Over-The-Counter Medicines for Infants and Children
Over-the-counter (OTC) drugs are medicines you can buy without a healthcare provider's
prescription. They usually come as pills, capsules, or liquids, and are sold in drugstores
OTC drugs have information on the bottle or box. Always read this information before
using the medicine. This information tells you:
Here are tips from some professional health organizations and the FDA on how to give
OTC medicines to children:
OTC cough and cold medicines should not be given to infants and small children without
talking with your child's healthcare provider first. The FDA and American Academy
of Pediatrics (AAP) recommend against giving them at all to infants and children under
the age of 2 because of possible serious life-threatening side effects.
Medicine doses for infants and young children are based on age and weight. Know your
Follow the directions for age and weight. If the recommended age is not your child's
age, don't give the medicine.
If no dose is given on the bottle or package for children under 12 years old, ask
your healthcare provider or pharmacist if it is OK to give the medicine to your child.
Ask how much you should give and when you should give it.
Liquid medicines usually come with a cup, spoon, or syringe to help measure the right
dose. Always use these items to give medicine to infants and very young children.
Using a kitchen teaspoon is not the correct way to measure. A teaspoon is usually
considered to be 5 cc or 5 mL, but kitchen teaspoons can vary in size from between
2 mL and 10 mL.
If you want to mix medicine with milk or formula, first put the medicine in 1 ounce
of milk and have the child drink it all. Then feed the remaining formula or milk in
Always measure or give medicine with a good light turned on. Insufficient light could
cause you to give the wrong medicine or the wrong dose.
Never let young children take medicine by themselves.
Many OTC cough and cold medicines contain a combination of ingredients to treat several
symptoms. Your child might be getting some of the same ingredients in other medicines.
For example, many cold medicines also contain acetaminophen. Be sure to read the list
of active ingredients (the ingredients that make the medicine work) for each OTC medicine
you give your child. Make sure he or she is not getting a double dose of the same
medicine. You need to make sure that the total amount of a medicine is not more than
the recommended dose.
Combinations of medicines found in multi-symptom medicines may cause more side effects
in children. The combination of antihistamines and decongestants in some "cold remedy"
medicines can have side effects like hyperactivity, sleeplessness, and irritability
in children. To be safe, don't combine prescriptions, supplements, or multi-symptom
medicines without checking with your healthcare provider or pharmacist.
Watch the ingredients
Sometimes the ingredients for a medicine change, but the name stays the same. For
example, the formulation of one OTC medicine for diarrhea, changed so it now contains
bismuth subsalicylate. The older versions contained only kaolin and pectin or attapulgite.
Bismuth subsalicylate is NOT recommended for children younger than 19 because of the
risk of a rare but sometimes deadly condition called Reye syndrome.
Because of Reye syndrome, don't give a child younger than 19 any product with aspirin
or similar drugs called "salicylates" unless your healthcare provider tells you to.
Instead of aspirin or other salicylates, you can give your child acetaminophen or
Watch the amounts
Be sure to take into consideration the concentrations of ingredients when you determine
the amount you give your child. Medicines with the same brand name can be sold in
different strengths. This includes infant, children, and adult formulas. Infant drops
of some medicines, for example, are stronger than the liquid elixir of the same medicine
for toddlers or children. This is because infants may not be able to drink a large
volume of medicine to give their proper amount. Don't make the mistake of giving higher
doses of the infant drops to a toddler thinking the drops are not as strong.
Here are some other suggestions:
Talk to your healthcare provider or pharmacist to find out what mixes well and what
doesn't. Medicines, vitamins, supplements, foods, and beverages don't always mix well
with one another.
Don't call medicine "candy." If children find medicine at a later time, they may consider
it "candy" and eat it without your knowing.
Always use child-resistant caps and store medicines in a safe place. Relock the cap
after each use. Be especially careful with any products that contain iron. They are
the leading cause of poisoning deaths in young children.
Before you give a medicine, check the outside packaging for damage such as cuts, slices,
or tears. Check the label on the inside package to be sure you have the right medicine.
Make sure the lid and seal are not broken. Check the color, shape, size, and smell
of the medicine. If you notice anything different or unusual, talk to a pharmacist
or your healthcare provider.
Classes of OTC medicines
OTC medicines are divided into the following classes:
Brand names of OTC medicines can change and store brands are common. Be sure to read
the labels to know what the active ingredients are in all products.
Analgesics treat pain and fever. Use caution with different forms of these drugs.
Some are more concentrated than others. Common analgesics for infants and children
are acetaminophen and ibuprofen. Don't give aspirin to children younger than 19, because
it can cause a rare but sometimes deadly condition called Reye syndrome.
Antihistamines treat runny noses, itchy eyes, and sneezing caused by allergies (but
not colds). Some can cause sleepiness. These are not recommended for children younger
than 2. Use only with your healthcare provider's OK in young infants or children with
asthma. Examples of antihistamines include chlorpheniramine, diphenhydramine, and
Expectorants and combination cough medicines may help loosen mucus. Cough suppressants
numb the reflex to cough. Coughing is needed to clear mucus and bacteria from the
lungs. Check with your child's healthcare provider before using cough-suppressing
syrups. Guaifenesin, an expectorant, helps thin mucus that is more easily removed
Decongestants can relieve stuffiness caused by allergies or colds by temporarily shrinking
the membranes in the nose to make breathing easier. They should not be used for more
than 2 to 3 days in a row. Decongestants taken by mouth can have a number of side
effects like irritability, sleeplessness, and dizziness.
Medicines for diarrhea. These are usually not necessary. Instead, give your child
plenty of fluids and let the disease run its course. Diarrhea can be dangerous in
newborns and infants. In small children, severe diarrhea lasting just a day or 2 can
lead to dehydration. Because a child can die from dehydration within a few days, see
a healthcare provider as soon as possible if an infant has diarrhea. Talk to your
healthcare provider before giving these medicines to infants or children. One medicine
for diarrhea, bismuth subsalicylate should not be given to a child younger than 19.
Another medicine for diarrhea, loperamide, should not be given to a child younger
Laxatives relieve constipation and work by several methods. Some add fiber or water
to stool to make it more bulky and easier for intestines to eliminate it. Some coat
the surface of the stool to make it more slippery. Some soften the stool so it passes
more easily. Others cause the intestines to contract more forcefully. Don't give infants
or children laxatives without talking to your child's healthcare provider. Examples
of laxatives include glycerin suppositories, magnesium hydroxide, mineral oil, and