Young children are much more likely than adults to have adverse drug reactions, so giving your preschooler prescription or over-the-counter (OTC) medication – even “herbal” medicines – is serious business. Here are some medicines you should never give your 2- to 4-year-old.
Aspirin
Never give your child aspirin or any medication containing aspirin unless instructed to do so by your child’s doctor. Aspirin can make a child susceptible to Reye’s syndrome – a rare but potentially fatal illness. Read labels carefully (aspirin is sometimes referred to as “salicylate” or “acetylsalicylic acid”), and ask your doctor or pharmacist if you’re not sure whether a product contains aspirin.
For fever and other discomfort, you may want to give your preschooler acetaminophen or ibuprofen (make sure the dosage is correct). However, if your child is dehydrated or vomiting or has asthma, kidney problems, an ulcer, or another long-term illness, talk to your doctor before giving ibuprofen. Also talk with your doctor about an alternative to acetaminophen if your child has liver disease.
Over-the-counter cough and cold medicines
The American Academy of Pediatrics (AAP) advises against giving OTC cough and cold medicines to preschool-age children. Studies show that they don’t actually help soothe symptoms in kids this age. And they can be harmful, especially when a child mistakenly gets more than the recommended dose.
In addition to side effects like drowsiness or sleeplessness, upset stomach, and a rash or hives, a child can suffer serious effects such as rapid heart rate, convulsions, and even death. Every year, thousands of children end up in emergency rooms across the nation after swallowing too much cough and cold medicine.
Over the past few years, though, emergency visits involving infants and toddlers who take too much of these medications have dropped in half. Health experts attribute the drop to the fact that manufacturers no longer market cough and cold medicines to young children.
If your preschooler is miserable with a cold, you may want to try a humidifier or other home remedies.
Anti-nausea medications
Don’t give your child a prescription or OTC anti-nausea medication unless his doctor specifically recommends it. Most bouts of vomiting are pretty short-lived, and children usually handle them just fine without any medication. In addition, anti-nausea medications have risks and possible complications. (If your child is vomiting and begins to get dehydrated, contact his doctor for advice on what to do.)
Infant and adult medications
Giving your preschooler a smaller dose of medicine meant for an adult is as dangerous as giving a higher dose of medicine meant for an infant. Many parents don’t realize that infant drops are more concentrated than liquid medicine intended for older children. If the label doesn’t indicate an appropriate dose for the weight and age of your child, don’t give that medication to your preschooler.
Any medication prescribed for someone else or for another condition
Prescription drugs intended for other people (like a sibling) or to treat other illnesses may be ineffective or even dangerous when given to your child. Give her only medicine prescribed for her and her specific condition.
Anything expired
Toss out medicines, prescription and OTC alike, as soon as they expire. Also get rid of discolored or crumbly medicines – basically anything that doesn’t look the way it did when you bought it. After the use-by date, medications may no longer be effective and can even be harmful.
In general, it’s not a good idea to flush old drugs down the toilet, as they may contaminate groundwater and end up in the drinking water supply. But a few drugs are so potentially harmful to children that the US Food and Drug Administration recommends disposing of them in the toilet rather than the trash.
Look at the label of the medicine to find out if it should be flushed. If you’re not sure, you can ask your pharmacist what to do with it or find out whether your community has a drug take-back program for old and expired medicines.
If a drug doesn’t need to be flushed and no take-back programme is available, empty the contents of the medicine bottle into a sealed container with something unpalatable (like kitty litter or coffee grounds) before throwing it out. Don’t crush tablets or capsules when you mix the medicine with the undesirable substance. Remove any personal information from the empty bottle before disposing of it alongside the sealed container of medicine in the trash.
Extra acetaminophen
Some medicines contain acetaminophen to help ease fever and pain, so be careful not to give your preschooler an additional separate dose of acetaminophen if he’s taking such medications. If you’re not sure what’s in a particular medicine, don’t give him acetaminophen or ibuprofen until you’ve first gotten the okay from your doctor or pharmacist.
Syrup of ipecac
Syrup of ipecac causes vomiting and used to be kept handy to prevent poisoning. Doctors no longer recommend syrup of ipecac, mainly because there’s no evidence that vomiting helps in the treatment of poisoning. In fact, syrup of ipecac may do more harm than good if a child continues to vomit after ingesting a remedy that has been shown to help, such as activated charcoal.
The American Academy of Pediatrics recommends throwing out any syrup of ipecac you have in your home and says the best way to prevent accidental poisoning is to keep potentially harmful substances locked up and out of sight.
Cautionary note: Chewables
Chewable medicines aren’t 100 percent off-limits, but you should carefully consider whether and how to give them to your child.
Most four-year-olds can handle chewable tablets, especially those that are fast-melting. But keep an eye on your child when you give her a chewable, especially if she isn’t proficiently chewing solids yet.
If you think chewables might be a choking hazard for your child, ask her doctor or your pharmacist if it’s okay to crush the tablet and put it in a spoonful of soft food, like yogurt or applesauce. And of course, you’ll need to make sure your child eats the entire spoonful to get the complete dose.