5 Rules For Dosing Medicines For Colds And Ear Infections

In clinic the last couple of weeks I’ve been reviewing medicine doses with families for common over-the-counter (OTC) medicines repeatedly. It’s the time of year when goopy illness comes into our homes and is chased by fevers and aches and discomfort, screams and coughs, and overall gloom. Sometimes the goop turns to things that cause bigger pains (ear infections, strep throat & influenza) that have bigger solutions. But most of the time these gnarly colds just disrupt our lives and our holiday harmony and then go away thanks to the magic of our immune system. No question the holidays gather us together but those Whoville-Circles-of-Love also have us exchanging common colds like nobody’s business. We all wanna make the symptoms from colds go away, especially in our infants and toddlers who just can’t explain how they feel and seem to have their sleep disrupted in wildly unfortunate ways. Obviously, there aren’t a bunch of wonder drugs out there for these wintertime illnesses. But there are some lovely solutions that do help our children feel better (acetaminophen and ibuprofen — tah dah!)…

5 Things To Know When Using Medicine From The Drugstore:

• Less Is More: My key takeaway for using OTC medicines is that often, you don’t need them. Don’t ever treat the thermometer. If your sweet human is bounding around the living room playing Twister and she feels warm to touch and you then confirm she has a fever with her sniffles (the thermometer reads 101.7 degrees) you don’t need to reach for acetaminophen. Keep her hydrated, have her cover her cough (yes, please!), make sure she gets rest so her body can do the dirty work of clearing out the infection. The acetaminophen should be used when she’s achy, not feeling well, or not wanting to be herself because of overall yuckiness. Treat your child, not the thermometer.
• Pain Medicines For Ear Infections: Without question the most important medicine for most ear infections are the OTC medicines (acetaminophen and ibuprofen around the clock for the first 48 hours of an ear infection). After age 2 year, most children won’t need antibiotics — and most can avoid them and their side effects — if given time to heal. But the best bridge to getting there is making sure you take away the pain from those infections. More information about when to treat ear infections with antibiotics here.
• Cough and Cold Medicines Only For School-Age: I think parents to infants and toddlers are desperate for solutions when their babes are unwell because of the profound amount of disruption a nasty cold virus brings to their life. Anyone who blows off the degree of ick of a 17 month-old with a bad cold and cough who isn’t sleeping nor eating and is coughing and choking and vomiting hasn’t parented one in a while. But quick reminder that not only are cough and cold meds not helpful in young children, they can be dangerous. Reach for a teaspoon of HONEY before anything in the medicine cabinet (as long as your little one is over 12 months of age). Research from 2007 found that honey has been found to help reduce nighttime cough better than OTC remedies.
• Dosing Device: This time of year all sorts of people want to “baby” your baby. Grandma, Cousin Judy, whoever. Make sure someone isn’t dosing the medicines with the kitchen spoon. Use the dosing device that comes with the bottle of medicine always.
• Weight Over Age Dosing: Always dose medicine by weight not age in young children. Here’s a dosing chart for acetaminophen and ibuprofen that includes doses for children under age 2 years. Here’s another version of acetaminophen and ibuprofen dosing that is easily downloadable! Print it out, keep it in the kitchen cabinet where you store your medicines. Call your pediatrician’s office if ever concern about how and when to dose. Those are never silly calls. Even if some jerky, tired, on-call provider makes you feel that way (I’m sorry if someone does). But it’s true, those are never silly calls if you’re confused or unsure.

Parents are genius at knowing their children. They are keen observers of the patterns of wellness and the patterns of illness. If something isn’t going the way you think it should, see your pediatrician. If you think the fever has gone on too long with or without the acetaminophen, check in. Use the medicines to keep your babe comfortable and please remember you don’t ever need to “hold off” on giving medicines for comfort before a visit to the pediatrician, either. I hear parents report they do that all the time because they want to make sure the peds believes them about how crummy their baby is doing. WE DO BELIEVE. When giving your child medicine for fever and discomfort (if over 3 months of age) you won’t “mask” anything important and you’ll help keep your child comfortable.
Trust your instincts, follow the rules on the bottle, and use the dosing cup/syringe/device that comes with the medicine. Keep medicine out of reach, tell Grandma Fran to keep her purse full of medicine out of the main hallway stairway, and Happy Holidays, Wonder Parents Everywhere.

This post was written in partnership with KnowYourOTCs.org. In exchange for our ongoing partnership helping families understand how to use OTC (over-the-counter) meds safely they have made a contribution to Digital Health at Seattle Children’s for our work in innovation. I adore the OTC Safety tagline, “Treat yourself and your family with care all year long.” Follow @KnowYourOTCs # KnowYourOTCs for more info on health and wellness.

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