Medication Tips: What Parents Need to Know

Getting your child to take medicine can be stressful and challenging for both of you. Your child probably doesn’t like the taste, and you need to make sure you’re giving the correct medication and dose, at the right time, and in the right way.

Nina Rezai, M.D., pediatrician at the Palo Alto Medical Foundation in San Jose, answers these common questions about medication safety and how to soothe children when they’re sick.

How can I store medicine safely and away from my curious child?

Medications are the leading cause of child poisoning, so it’s important to take several steps to protect your child. Be sure to buy medicines with child-proof caps and keep all medications up and out of reach. You should also add the Poison Control number, (800) 222-1222, to your cell phone. In an emergency, you’ll want to call quickly no matter where you are.

What's the best way to treat my child's fever?

Parents get concerned when their child has a fever, but a little fever may be a good thing. Fever is actually your body’s way of fighting off a virus, so as long as the child is comfortable, I don’t recommend treating a fever under 102 F. 

For higher fevers or if your child is miserable, treat with Tylenol (acetaminophen), it’s easier on the stomach. Babies 6 months of age and older can also take ibuprofen with food. 

Although aspirin is approved for use in children ages 2 and up, I don’t recommend it for anyone under 18 years of age. It’s been linked to a serious condition called Reye’s syndrome, which causes swelling in the liver and brain.

What can I give my toddler to help ease a cold?

A cold is a virus that the body will fight off on its own in a few days or a week. Cough and cold medicines aren’t approved by the U.S. Food and Drug Administration (FDA) for children under 2, and they can only ease the symptoms, not make the virus go away any faster. Over-the-counter cold medicines don’t help much, and if they are used improperly they can cause harmful side effects. I tell parents not to use them in children under age 6. 

Instead, treat your child naturally. Congestion is the biggest problem for kids with colds. In young babies, you can use a suction bulb to get mucus out of their noses. A humidifier or a steam shower before bed also helps. I’ve also had luck using Baby Vicks on the child’s feet or chest. For kids over 1 year old, buckwheat honey may help ease a cough.

Is there any way to ease the diarrhea my child gets when he takes antibiotics?

I find probiotics are very beneficial for antibiotic-associated diarrhea. You can get them from yogurt made with active cultures. Studies show that probiotics can help reduce many stomach problems.

I've heard you should never use a kitchen teaspoon to give children medicine. Why not?

It’s important to be careful how much medicine you give your child. Household spoons vary greatly in size, so they aren’t accurate. If the medication came with a dropper or syringe, always use it. If your child is an infant or very young, use an oral medication syringe (available at most drug stores). 

When you use the oral syringe or dropper, don’t squirt the medication into the back of the child’s throat – it can cause gagging or choking. To help your child swallow, gently and slowly squirt the liquid between the tongue and the side of the mouth. 

If your child is cooperative and able to drink from a cup without spilling, a medicine cup is a good choice, too. Never mix medication into your child’s bottle or cup. If it isn’t completely finished, it’s impossible to know exactly how much of the medicine he or she received.

How can I get my child to take medicine that she doesn't like?

Often kids resist taking medication because it doesn’t taste good. There are a few things you can try to improve the taste. You can choose a flavor you think your child might like for over-the-counter medications. Some pharmacies can flavor medicines – be sure to ask your pediatrician to indicate the flavor your child likes on the prescription.

To hide the taste of a medicine your child doesn’t like, sometimes a little juice or syrup can do the trick. If you have an infant, ask your pharmacist if mixing liquid medication with breast milk or formula (in a syringe, not a bottle) is an option. Always talk to the pharmacist first before using milk or juice, as some medicines have to be taken on an empty stomach, and some shouldn’t be taken with milk.

You can also make taking medicine more fun for your child by turning it into a game. Track doses with a sticker chart or have a stuffed animal take a dose first. When your child is old enough to understand (usually at age 4 or older), explain why it’s important to take medicine, even when we don’t want to.

If your child can’t swallow her medicine or if he throws it up, contact your pediatrician.

I was told I need to read the ingredients list and follow the instructions on the label. Is that a must or more of a suggestion?

It’s very important to read the medication’s ingredients list and carefully follow the instructions for giving your child the medicine. 

Use this checklist before giving medicine to your child, both prescribed and over-the-counter:

• Make sure the medication name is correct.
• Look for any ingredients your child may be allergic to.
• Check the expiration date.
• Give the correct dosage – double check if it’s teaspoon or tablespoon, and if you need to reference your child’s age or weight. See the section below on liquid dosing.
• Give dosages at the right time. For example, don’t give your child medicine every three hours if the label says six. Your child could have a reaction if you give the medicine too often.
• Set a reminder to keep track of how often to give medication so you don’t skip a dose.
• Always finish medication as directed – especially antibiotics – even if your child starts to feel better.
• Give the medicine the right way – some may need to be given with food, on an empty stomach, shaken before given or refrigerated.
• Make sure you’re not giving your child duplicate medication. If you give your child two medications that share the same ingredients, he or she could overdose.
• Remember to always talk to your pediatrician or pharmacist if you have questions or concerns, especially about side effects.

A Note on Liquid Dosing

There are several varieties of liquid Tylenol available, ranging from concentrated drops for infants to adult extra strength. This medication is generally safe if you follow the directions for dosage. 

It’s critical parents carefully read the labels of medications marketed for infants to avoid giving the wrong dose to their children, according to the FDA. Some drops may be concentrated and others may be less concentrated, and the dosage may be significantly different from one child to the next.

Ask your pediatrician what milligram dose is appropriate for your child’s age and weight, and double check the concentration before giving the medicine.

Giving too little of a medication can cause it to be ineffective, and giving too much can have serious side effects. Just taking a little more than the recommended dosage, or more than one medication with Tylenol in it, can cause nausea and vomiting.