Health Encyclopedia

The Do's and Don’ts for Children's Meds

There are some simple rules for using over-the-counter (OTC) medicines for children. The first and most important is never give any OTC medicine to children 2 years and under without talking to a health care provider, says the FDA. But what about older children between 2 years and 12 years? Here is some advice:


Don't give aspirin to a child under the age of 19 without talking with your health care provider first. Use of aspirin in sick children has been associated with Reye syndrome, a possibly deadly illness.

Acetaminophen and ibuprofen

Acetaminophen and ibuprofen are usually safe alternatives to aspirin for children. They relieve pain and reduce fever as effectively as aspirin. Both are available under various brand names. Some brands are available in baby and junior strengths. Be sure to follow the dosages on the container because the strength of each brand is different. The doses for children under 2 are not given on the package and you should talk to your child's health care provider before giving any OTC medication.  


Decongestants can shrink swollen mucous membranes. This relieves stuffy noses and clogged ears. They're sold as tablets, liquids, nose drops, and nose sprays. Be sure to check with your child's health care provider before giving a decongestant. OTC decongestants should not be given to children younger than 2 years of age unless directed by a health care provider. In fact, children younger than 4 years of age should not be given these OTC products. In any case, don't give decongestants to a child by mouth for more than 5 days to 7 days. If symptoms last longer than that, talk with your child's health care provider. Sprays and drops should not be used for more than 3 days because a "rebound effect" may occur. When the effect of a decongestant spray wears off, membranes swell to even greater levels. The nose and ears become severely clogged. Using a spray or drops for a longer time may permanently damage the mucous membranes. Use saline (salt water) nasal drops or sprays instead. In addition, cool mist humidifiers may also help.

Cough medicines

A cough is the body's way of clearing mucus secretions from the throat and bronchial tubes. You should encourage your child to cough rather than hold back. But OTC cough medicines can temporarily reduce discomfort, especially at nighttime and may help with dry or nonproductive coughs. OTC cough medications contain dextromethorphan as the active ingredient. Always consult a health care provider or pharmacist to determine which preparation is best for your child's condition. Expectorants are used to help clear mucus secretions from the airway by loosening or liquefying secretions and making them easier to cough up. The only available OTC expectorant is guaifenesin. To work best, it should be taken with plenty of water.

Anti-diarrheal medicines

Give your child oral rehydration solution or clear liquids to replace any fluids they lose due to diarrhea. Most diarrhea disappears without treatment. If it does not improve in a few days, or your child's behavior changes, or he or she has bloody stools or a high fever, talk to your health care provider.

Anti-diarrheal agents:

  • Kaopectate. Kaopectate is not recommended for children younger than 12 years. This is because it contains a salicylate, which is like aspirin. Aspirin should not be given to children or teenagers under 19 years old because of its association with Reye syndrome. 

  • Imodium. The manufacturer of Imodium recommends that this preparation be used with caution in young children because of the risk of losing fluids. Always talk to your health care provider first.

Both Kaopectate and Imodium relieve diarrhea although neither cures the cause of the diarrhea. These medicines are only to relief symptoms.


These sometimes are helpful for treating severe or long-lasting cases of constipation. They should not be given without first talking to your child's health care provider. To treat most cases of constipation, add fiber (fruits, vegetables, bran and other whole grains), water, and juices to your child's diet. Never give your child an enema unless you are told to do so by a health care provider.

Medical Reviewers:

  • Holloway, Beth, RN, MEd