Kids and meds: ­­8 tips for safe dosing

What to know about giving over-the-counter medications to children.
If you’re unsure of how to administer your child’s over-the-counter medicine, consult a pharmacist or your physician. (For Spectrum Health Beat)

When your child is feeling miserable, you want to do whatever you can to ease the pain or discomfort. But how do you know when it’s safe to give over-the-counter medications and when it’s best to avoid them?

And how can you be sure to give your child a safe dose?

Lindsey Jelsma, PNP-PC, a pediatric nurse practitioner at Spectrum Health Helen DeVos Children’s Hospital, has a few tips and recommendations for parents and caregivers.

For starters, Jelsma said, don’t assume that medicine is always the best answer.

“Remember that medicine can be an adjunct to other ways to feel better—whether that be rest or an ice pack or heat or taking a bath or just letting the symptom run its course,” she said.

“Lots of families want to give adult medicines to children for their coughs, and that’s not always recommended. Sometimes for a cough the most effective thing for a child is just a teaspoon of honey to coat the throat.”

Jelsma noted, however, that children under the age of 12 months should not get honey—it carries the risk of infant botulism.

If you do choose to give your child non-prescription medicine—and there are definitely situations when this is appropriate, such as giving acetaminophen (Tylenol) to combat pain or fever, or giving Benadryl for minor allergic reactions—be sure to give the right dose.

Here are Jelsma’s top tips for safe dosing with children:

1. Read the package

Before you give a child any medication—prescription or over-the-counter—be sure to read the label and any package inserts. Remember that many non-prescription medications are formulated for adults, so they may not be safe for kids. Look for:

  • Minimum recommended age. For example, aspirin shouldn’t be given to anyone younger than age 12 because of the risk of Reye Syndrome (and it shouldn’t be given to anyone recovering from a viral illness). Ibuprofen (Advil or Motrin) shouldn’t be given to a child under 6 months of age because of various risks, including risk of seizure.
  • Safe dosing amounts based on weight or age.
  • Wait time between doses—this can vary widely from one medicine to another.
  • “Black box warnings” about serious risks. For example, certain cough medicines can cause cardiac arrhythmia in young children.
  • Other risks or potential side effects.

Drug manufacturers typically base dose recommendations on the child’s age or weight, given in kilograms or pounds. This leads to Tip No. 2:

2. Know your child’s weight

The child’s weight is the biggest factor in safe dosing, Jelsma said. “Kids around the age of 12 normally start to fall within the safe range dosing for adults,” she said, but if your child is small for their age, be careful. To avoid giving an overdose, follow any weight-based recommendations.

3. Measure liquid medicines accurately

If the dose is 1 teaspoon, any old spoon won’t do! Be sure to use an accurate measuring utensil: a syringe, a medicine dropper or the plastic cup that came with the bottle. If you don’t have a proper measuring device, ask for one at your pharmacy.

“Whatever you’re dispensing, make sure your dosing is accurate,” Jelsma said.

4. Write it down

Make a timeline of your child’s illness, keeping track of when you administer each medication.

“When kids are sick and they’re not sleeping, neither is that parent,” Jelsma said. At times like this, you may have a hard time remembering when you gave what medicine. “The risk of giving the kids too much is pretty high.”

5. Be careful with medicines that have multiple components

Many over-the-counter cold and flu medicines contain multiple ingredients, such as acetaminophen plus a decongestant and other things. Again, read the label carefully. Even if your child weighs enough to take a cold medicine, don’t give Tylenol on top of it. This could amount to giving a double dose, which carries the risk of organ damage.

When your child has a cold, Jelsma suggests using alternatives to drugs, such as a humidifier to keep congestion loose and saline drops with a bulb syringe to clear the nose.

Cough and cold medicines are not recommended for children under age 4, she said. For children between ages 4 and 6, use them only if prescribed by the child’s health care provider. For children over age 6, follow the dosing instructions.

6. Ask a professional

If you’re unsure of what medicine to choose, how much to give or whether two medications can be combined, call your pediatrician or primary care provider. They can help you come up with a plan for your child. Or ask a pharmacist: “They’ll be able to help families determine what the safe dose is and if that medication is safe for their child,” Jelsma said.

7. Keep medicines out of reach and out of sight

“Kids want to do what their parents are doing, so we have to be really careful with medications that we’re taking as adults,” Jelsma said. If young children have access to their parents’ or grandparents’ pills, they might try to take them, thinking they’re candy. Jelsma has treated children who have swallowed adult blood pressure pills, leading to dangerously low blood pressures.

Even vitamins can be harmful in large quantities, so treat them like medicines and keep them up and out of the way, Jelsma said.

Rather than leaving medications on the counter as a visual reminder, Jelsma recommends setting a reminder on your phone or developing the habit of taking pills when you brush your teeth.

8. Don’t hesitate to call Poison Help

If you think you may have given your child too much medicine, or if a child has accidentally ingested something, call 1.800.222.1222. The Poison Help hotline is a ready resource that can help put your mind at ease or tell you what action to take. Save the number in your phone and post it somewhere in the home where babysitters can see it.

Another helpful resource in non-emergency situations is healthychildren.org, published by the American Academy of Pediatrics.

While Jelsma believes that most over-the-counter children’s medicines are safe, she cautions that every drug comes with risks and potential side effects, so it’s best to be informed.

Learn more about Pediatric Trauma Services at Spectrum Health Helen DeVos Children’s Hospital.

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