Quick reminders as we tidy our lives at the beginning of the school year. With little ones and children all heading back to school, we know it's time to buckle down and get ready for the shift in schedules and in illness that comes with onslaught of viruses that come with preschoolers and elementary-aged kids back in the classroom. Before the fall is upon us, it's a great time to really learn how to read the drug label and learn the ingredients, why or if it's safe for a child the ages of your kids, why the inactive ingredients matter, and organize the cupboard! In some ways it's combination medicines that make me worry the most — so this is a quick review on what you can do to feel confident when dosing and using OTC medications at home with your family.
1. Read the label. Plain and simple get in the habit of always reading it as we don't want to forget to make sure we really know what ingredients we're giving and why. No question that sometimes we use medicines to "cure" children of illnesses, infections, or deficits (prescription antibiotics, anti-infectives, chemotherapy) but most OTC medicines only treat symptoms our children experience from infections or injuries. That makes them less necessary, although sometimes wildly helpful and soothing. Treating pain and discomfort is of course a priority for all parents when our children are uncomfortable! Consequently, we want to use OTC when they earnestly help and match the correct medicine with the symptom we're targeting…the label can help.
2. Know the ingredients — watch out for double dosing! So many products out there have combination medications. Many medicines for cough and cold will combine medicines for fever with medicines for mucus with medicines for cough. Some medicines combine medicines for allergy symptoms with medicine for fever. You might inadvertently be giving your child a second dose of acetaminophen (AKA "Tylenol") when using a combination medicine without knowing it. Expert toxicology and pediatric emergency room friend, Dr. Suzan Mazor reminds, "that sneaky acetaminophen shows up in all sorts of combination medicines" so watch out! If you're dosing acetaminophen for fever make sure you're not double dosing if you're also treating other symptoms with medicine.
3. The syringe or dosing cup -KEEP IT! Keep the dosing devices that comes with the OTC medicine you buy (use a rubber band as needed to attach it to the bottle)! No question that it is confusing to dose medicines based on weight. In the past, data finds that 98% of liquid OTC medications for children have inconsistencies, excess information, or confusing dosing instructions — thankfully this is changing and there is national push to have pediatricians write and explain doses only in milliliters or milligrams as opposed to dosing and explaining in "teaspoons" and "ounces." As we work to standardize this there will still be some confusion.
TIP: Never use a "teaspoon" from the drawer to measure medicines and don't let Grandma or a babysitter. Different teaspoons hold different amounts. Dosing devices typically measure in either milliliters or ounces, so always use the tool that came with the medicine you're going to give a baby of young child. If you're ever confused reach out. Using the dosing device that comes with the medicine will help ensure you won't have to make conversions (mL –> ounces or milliliters to teaspoons) and you can follow instructions on the label more precisely. Dosing by weight (like we do for children) is very different than dosing by age (like we do for adults).
Know Your OTCs have created a few easy-to-read image to help better explain OTC labels. I've included a few below, but you can view them all here.