As a doctor and mother of kids, I often wonder what would be the most useful topic for other mamas that don’t have a medical degree in their parental toolbox. Right now, as we are all facing social distancing or are “sheltering in place,” I want to help you stock your medicine cabinet so that you will have what you need to take care of your family should someone become ill.
My least favorite aisle of the ever-familiar and frequented grocery store, my second home as a mom, is the pharmacy aisle. As a physician, I can only imagine how intimidating this aisle is to those who haven’t been through formal medical training. I’d like to give you a little tour through what a mama doc always keeps in her medicine cabinet, a few warnings about what I never buy, and why. My aim is that your next adventure into the medicine aisle will be approached with less confusion, more confidence, and the satisfaction of knowing you’ve planned for the future in hopes of preventing those late-night, panicky, pharmacy runs and head-scratching sessions in front of the medicine cabinet.
Here I’m only touching on over the counter items, things you can buy all on your own without a prescription. Luckily, for many illnesses, this will cover most of what your family needs.
Some Hard and Fast Rules
There are a few hard and fast rules that I feel need to be addressed right off the bat:
- Keep ALL medication out of the reach of even your most athletic, daring child.
- NEVER give a child aspirin (salicylic acid) unless specifically prescribed by a doctor. Aspirin can cause Reye’s syndrome (a rare but serious condition that causes swelling in liver and spleen); Pepto-Bismol contains Bismuth subsalicylate which also increases risk for Reye’s.
- Do not give decongestant or cough suppressants to children under 2 years old.
- Never buy a combination medicine that contains acetaminophen or ibuprofen. These medicines have daily maximum safe dosages that are too easy to exceed if you inadvertently double dose. It’s not worth it. Check the active ingredients of everything in your medicine cabinet. If you find one that contains acetaminophen or ibuprofen in addition to other active ingredients, I’d recommend replacing them with medicines that do not. According to the NIH, acetaminophen toxicity is the most common cause of liver transplantation in the U.S. It is responsible for 56,000 emergency department visits each year, 2600 hospitalizations, and 500 deaths. Fully HALF of these are unintentional.
- Always read the package insert dosing instructions and make yourself aware of all active ingredients before you give a medication to your child. Remember, if you have a question, you can always call a 24-hour pharmacy and ask to speak directly to the pharmacist. Yes. You can. They are okay with it.
The Basics of Over-the-Counter Medications for Kids
- Avoid unnecessary medications and accidental double dosing by using single ingredient preparations
- For fever or pain –
- ibuprofen (Advil, Motrin) – lasts longer than tylenol, works better for inflammation
- acetaminophen (Tylenol);
- alternate these only if given specific instructions by your physician
- these should be dosed by weight and given with syringe and graduated stopper (if you are unsure of the appropriate dose for your child, call your pharmacist, advise them of exactly what you have at home and the current weight of your child)
- For congestion, stuffiness, and thin mucus – decongestants such as psuedoephedrine (plain Sudafed) and phenelephrine (plain Dimetapp); dries up thin mucus and decreases nasal stuffiness. Unfortunately, most branded cough and cold formulas are multi-ingredient, so read those labels!
- For thick mucus – expectorant such as guaifenesin (plain Mucinex or Robitussin)(tastes awful, so avoid unless really needed; also this only works if the child is well hydrated); many cough/cold medicines contain this and it’s the reason they taste so bad. I find that trade-off makes it not worth it for most illnesses in my opinion.
- For allergies – antihistamine such as chlorpheniramine, diphenhydramine, or brompheniramine; should NOT be given for a cold; check your OTC cough/cold medicines; avoid them if they contain these (unless treating allergies) as they can cause grogginess or hyperactivity which is miserable AND makes their medical status harder to evaluate.
- For cough – cough suppressants such as dextromethorphan (Delsym)
What I Have in My Medicine Cabinet
- Children’s dye-free Motrin
- Children’s Tylenol
- Children’s Sudafed
- Delsym 12 hour cough (so nice because it lasts through a normal night’s sleep!)
- Children’s Mucinex (combines phenyleprhine decongestant with guaifenesin expectorant) so ok to give with Delsym and Motrin or Tylenol, but NOT with Sudafed (another decongestant)
- Liquid Benadryl (just for emergency-only give if instructed by a physician)
- Tylenol Meltaways (ages 6-11)
- Topical Benadryl (not only an antihistamine good for itching but also relieves pain) – GREAT for mosquito bites
- A topical steroid such as Cortaid for rashes (your doctor will tell you when/if to use it but it’s nice to already have it on hand)
- Bacitracin ointment-topical antibiotic (bacitracin, NOT Neosporin- approx 8-10% of people are allergic to this and will get a local allergic reaction to it)
- Miralax for constipation
- Antihistamine eye drops for itchy allergy eyes
Helpful Tidbits in Dealing with Sick Kids (stuff I didn’t learn in med school)
Having sick kids at home is exhausting, worrying, and messy. I’ve come up with some tips through experience that will make your experience a little better.
- Every household with a child should contain a rectal thermometer; sometimes, the doctor will ask for the rectal temperature, as that is the most accurate way to measure temperature in younger kids and the only appropriate way to measure temperature in a baby 3 months old and under.
- But also buy a temporal artery thermometer. These are the easiest to use and read and will do for most illnesses.
- Dose liquid medication with a graduated syringe (your pharmacist will give you as many as you need); extract it from the medicine bottle using a graduated rubber stopper.
- Put young kids in pull-ups when coughing or vomiting even if they are potty trained. Incontinence is messy and you are dealing with enough! I learned this the hard way.
- Make a “barf zone” on the couch or a chair for kids too young to hit the bucket (waterproof mattress pad for upholstery protection with quilt over if for coziness). Have a duplicate set ready to go for when the first one has to go in the washing machine. Add a waterproof mattress pad to their bed as a routine item and have a spare for nights when it’s pressed into action. Have a waterproof pad to put on the floor and over their pillow if things are really messy. Have spares for laundry time.
- Have a bulb syringe for babies to aid with clearing nasal secretions.
- Use a cool-mist humidifier overnight in the bedroom of anyone with congestion. It really does help!
- Keep written track of medication given, dose, and time near where medicines are kept. This is SO important! You’ll be tired and stressed, might be sick yourself, and maybe treating multiple sick kids, so set yourself up for success ahead of time by printing a Handy Medication Tracker like this one and taping it to the inside of a cabinet door before anyone is sick. Believe me. This is crucial. Scott and I are a doctor and dentist and only have 2 kids. But there was NO WAY we could have kept track of meds when both girls were sick without this central record.
- Keep emergency numbers and poison control numbers next to the phone or in an easy to find place in your phone. Don’t leave it up to google. Look these up now and make a note.
- Make a list of questions during the week before a doctor’s appointment. This will help ensure you don’t forget anything during the few minutes you get with the doctor when you might be frazzled by a hurried doctor and crying kid.
- Frequent application of original chapstick to dry, raw noses can really relieve discomfort.
When to Call the Doctor
You can deal with a lot of childhood illnesses just by treating the symptoms at home. But NEVER feel bad for calling the doctor or 911 if the need arises. Here are some things you NEED to call about:
- Fever if any of the following occur :
- Baby 3 months old or under – rectal temp 100.4 or over
- Ages 3 months to 3 years – one time temperature over 102, temperature over 100.4 for 3 days, or any fever if your child looks ill
- Kids 3 and over – temperature of 103 or over
- Any temperature of 104 or over.
- Any fever that lasts 7 days no matter how intermittent or low grade
- Any fever that comes with a new skin rash
- Any fever in a child that has a chronic illness such as heart disease, cancer, lupus, or sickle cell anemia
- Head injury
- Difficulty breathing
- Exposure to known allergen
- Will not eat or drink
- Vomiting frequently or severe diarrhea
- Severe headache
- When in doubt, call your doctor, or call 911 in an emergency. It’s always best to be on the safe side
I am not your child’s doctor. I am merely a fellow parent with a medical degree trying to let you in on some of the things I’ve learned as a doctor and mom. You need to establish a primary care physician (family physician or pediatrician) and seek medical care for your child on a regular basis for health care maintenance. If you have general questions about the information I have provided here, I’d LOVE to reply to a comment! If you have a specific question about your child, you’ll need to call their doctor. This protects all of us. Thanks so much for reading this article! I hope it helps clear up some confusion and will be a handy reference for you. I’d love to hear from you!