contains a salicylate that also should not be given to children or teenagers because of its association with Reye’s syndrome. 

• Imodium. The manufacturer of Imodium recommends that this preparation be used with caution in young children because of the risk of dehydration. Always consult your doctor for directions.

Both Kaopectate and Imodium relieve diarrhea although neither cures the cause of the diarrhea. They are for symptomatic relief only.

Laxatives

These sometimes are helpful for treating severe or long-lasting cases of constipation, but should not be given without first consulting your child's doctor. To treat most cases of constipation, add fiber (fruits, vegetables, bran and other whole grains), water and juices to your child's diet. Never give your child an enema unless instructed to do so by a doctor.