Children aren't just small adults. It is especially important to remember this when giving medicines to children. Giving a child the wrong dose or a medicine that is not for children can have serious side effects.

The drug labels for prescription medicines have a section on "Pediatric Use." It says whether the medicine has been studied for its effects on children. It also tells you which age groups were studied. Some over-the-counter (OTC) medicines, like those that treat fever and pain, have been studied for effectiveness, safety, or dosing in children. But many other OTC medicines have not. It is important to read the labels carefully, to make sure that the medicine is right for your child.

Here are some other tips for giving medicine safely to your child:

• Read and follow the label directions every time. Pay special attention to usage directions and warnings.
• Watch out for problems. Contact your health care provider or pharmacist right away if
  • You notice any new symptoms or unexpected side effects in your child
  • The medicine doesn't appear to be working when you expect it to. For example, antibiotics may take a few days to start working, but a pain reliever usually starts working soon after your child takes it.
• Know the abbreviations for the amounts of medicines:
  • Tablespoon (tbsp.)
  • Teaspoon (tsp.)
  • Milligram (mg.)
  • Milliliter (mL.)
  • Ounce (oz.)
• Use the correct dosing device. If the label says two teaspoons and you're using a dosing cup with ounces only, don't try to guess how many teaspoons it would be. Get the proper measuring device. Don't substitute another item, such as a kitchen spoon.
• Check with your health care provider or pharmacist before giving two medicines at the same time. That way, you can avoid a possible overdose or an unwanted interaction.
• Follow age and weight limit recommendations. If the label says don't give to children under a certain age or weight, then don't do it.
• Always use the child-resistant cap and re-lock the cap after each use. Also, keep all medicines out of the reach of children.
• Ask your health care provider or pharmacist if you have any questions.

Each year, thousands of children are treated in emergency departments after finding and ingesting medicine, or after accidentally being given the wrong amount. Learn how to keep children safe by practicing safe dosing and storage.

June is National Safety Month and a perfect opportunity for parents and caregivers of young children to remember the importance of safe medication use and storage.

Safe Medicine Use

“Dosing errors (when a parent or other caregiver gives too much or too little medicine) are the type of medication error that most often brings children into the Emergency Department.” says Dr. Shonna Yin, an Associate Professor of Pediatrics and Population Health at the NYU School of Medicine.

When giving children liquid medicine, confusion about units of measurement can lead to large dosing errors. For example, giving a child 5 teaspoons (tsp) instead of his/her prescribed dose of 5 milliliters (mL) would result in giving five times more than the prescribed dose!

To prevent dosing errors, medical professional organizations recommend using milliliters (mL) when prescribing oral liquid medicines and that mL units be the only units appearing on dosing instructions, labels, and dosing devices (such as oral syringes and dosing cups).

It’s important to always use the dosing device that comes with your children’s medicine to make sure that they get the right amount.

Household spoons should not be used to measure medicine since they come in so many different shapes and sizes. Open the silverware drawer and you might see teaspoons, tablespoons, soup spoons, grapefruit spoons with “teeth,” long-handled iced tea spoons for stirring a glass of cold tea on a hot summer day – you get the idea.

Four simple tips for safe dosing

• Know the Dose: Read all the information on the medicine label and follow the directions. Do not give a child medicine more often or in greater amounts than is stated on the package.
• Measure the Right Amount: Always measure your child’s dose using the dosing device (oral syringe or dosing cup) that comes with the medicine.
• Use the Right Tool: If you do not have a dosing device, ask your pharmacist for one. Do not use household spoons to give medicines to children.
• Get Questions Answered: If you do not understand the instructions on the label, or how to use the dosing device, talk to your pharmacist or doctor before giving the medicine.

Safe Medicine Storage

Each year, approximately 60,000 young children are treated in emergency departments after getting into medicines on their own or after dosing errors by adults. After ensuring that your children get the right amount of medicine, it’s just as important to make sure that the medicine is immediately returned to a safe storage location.

Five simple tips to safe storage at home and on-the-go:

• Choose a Safe Spot: Walk around your house to find the safest place to keep your medicines. The location should be up and away and out of the sight and reach of young children.
• Lock the Safety Cap: Always relock the cap on a medicine bottle. If the bottle has a locking cap that turns, twist it until you hear the click or cannot twist anymore.
• Put Medicines Away: After locking the safety cap, it’s important to always put medicines back in their safe storage location. Curious children act fast, so never leave medicine out on a kitchen counter or at a sick child’s bedside, even if you have to give it again in a few hours.
• Remind Guests: Ask family members, houseguests, and other visitors to keep purses, bags, or coats that have medicine in them up and away and out of sight when they are in your home.
• While Traveling: While staying with family or friends or at a hotel, find a safe storage place that is out of sight and reach of young children, like a high cabinet. If you’re in a hotel room, try the passcode-protected room safe for safe storage.

Practicing these safe use and storage tips this National Safety Month and always, can help parents and caregivers keep children safe from unintentional medication overdoses.

Be prepared in case of an emergency.

• Call your poison control center at 800.222.1222 right away if you think your child might have gotten into a medicine or vitamin, even if you are not completely sure.
• Program the Poison Help number into your home and cell phones so you will have it when you need it.

When it comes to taking medicines, kids aren’t just small adults. When using nonprescription medicines, here are 10 ways to be sure you’re giving your children the right medicine and the right amount.

1. Read and follow the label directions every time. Pay special attention to usage directions and warnings. If you notice any new symptoms or unexpected side effects in your child or the medicine doesn't appear to be working, talk to your doctor or pharmacist immediately.

2. Know how much medicine to give and when. Read and follow the label.

3. Know the abbreviations for tablespoon (tbsp.) and teaspoon (tsp.). You should also know: milligram (mg.), milliliter (mL.), and ounce (oz.).

4. Use the correct dosing device. If the label says two teaspoons and you're using a dosing cup with ounces only, don't guess – get the proper measuring device. Don't substitute another item, such as a kitchen spoon.

5. Never play doctor. Twice the recommended dose is not appropriate just because your child seems twice as sick as last time. When in doubt about your child's condition, call your doctor.

6. Talk to your doctor, pharmacist, or other health care professional before giving two medicines at the same time to avoid a possible overdose or an unwanted interaction.

7. Follow age and weight limit recommendations. If the label says don't give to children under a certain age or weight, don't do it. Call your doctor.

8. Always use the child-resistant cap and re-lock the cap after each use. Be especially careful with iron-containing vitamins or supplements, which have been a source of accidental poisoning deaths in children under three.

9. Follow the "KEEP OUT OF REACH" warning. Today's medicines are often flavored to mask the taste of the medicine, which is all the more reason to keep all drugs out of the sight and reach of children.

10. Always check the package and the medicine itself for signs of tampering. Don't buy or use any medicine from a package that shows cuts, tears, slices, or other imperfections. Report anything suspicious to the pharmacist or store manager.

Ah-choo!

If your child is sneezing up a storm, it must be allergy season once more.

And if your child is taking more than one medication at the same time, there could be dangerous health consequences if those medicines have the same active ingredient, according to Hari Cheryl Sachs, M.D., a pediatrician at the Food and Drug Administration (FDA).

A medicine is made of many components. Some are "inactive" and only help it to taste better or dissolve faster, while others are active. An active ingredient in a medicine is the component that makes it pharmaceutically active—it makes the medicine effective against the illness or condition it is treating.

Active ingredients are listed first on a medicine's Drug Facts label for over-the-counter (OTC) products. For prescription medicines, they are listed in a patient package insert or consumer information sheet provided by the pharmacist.

Many medicines have just one active ingredient. But combination medicines, such as those for allergy, cough, or fever and congestion, may have more than one.

Take antihistamines taken for allergies. "Too much antihistamine can cause sedation and—paradoxically—agitation. In rare cases, it can cause breathing problems, including decreased oxygen or increased carbon dioxide in the blood, Sachs says.

"We're just starting allergy season," says Sachs. "Many parents may be giving their children at least one product with an antihistamine in it." Over-the-counter (OTC) antihistamines (with brand name examples) include diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton), clemastine (Tavist), fexofenadine (Allegra), loratadine (Claritin, Alavert), and cetirizine (Zyrtec).

But parents may also be treating their children for a separate ailment, such as a cough or cold. What they need to realize is that more than one combination medicine may be one too many.

"It's important not to inadvertently give your child a double dose," Sachs says.

Other Health Complications

The same goes for other active ingredients, often found in combination products for allergies but also used to treat other symptoms, such as fever, headache or nasal congestion:

• Acetaminophen (in Tylenol and many other products), a pain reliever often used to treat fevers, mild pain or headache. Taking too much can cause liver damage.
• Ibuprofen (for example, Advil or Motrin), another common medicine for relieving mild to moderate pain from headaches, sinus pressure, muscle aches and flu, as well as to reduce fever. Too much ibuprofen can cause nausea, vomiting, diarrhea, severe stomach pain, even kidney failure.
• Decongestants such as pseudoephedrine or phenylephrine (found in brand name drugs such as Actifed and Sudafed) taken in large amounts can cause excessive drowsiness in children. They can also cause heart rhythm disturbances, especially if combined with products and foods containing caffeine. In the form of nasal sprays and nose drops, these products, as well as oxymetazoline (the active ingredients in products such as Afrin), can cause "rebound" congestion, in which the nose remains stuffy or gets even worse.

Any of the above symptoms may indicate a need for immediate medical attention. "The bottom line is that neither you, nor your children, should take multiple combination medicines at the same time without checking the active ingredients and consulting your health care professional first," recommends Sachs.

Furthermore, two different active ingredients may serve the same purpose, Sachs says. For example, both acetaminophen and ibuprofen help reduce pain and fever. So there's generally no need to give your child both medicines for the same symptoms.

Write It All Down

Whether you're treating your child's condition with OTC medicines from the drug store or ones prescribed by your doctor, it's essential that you keep track of every medicine and the active ingredients each contains, Sachs says.

"It's easy to forget which medicines you're giving your child," Sachs says. "And if you have more than one child, it can get even more complicated." She recommends making it a habit to write down the name of any medicine you give your child, whether it's OTC or prescription (download a daily medicine records template).

"It's really a good idea to carry that list with you when you go to see your pediatrician or even when you go to the pharmacy," she adds. You should also note whatever vitamins or supplements your child is taking, as these can interact unfavorably with certain medicines, too.

Most importantly, Sachs says parents should always read the Drug Facts label on OTC products, and the patient package insert or consumer information sheet that comes with prescription medicines, every time they're considering a medication for their child, even if they think they already know the ingredients. They should know that the ingredients can change without an obvious change in the packaging. And they should contact their health care professional with any questions.

March 12, 2013

When it comes to taking medicines, kids aren’t just small adults. When using nonprescription medicines, here are 10 ways to be sure you’re giving your children the right medicine and the right amount.

1. Read and follow the label directions every time. Pay special attention to usage directions and warnings. If you notice any new symptoms or unexpected side effects in your child or the medicine doesn't appear to be working, talk to your doctor or pharmacist immediately.
2. Know how much medicine to give and when. Read and follow the label.
3. Know the abbreviations for tablespoon (tbsp.) and teaspoon (tsp.). You should also know: milligram (mg.), milliliter (mL.), and ounce (oz.).
4. Use the correct dosing device. If the label says two teaspoons and you're using a dosing cup with ounces only, don't guess – get the proper measuring device. Don't substitute another item, such as a kitchen spoon.
5. Never play doctor. Twice the recommended dose is not appropriate just because your child seems twice as sick as last time. When in doubt about your child's condition, call your doctor.
6. Talk to your doctor, pharmacist, or other health care professional before giving two medicines at the same time to avoid a possible overdose or an unwanted interaction.
7. Follow age and weight limit recommendations. If the label says don't give to children under a certain age or weight, don't do it. Call your doctor.
8. Always use the child-resistant cap and re-lock the cap after each use. Be especially careful with iron-containing vitamins or supplements, which have been a source of accidental poisoning deaths in children under three.
9. Follow the "KEEP OUT OF REACH" warning. Today's medicines are often flavored to mask the taste of the medicine, which is all the more reason to keep all drugs out of the sight and reach of children.
10. Always check the package and the medicine itself for signs of tampering. Don't buy or use any medicine from a package that shows cuts, tears, slices, or other imperfections. Report anything suspicious to the pharmacist or store manager.

About 50,000 young children end up in emergency rooms each year because they got into medicines while an adult wasn’t looking. These emergency visits can be prevented by always putting every medicine up and away and out of children’s reach and sight every time you use it.

Families take medications and vitamins to feel well and to stay well. However, any medication, including those you buy without a prescription, can cause harm if taken in the wrong way or by the wrong person. Practicing safe medication storage, while at home and when on-the-go, can help keep children safe.

Protect your children. Here’s how:

• Put medicines up and away and out of children’s reach and sight.
  • Children are curious and put all sorts of things in their mouths. Even if you turn your back for less than a minute, they can quickly get into things that could hurt them.
  • Pick a storage place in your home that children cannot reach or see. Different families will have different places. Walk around your house and decide on the safest place to keep your medicines and vitamins.
• Put medicines away every time.
  • This includes medicines and vitamins you use every day. Never leave medicine out on a kitchen counter or at a sick child’s bedside, even if you have to give it again in a few hours.
• Make sure the safety cap is locked.
  • Always relock the cap on a medicine bottle. If the bottle has a locking cap that turns, twist it until you hear the click or cannot twist anymore.
  • Remember, even though many medicines have safety caps, children may be able to open them. Every medicine must be stored up and away and out of children’s reach and sight.
• Teach your children about medicine safety.
  • Teach your children what medicine is and why you or a trusted adult must be the one to give it to them.
  • Never tell children medicine is candy to get them to take it, even if they don’t like to take their medicine.
• Tell your guests about medicine safety.
  • Ask family members, houseguests, and other visitors to keep purses, bags, or coats that have medicine in them up and away and out of sight when they are in your home.
• Be prepared in case of an emergency.
  • Call your poison control center at 800.222.1222 right away if you think your child might have gotten into a medicine or vitamin, even if you are not completely sure.
  • Program the Poison Help number into your home and cell phones so you will have it when you need it.
• Take Action.
  • Visit the Up and Away Campaign’s website to learn more about storing medications safely while at home and when traveling with young children. Share these safe storage tips with family and friends.

Why should I keep a Daily Medicine Record for My Child?

• To keep your child safe. A daily record will help you keep track of the amount of medicine your child takes so you or someone else won’t accidently give too much.
• To have a way of sharing this information with others who may be caring for your child, such as a spouse, grandparent, babysitter, and your child’s healthcare professional.

How do I keep a Daily Medicine Record?

Use the blank record provided, or make your own record and write down the following:

• name of the child
• child’s age and weight. (It is always best to use your child’s weight to decide how much medicine to give. Use age if you don’t know your child’s weight.)
• today’s date
• time of day you give the medicine
• symptom or problem the medicine is used for
• medicine’s name
• medicine’s active ingredient(s)
• the medicine’s formula (infant, children, junior, or other)
• the amount of medicine you give

Where should I keep the Daily Medicine Record?

You should keep it where all of your child’s caregivers can easily find it. The information you write will help you and others remember the last time a dose was given and how much your child has taken.

Always keep medicines where they cannot be seen or reached by children and pets. A locked box, cabinet, or closet is best.

Mother’s Day and Father’s Day are special for parents. But they can also be stressful times for new moms and dads caring for a newborn or infant.

Your health care provider can be a great resource. A good time to check in is during preventive “well-child” health visits with your child’s pediatrician, says Donna L. Snyder, M.D., F.A.A.P., a pediatrician with the U.S. Food and Drug Administration’s Office of Pediatric Therapeutics. These visits can continue at periods throughout childhood and adolescence.

But if you’re between appointments and think your child is sick, or just have questions, contact your health care provider to confirm what to do next, Snyder says. And consider the following advice on medication safety—for prescription and over the counter medicines.

Get Expert Advice Before Giving Medication to Your Baby

Certain medications may not be appropriate for your baby, so you should ask your health care provider before giving your child any medication, says Snyder. If he or she has recommended a medicine for your infant, ask questions to be sure you use the right dose.

Store Medications Safely

Store any medications that you or your baby may take out of reach of your child, says Snyder. She notes that babies can start to crawl as early as 5 to 6 months. “But even if babies are under the age when you’d expect them to be able to get to your medication, get into the habit of putting medication out of their reach,” she advises.

Also read all storage instructions. “For instance, some antibiotics need to be kept in the refrigerator,” Snyder says. “So you want to make sure you’re storing it according to the instructions.” If you have questions about how to safely store a medicine, contact your pharmacist or other health care provider.

Give Medications Properly

Use the appropriate dosing device—such as an oral syringe, not a regular kitchen spoon—to give the recommended amount of medicine. Some products are packaged with these devices, but devices are also available for purchase over the counter. “If your baby is prescribed a specific amount of medicine, make sure you measure and give the specific amount using a dosing device,” Snyder adds. And talk to your baby’s pharmacist or other health care provider if you have questions.

If You Take Medication, Seek Breastfeeding Advice

“If mothers are taking medications, it’s important to ask their health care provider whether it’s okay to breastfeed,” says Leyla Sahin, M.D., an obstetrician with the FDA’s Division of Pediatric and Maternal Health. Moms should ask about any prescription or over-the-counter products, including supplements. Stopping a medication can be dangerous for some women with chronic health problems, Sahin notes, but some medications can pass through the breast milk and may not be safe for your baby. So check with your health care provider if you are breastfeeding, or plan to breastfeed, and you are taking any medication.

Take Care of Yourself

You may feel like you’re devoting most waking (and sleeping) hours to your baby, but try to squeeze in time for yourself. Not getting enough rest can be an issue if you have a new baby. “Sleep when the baby sleeps and take naps during the day,” Sahin recommends. “If you’re a new mom feeling constantly very sad, it could be a sign of postpartum depression,” she adds, so you should talk to your health care provider to get help if needed.

Also it’s important to check in with your healthcare provider by phone or in person within 3 weeks after delivery, and as needed, until your postpartum appointment within 3 months after delivery.

Remember, your first year of parenthood may not be perfect but you can adjust to this new stage.

“Keep in mind that being a new parent is a transition period that may be stressful,” Sahin adds. “But take the time to celebrate being a new mom or dad.”

As parents and guardians, you have the important jobs of protecting your children from harm and of teaching them to make good choices as they grow and become adults. At a young age, start talking to your children about medicines and how you make medicine decisions for yourself and for them. This teaches children how to use medicines safely and correctly and to avoid harm from misuse of medicines. It also encourages them to ask questions about medicines and medicine decisions.

Sometimes your child may ask you a question for which you have no answer. This is a great chance to show your child that it is okay to ask health professionals for advice about medicines – health professionals, like doctors and pharmacists, are there to help you and your family make smart medicine and health choices.

This table suggests the kinds of information you should share with your children about medicines at different ages. Every child is different, so your child may be ready for some of these ideas a little earlier or a little later than the age suggested here.

Lessons About Medicines To Teach Your Children

Use care when giving any medicine to an infant or a child. Even over-the-counter (OTC) medicines that you buy are serious medicines. The following is advice for giving OTC medicine to your child, from the U.S. Food and Drug Administration (FDA) and the makers of OTC medicines:

1. Always read and follow the Drug Facts label on your OTC medicine. This is important for choosing and safely using all OTC medicines. Read the label every time, before you give the medicine. Be sure you clearly understand how much medicine to give and when the medicine can be taken again.
2. Know the “active ingredient” in your child’s medicine. This is what makes the medicine work and is always listed at the top of the Drug Facts label. Sometimes an active ingredient can treat more than one medical condition. For that reason, the same active ingredient can be found in many different medicines that are used to treat different symptoms. For example, a medicine for a cold and a medicine for a headache could each contain the same active ingredient. So, if you’re treating a cold and a headache with two medicines and both have the same active ingredient, you could be giving twotimes the normal dose. If you’re confused about your child’s medicines, check with a doctor, nurse, or pharmacist.
3. Give the right medicine, in the right amount, to your child. Not all medicines are right for an infant or a child. Medicines with the same brand name can be sold in many different strengths, such as infant, children, and adult formulas. The amount and directions are also different for children of different ages or weights. Always use the right medicine and follow the directions exactly. Never use more medicine than directed, even if your child seems sicker than the last time.
4. Talk to your doctor, pharmacist, or nurse to find out what mixes well and what doesn’t. Medicines, vitamins, supplements, foods, and beverages don’t always mix well with each other. Your healthcare professional can help.
5. Use the dosing tool that comes with the medicine, such as a dropper or a dosing cup. A different dosing tool, or a kitchen spoon, could hold the wrong amount of medicine.
6. Know the difference between a tablespoon (tbsp.) and a teaspoon (tsp.) Do not confuse them! A tablespoon holds three times as much medicine as a teaspoon. On measuring tools, a teaspoon (tsp.) is equal to “5 cc” or “5 mL.”
7. Know your child’s weight. Directions on some OTC medicines are based on weight. Never guess the amount of medicine to give to your child or try to figure it out from the adult dose instructions. If a dose is not listed for your child’s age or weight, call your doctor or other members of your healthcare team.
8. Prevent a poison emergency by always using a child-resistant cap. Re-lock the cap after each use. Be especially careful with any products that contain iron; they are the leading cause of poisoning deaths in young children.
9. Store all medicines in a safe place. Today’s medicines are tasty, colorful, and many can be chewed. Kids may think that these products are candy. To prevent an overdose or poisoning emergency, store all medicines and vitamins in a safe place out of your child’s (and even your pet’s) sight and reach. If your child takes too much, call the Poison Center Hotline at 1-800-222-1222 (open 24 hours every day, 7 days a week) or call 9-1-1.
10. Check the medicine three times. First, check the outside packaging for such things as cuts, slices, or tears. Second, once you are at home, check the label on the inside package to be sure you have the right medicine. Make sure the lid and seal are not broken. Third, check the color, shape, size, and smell of the medicine. If you notice anything different or unusual, talk to a pharmacist or another healthcare professional.