Whether you're dealing with a doctor's prescription or an over-the-counter cold medicine, there's so much to worry about: How many doses can I give my child? Is she supposed to eat first? Can I sneak it into her orange juice so that she'll actually take it? Before you hit the speed-dial button and quiz your pediatrician, read up on these medication how-tos.
Usually not, says Dianne Murphy, MD, director of the Office of Pediatric Therapeutics at the FDA. Commonly prescribed medications like antibiotics and pain relievers are safe in generic form. "They have to meet the same manufacturing standards as brand-name drugs," says Dr. Murphy. That means a generic must have the same active ingredient and come in the same form (such as a tablet or capsule). The inactive ingredients -- which are used for color and flavor and as preservatives -- may be different, though. "Some brand-name medications taste better than generics," says Mary Hegenbarth, MD, associate professor of pediatrics at the University of Missouri, Kansas City School of Medicine. "And if a medication tastes bad and your child won't take it, it won't be effective." If your pediatrician prescribes a brand-name drug, always ask whether a generic exists and whether she recommends it.
No. "Dosing is usually based on weight, not age," says Dr. Hegenbarth. "Although the guidelines on some labels include age ranges, they're averages. So if your child is much heavier or lighter than average, the recommended dose may not be right for him." Check with your pharmacist or doctor to make sure you use the correct measurement.
You're better off using something semisolid like applesauce, says Sarah Erush, clinical manager of pharmacy at The Children's Hospital of Philadelphia. "If the contents settle at the bottom of a drink, your child may not get the full dose," she points out. However, giving food with time-released medication may change the way it works, so always ask your pharmacist before you start mixing. And you may need to avoid foods containing calcium, says Dr. Murphy. Studies have shown that combining milk or other calcium-rich foods with certain medications (such as the antibiotic tetracycline) can weaken the dose.
If your pharmacist gives you the green light, use the smallest amount of food possible (ideally just one or two spoonfuls) so your child will eat the whole thing. Serve it immediately -- if the mixture sits, the drug may start to degrade.
You can't give him "the pink stuff" because it contains bismuth subsalicylate, a component of aspirin associated with Reye's syndrome, a rare but serious disease that can strike children who have viral illnesses. There is a remedy for children with heartburn or acid indigestion -- chewable pink tablets that contain calcium carbonate, which is found in antacids -- but it won't help a stomach virus.
When your child has a stomach bug and is vomiting, simply give him small amounts of fluids or electrolyte solutions like Pedialyte or Infalyte (aim for 1 or 2 teaspoons every five minutes) until he feels better, says Dr. Hegenbarth.
Call your pediatrician immediately. If you can't reach her, call the American Association of Poison Control Centers at 800-222-1222 (the number is also in the front of your phone book). "When given in high doses, drugs sometimes act like poison," says Erush. And don't use syrup of ipecac; it's no longer recommended as a treatment for poisoning.
Both medications reduce fever by blocking prostaglandins, chemicals that promote pain and fever. Ibuprofen has the advantage of lasting longer (six to eight hours, compared with four hours for acetaminophen). Beyond that, the one you choose really depends on your child's ailment, age, and stomach sensitivity. Ibuprofen is very effective at targeting pain caused by inflammation, like tooth and muscle aches; it also seems to relieve fever better in most kids. But keep in mind, ibuprofen can cause stomach upset and, unlike acetaminophen, it's not FDA-approved for infants under 6 months.
If she vomits five or 10 minutes later, it's safe to repeat the dose since the medication didn't have time to be absorbed into her bloodstream. (If your child throws up a second time, don't try to give her the medication again.) But if half an hour goes by, hold off until it's time for the next dose, says Dr. Hegenbarth.
At age 5, most kids can swallow a pill the size of a Tic Tac, says Erush. But your child may not be ready to pop a larger one until he's 9 or older. "The best way to get started is to make the pill slippery," advises Erush. Rub a tiny bit of butter on the pill, then place it in your child's mouth. Give him a spoonful of applesauce and tell him to swallow. Don't give him water or juice, since the pill may just float around in his mouth.
Try blowing on the middle of her face, which will cause her to blink and swallow, says Erush. Or you can break up the dose into small amounts. If the dose is 5 milliliters (mls), for example, give her 1 ml at a time. Using a calibrated syringe applicator, aim the dose toward the side of her cheek, not onto her tongue. If you're still struggling, ask your pediatrician whether the medication comes in suppository form.
Do tell your doctor and pharmacist about other medications your child is taking, including over-the-counter products and herbal supplements.
Don't wing it when you give your child medication. Always read the dosing instructions.
Do double-check with your pharmacist that you have the right dosing equipment. Never use silverware; stick with the medication cup, dosing spoon, or dropper that comes with the medication.
Don't give a child a drug that isn't labeled for her age group. For example, never give cough or cold meds to kids under 2 without your pediatrician's approval -- the results could be harmful, according to the Centers for Disease Control and Prevention.
Do check your prescription when you get refills to make sure it's the right medicine.
Don't give your child two medications with the same ingredients. For example, many cough and cold products contain acetaminophen, which parents often give separately for fever. When in doubt, check with the pharmacist.
Copyright © 2007. Used with permission from the September 2007 issue of Parents magazine.
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