Education

The following information is provided so parents might better understand and more accurately follow the instructions given by our office for the care of their children.

Over-the-Counter Medications

New information about over-the-counter cough and cold medications has shown that they are not effective for treating cold symptoms in children under six years old. Because they do not work, and because there is potential for serious side effects with misuse or overdose, we do not recommend using these medications to treat cold symptoms or coughs in children under 6 years old.

Colds are caused by viruses. Cold symptoms include fever, cough, and nasal congestion. These infections resolve by themselves, and do not need antibiotics. Young children can get 6-8 colds per year, and each one can last over two weeks.

The pediatricians at Garden City Pediatrics recommend comfort measures and non-medication treatments as the best therapy, especially for the very young. Our advice includes: ensure good fluid intake, use saline drops in the nose, suction the nose with a bulb syringe, and run a cool mist humidifier at night. These measures are safe and they help sick children feel more comfortable.

Although low grade fevers do not require treatment, fever reducers (e.g. acetaminophen) may be given to help children who are uncomfortable with fever. Please call our office first for babies less than 3 months old. And call for fevers lasting longer than 72 hours, and temperatures at or above 105 degrees.

Cough suppressants (e.g. Delsym) may decrease cough, but coughing protects the lungs by clearing out mucous. There may be a role for nighttime use in older childrem, if it allows a child to sleep. An overdose can interfere with breathing, and they should not be used with asthma.

Decongestants (e.g. Sudafed) may decrease congestion and open nasal passages. But they can cause jitteriness and interfere with sleep. An overdose can affect the heart and blood pressure.

Antihistamines (e.g. Benadryl) may dry up secretions, and decrease cough. They are often sedating and can improve sleep in children with cold symptoms, which may justify their occasional use at bedtime in older children. Few children get agitated instead. An overdose can interfere with breathing.

Claritin (loratadine) is a once-daily non-sedating antihistamine. Give 5mg or 1tsp for children 2-6 years old, and 10mg or 2tsp for children over 6 years old. Zyrtec (cetirizine) is a once-daily antihistamine, and is dosed similarly, but is sedating for a small percentage of patients. These may both be used for allergy symptoms. Benadryl can be given every six hours for more serious allergic reactions, including reactions to foods and stinging insects.

Acetaminophen (APAP, Tylenol, or other store brand):

A pain reliever and anti-fever medication. A first choice for fever or teething pain. Can be given every 4-6 hours as needed. Usually not used for babies less than 2-3 months old.

If your child is less than 2 months of age, please call our office during regular office hours to ensure these medications are appropriate.

Ibuprofen (Advil, Motrin, or other store brand):

A pain reliever, anti-fever medication and anti-inflammatory medication. Ibuprofen is not routinely recommended for treatment of fevers and teething because it has a risk of significantly more stomach upset and even serious gastrointestinal bleeding. Ibuprofen should always be given with food or at least a glass of milk. Can be given every 6-8 hours as needed. Usually not used for babies under 6 months old.

Medications	Frequency	16 lbs	22 lbs	33 lbs	44 lbs	66 lbs	88 lbs	Adult
Infant Drops 50 mg / 1.25 ml	every 6 hrs	1.25 ml	2.5 ml
Children’s Suspension100 mg/ml	every 6 hrs		1 tsp	1 1/2 tsp	2 tsp			4 tsp
50 mg. Chew	every 6 hrs		2	3	4	6	8
100 mg. Chew or tablet	every 6 hrs		1	1 1/2	2	3	4	4
200 mg. Tablet	every 6 hrs				1		2	2

If your child is less than 6 months of age, please call our office during regular office hours to ensure these medications are appropriate.

• Use Bacitracin, Neosporin or other antibiotic ointment 2-4 times a day for minor skin infections
• Use salt water (saline) nose drops, ‘Ocean’ or ‘Nasal’, 2-4 drops every few hours as needed for congestion.

Common Medication Dosages

Dosages are listed below for common brand names. Generics and store brands that compare with these are always acceptable and generally less expensive.

Medications	Frequency	11 lbs	16 lbs	22 lbs	33 lbs	44 lbs	66 lbs	88 lbs	Adult
Benadryl	every 6 hrs	1/2 tsp	3/4 tsp	1 tsp	1 1/2 tsp	2 tsp	3 tsp	4 tsp	4 tsp
Dimetapp	every 6 hrs				1 1/2 tsp	2 tsp	3 tsp	4 tsp	4 tsp
Pediacare	every 6 hrs				1 1/2 tsp	2 tsp	3 tsp	4 tsp	4 tsp
Triaminic	every 6 hrs				1 1/2 tsp	2 tsp	3 tsp	4 tsp	4 tsp
Plain Robitusin	every 6 hrs				1 1/2 tsp	2 tsp	3 tsp	4 tsp	4 tsp
Sudafed	every 6 hrs				1 tsp	1 1/2 tsp	2 tsp	3 tsp	4 tsp
Delsym	every 12 hrs				3/4 tsp	1 tsp	1 1/2 tsp	2 tsp	2 tsp

Please follow these guidelines:

• Do not use cold or cough medications for children less than 6 years old
• Choose medications with a single active ingredient
• Do not mix different medications (except to add a fever reducer if needed)
• Use medications sparingly, generally no more than once or twice daily
• Use medications at appropriate doses for a child’s weight
• Only treat symptoms that cause significant discomfort or lack of sleep
• Only use medications for short time periods, generally a few days
• Stop using medications that are not helpful to your child
• Store medications safely out of reach of your children.
• Measure medications with a measuring spoon, syringe or dropper. (kitchen spoons are not accurate)