FAQ

The doses for over the counter medicines are usually given as adult doses which means for 12 years of age and older and six year old doses. In the past a general rule of thumb commonly used is listed below, however, it is much safer to base doses on a child's body weight. Still for general reference

An average size 12 year old can take an adult dose.
A six year old can take half of an adult dose.
A two year old can take half of a six year old dose

Fever and its medications

Tylenol (acetaminophen, Tempra, Liquiprim) comes in the following preparations:

drops of 80 mg per 0.8 dropper
elixir and syrups of 160 mg per teaspoon (5cc)
chewable tablets of 80 mg AND 160 mg
jr. strength of 160 mg per tablet
regular adult of 325 mg
extra strength adult of 500 mg

The dose of acetaminophen is roughly 75 mg (one dropper) for every 11 pounds of body weight.

Ibuprofen = Advil = Motrin comes in the following preparations:

drops of 50 ml per dropper
syrup of 100 mg per teaspoon (5 cc)
chewables of 100 mg
pills and caplets of 200 mg

The dose of ibuprofen is 5 to 10 mg for every 22 pounds of body weight (over 6 months of age)

Suppositories are useful for kids who don't take medicine very well or are vomiting. They come in the following doses:

80 mg per suppository
120 mg per suppository
325 mg per suppository.

The dose is the same for the oral medicines.

Dosage Table

Approximate Weight	Tylenol drops	Tylenol liquid	Motrin drops	Motrin liquid
22 lbs	2 droppers	one teaspoon	2 droppers	one teaspoon
33 lbs	3 droppers	one and a half tsp	3 droppers	one and a half tsp
44 lbs	4 droppers	2 tsp	4 droppers	2 tsp
66 lbs		3 tsp		3 tsp
88 lbs		4 tsp = adult dose		4 tsp = adult dose

If the fever doesn't come down can I sponge my child to reduce the fever?

Remember that it takes up to 2 hours for fever meds to work. Remember also that fever is not harmful (see also FEVER).

You can sponge your child and this will lower the temperature but it is not necessary to do so. Sponging your child is kind of like coming home one winter day, finding your house too warm and deciding to open the doors and windows to cool it off. It will work but it is better to reset the thermostat with fever meds. Do it only if you think it will make your child more comfortable. DO NOT USE ALCOHOL. If you choose to sponge your child use tepid water and rub the skin to promote exchange of heat. Your child may not like this. If sponging makes your child more unhappy than the fever do not do so. Sponging works well only on young children.

Alternating Tylenol and Advil.

In some illness the fever does not come down with only one medicine. Although high fever is not harmful and not necessarily indicative of a more serious illness, there may be times that you elect to make your child more comfortable by using both Tylenol and Advil. While this may be commonly done, be aware that alternating Tylenol and Advil has never been adequately studied to determine whether it is safe or effective. If you choose to do this, remember not to give Advil more than every 6 hours and that Advil, Motrin, & ibuprofen are all the same drug.. A typical schedule would be as follows:

Noon --give Tylenol
3 pm --give Advil
6 pm -- give Tylenol
9 pm -- give Advil

When can my child return to school or childcare?

For some illness the period of being contagious is well defined. For strep throat it is 24 hours after being on antibiotics. For many viruses the child may be contagious 5-7 days which would be a very difficult imposition for a child who may have 5-6 colds a year. Generally a child can return to school or regular childcare when he/she no longer has fever.

Ear infections and sinus infections are not contagious.

Being on antibiotics does not make a child non contagious.

Cold Medications (See also URI, Coughs)

Stuffy Noses

A stuffy nose may decrease the appetite of a child of any age and make it difficult for an infant to take a bottle or nurse. For stuffy noses:

Encourage clear liquids
Increase humidity in the room with a vaporizer or humidifier
Frequent baths or showers will help, particularly before bedtime to help your child sleep
A warm wet wash rag over the face while an older child lies down can also provide humidity
Saline or saltwater nose drops will help unclog the nose
Bulb suctioning can remove secretions particularly after placing salt water nose drops to loosen the mucous
You can make salt water nose drops by adding one fourth teaspoon of table salt and one fourth teaspoon of baking soda to one cup of water, mix well and make up a new supply daily

Runny Noses

Older children with runny noses can be given cold medicines but they will not shorten the illness, have not been shown to help and may only have side effects. No one product is better than any others and consult the package insert prior to use.

Antihistamines help the runny nose of allergies. The drying side effect of antihistamines is also sometimes used and is found in preparations such as Dimetapp.

The color of the runny nose (clear, green, yellow etc) is no longer felt to be an important indicator of whether a sinus infection is present. The length of time (persisting runny nose with cough > 10 days) is more important.

Coughs (For more information)

Home treatment of coughs can be done using the following:

For children of any age encourage fluids to keep phlegm loose
If the air is dry increase the room's humidity
Give Tylenol or Advil for fever or discomfort
For children over one year a mixture of equal parts lemon and honey in warm water can be soothing..
Children over 4 years of age can use cough drops.
Elevated the head of the bed or propping the child up can help relief night time coughs
For coughs that interfere with sleep, Dextromethorphan (the DM in cold products) can be used for children over six years but in controlled studies this has not been shown to make any difference.
For congested coughs albuterol can be tried.
Avoid irritants such as smoke.

Cough & Cold Medications (See also URI, Coughs , Croup & Bronchiolitis, Ear Infections)

Whether it be a prescription or an over the counter medicine, the ingredients vary little among preparations. Many contain dextromethorphan (DM) for cough suppression. Some contain a medication for drainage such as phenylephrine and pseudoephedrine may be available by request. Antihistamines such as benadryl (diphenyhydramamine), brompheniramine, loratadine, or chlorpheniramine are found in many and all of these except ffor loratdine can cause drowsiness.

Recently cough and cold medications have come under scrutiny as far as safety and efficacy. Most have not been proven to be effective in children and many have not even been studied to show that they are safe. Hence , although runny noses and coughs can be annoying, treating them with medicine may not help and carries the potential for harm.

Reminder 2.5 cc = 1/2 tsp 5 cc = 1 tsp 7.5 cc = 1 1/2 tsp 10 cc = 2 tsp

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