Medications

At Falmouth Pediatrics, we recommend the same medications we would use for our own children. Sometimes that means admitting that the best thing to give is nothing.

Here are some common over-the-counter medications:

Fever, pain

Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) are the two medications that are used really often. If you ask 100 pediatricians how and when they should be given for fever, you will get 110 different answers. In other words, some say give acetaminophen, some say ibuprofen and others say alternate the two medications. As a rule of thumb, aim for comfort rather than a certain timeframe or number on the thermometer. If acetaminophen is working, great. If not, ibuprofen may work better. At FPA, we tend to use both medicines only when one alone is not working.

Here are some important that doctors do agree on:

  • For babies under three months of age, any fever of 100.5 degrees F (rectal) or over requires a call to the doctor, even at night.

  • Acetaminophen can be given up to every 4 hours. It is safe at any age. Dosing chart for Acetaminophen

  • It can also be given as a rectal suppository if vomiting is an issue.

  • With ibuprofen, remember infant drops are stronger (more concentrated) than syrup for toddlers. For example, more medicine is in 5 mL of infant drops than in 5 mL of syrup for toddlers. Never give the same amount of infant drops as you would syrup. Ibuprofen dosage table

  • Also, acetaminophen and ibuprofen can be ingredients in many OTC and prescription medicines (eg, pain relievers, fever reducers, cough/cold medicines). If your child is taking more than one medicine, read the ingredient list to prevent double dosing.

  • Note: Never give aspirin to your child unless your child’s doctor tells you to. Children who take aspirin may get a serious illness called Reye syndrome.

Cold and cough

The American Academy of Pediatrics recommends cough and cold medicines not be given to infants and small children under 6 years because they have not been proven effective and can be harmful. Saline nose drops can be used for congestion. For older children (over 2 years), lemon and honey is sometimes good for cough at night.

Allergy, itching

Antihistamines can be used to treat your child’s runny nose, itchy eyes, and sneezing due to allergies. Cetirizine (Zyrtec) is probably the best non-sedating general allergy medicine for hay fever etc. For hives, we recommend dimenhydrinate (Benadryl). Here is the dosage table

Rash, itching

Hydrocortisone cream or ointment is used for itching from bug bites, and eczema. It takes a couple of days to work.

Wound, cuts, and scrapes

Antibiotic ointment is used to prevent or control infection in wounds, cuts, and scrapes.

Constipation

Remember that constipation is a state of poop (=hard), not a state of calendar. Some breastfed babies go over a week between bowel movements.
For infants with hard bowel movements, the best first approach is to change the diet to include more fruit such as peaches, pears and prunes, and less bananas and apples. If juice is given, then give it in one sitting (not spread out over the day, which can hurt the teeth). If that is not enough, infants often do well with a glycerin suppository. Older children usually are better to take something by mouth. The most common medicine we recommend is glycolax (Miralax).