Stocking Baby's Medicine Cabinet

Creams, Lotions & Gels

When I started my practice more than 20 years ago, there was only one pharmacy open late in my town. If your baby got sick in the middle of the night, you couldn't buy any medicine until morning. But even in these days of 24-hour pharmacies and grocery aisles stocked to the ceiling with remedies, it's wise to keep the basic supplies on hand. Of course, always consult your child's pediatrician before administering any medication. Here are the essentials.

• Diaper rash cream Diaper rash is inevitable for all babies. Look for a product that contains zinc oxide, which is best for soothing irritated skin.
• Hydrocortisone cream This anti-inflammatory salve is sold in pharmacies in 1/2- or 1-percent strengths. Both are mild enough for infants and are used mainly for eczema (a red, scaly rash); dry, itchy skin; or to treat bug bites. Use as directed on the tube, but not for more than seven days because it can cause changes to the skin, such as loss of pigment.
• Triple antibiotic ointment Once your child is crawling and walking, he's likely to get minor cuts or scrapes. This topical cream can be applied to scratches, cuts, or abrasions to prevent infection.
• Petroleum jelly Besides working wonders on dry skin and eczema, this cheap, tried-and-true moisturizer can be applied to diaper rash to shield the skin from contact with irritating urine and stool. If your son has been circumcised, put it on the circumcision wound for the first week to prevent the penis from adhering to the diaper.
• Teething medicines Chew toys are often sufficient to soothe teething pain, but if your baby is truly uncomfortable, a topical teething remedy can help.

Pain-Relief Liquids

• Acetaminophen (Tylenol) I recommend the infant drops or liquid for fever or pain, but never give this medicine to a baby younger than 2 months old without specific instructions from your doctor. Read the label to check the dosage, and use the dropper that comes with the product or another dosing instrument (see Medicine syringe or dropper, next page).
• Ibuprofen (Advil, Motrin) As with acetaminophen, ibuprofen infant drops or liquid can relieve pain and fever. Never give it to a child younger than 4 months old without your doctor's consent. Ibuprofen is a little stronger and lasts a bit longer than acetaminophen. However, most pediatricians prefer acetaminophen for babies younger than 6 months old because it's easier on the stomach and is an older drug with a long history of safe use in babies. I think parents should keep both products on hand, since occasionally you'll need to use them together, under the direction of your doctor, for high fever or severe pain, such as from a bad earache.
• Decongestant An over-the-counter decongestant or a combination decongestant/antihistamine product is commonly recommended for a runny nose and congestion. These medicines should not be given to a baby younger than 4 to 6 months old; consult your doctor about dosage and use.
• Cough suppressant Again, this product is for babies at least 4 to 6 months old. The most common ingredient in a children's formula is dextromethorphan (look for "DM" on the label).
• Simethicone (Mylicon) drops This over-the-counter gas remedy stays in the gastrointestinal tract and is not absorbed into the body. It doesn't always produce results, but it's safe to try.
• Electrolyte solution Used to alleviate dehydration, this fortified beverage comes in ready-to-drink bottles or packets to be mixed with water. It's used mostly for bottlefed babies suffering from significant diarrhea or vomiting. (Breastfed infants can usually continue to take breast milk.) Give this drink only under the direction of your doctor.
• Saline nasal drops Made from pure salt water, these drops help loosen and clear baby's stuffy nose. They can be used alone or with a nasal aspirator. A cool-mist humidifier will also soothe upper respiratory infections.

Get-Better Tools

• Medicine syringe or dropper These devices are essential to ensure that you're giving your child the right amount of medicine (a baby can easily overdose). Syringes, which are measured off in teaspoons and milliliters, are best. They don't drip and are easy to direct into the mouth of a squirming baby. You can also try droppers measured off in teaspoons, but they tend to drip. A hollow-handled spoon that can be filled with medicine works well for babies old enough to sit up on their own.
• Nasal aspirator Made of soft rubber, aspirators are often given to new parents before they leave the hospital. Since an infant can't blow his nose, mucus buildup can make it difficult for him to breathe, and can even cause gagging. This device creates a suction that clears baby's nasal passages. (Keep one close by in the first weeks, when baby's learning to feed. If he has a choking spell and milk comes out of his nose, the bulb can be used to clear it.)
• To use, first squeeze the bulb and then place it in the nostril as far as it will easily go, angling it toward the top of the ear. As you slowly release your grip on the ball, it will suck up the mucus. But remember: Babies hate having their nose messed with. So if your child has a mild cold, you can leave him alone.
• Cotton swabs Use swabs to clean the folds of the outer ear. Never insert them into the inner canal of baby's ear; you risk perforating the eardrum.
• Bandages The famous plastic strips protect boo-boos but can be a choking hazard for babies. Don't leave a child younger than 2 years old alone with a bandage on unless you're sure it's securely in place or that he can't reach it.
• Digital rectal thermometer Parents should take their child's temperature rectally until 6 months of age. The results are more accurate than from an under-arm or ear thermometer reading, and accuracy is crucial in infancy, when even low fevers can be significant. Any fever requires a doctor's visit for a child younger than 4 months old, and babies younger than 2 months old may need to be hospitalized for a high fever. To get the best reading, hold the thermometer about 1 inch from the end that will go in. Then slide it in gently, resting your fingers on baby's buttocks without letting go until you're ready to take it out.
• Nail clippers Infants grow so quickly, they may need their nails trimmed every five to seven days. Use clippers designed specifically for babies, and be careful not to cut their fingertips. If your baby is resistant, try clipping her nails while she's sleeping or feeding.

Medicine Dos and Don'ts

When it comes to treating your child, keep these medicine pointers in mind.

• Ask your doctor whether medicine should be given before or after meals (or with breast milk or formula).
• Inform your doctor if baby is taking any other medicine -- mixing certain over-the-counter medicines may not be safe.
• Keep medicine out of children's reach.
• Don't call your child's medicine "candy."
• Measure medicine carefully -- even the difference of a milliliter can overdose a baby -- and use an appropriate dosing device rather than a kitchen spoon.
• Call your doctor if the medicine doesn't seem to be working, your child's condition worsens, or you notice unexpected side effects.
• Never give your child aspirin. It can cause Reye's syndrome, a serious condition that affects the brain and internal organs.

Catherine Dundon, MD, FAAP, is an associate clinical professor of pediatrics at Vanderbilt University Medical School.