When your baby is sick, you probably immediately head to the drugstore to buy medicine to help them feel better. But there are a surprising number of over-the-counter remedies that aren’t safe for babies.
“We tell a lot of parents to exercise caution when using this, that or the other thing they got at the drugstore,” says Christopher Sulowski, the deputy chief of the pediatric emergency department and associate professor in the department of pediatrics at McMaster University. “Just because it’s available doesn’t mean it’s a good thing.”
If your child is younger than three months old and isn’t feeling well, Sulowski stresses that you should head straight to the doctor or the emergency room, especially if they have a fever. “There are so many things that could be going on,” he says. “Don’t tough it out at home at this age.” Never worry that you are a nuisance for heading to the doctor for a common cold—Sulowski says doctors should be happy to see newborns and provide proper guidance to ensure everything is OK. 6 common medication mistakes parents make with kids
And until your baby is three months old, you shouldn’t be giving them medication without talking to your doctor first.
“The only medication a newborn should take without consultation is vitamin D drops if they are being breastfed exclusively. Otherwise, medications even as benign as Tylenol should not be given to babies younger than 90 days old without having the baby assessed first,” says Sulowski.
For babies older than three months, here are eight common medications you shouldn’t give them—and what to give them instead.
1. Aspirin (acetylsalicylic acid)
Not recommended for: Any child under 18 years old, unless otherwise directed by a doctor.
Aspirin for kids is a straight-up “no-no,” says Sulowski. It has been proven to cause Reye’s Syndrome, which is a serious condition that can lead to swelling in the liver and brain. The only time aspirin is prescribed for children is in rare and special cases for children with certain diseases or conditions, and those are monitored closely by doctors. Aspirin of any type should never be given at home.
If your baby is in need of pain relief, turn to an infant formula of acetaminophen (Tylenol).
2. Advil or Motrin (ibuprofen)
Not recommended for: Babies younger than six months.
Although there are infant ibuprofen products on the market, according to Sulowski, most doctors prefer to recommend acetaminophen (Tylenol) for babies between three and six months of age, when necessary—say to treat a fever or teething pain. It’s an older and more familiar medication and doesn’t have the risk of reducing blood flow to the kidneys, which is the main concern with ibuprofen.
3. Cough syrups
Not recommended for: Not recommended for anyone, but especially children younger than six.
In 2009, Health Canada reviewed over-the-counter cough and cold medications for children and found them to be ineffective. They also found that the medicine could be potentially harmful to young kids. “Serious harm, including misuse, overdose and side effects may occur in children under six years of age when using over-the-counter cough and cold products, although the risk of such serious harm is low.” It’s now recommended that cough and cold medications shouldn’t be given to kids younger than six. Some over-the-counter homeopathic cough and cold medications are labelled for kids aged zero to six years old, but Sulowski says these have more of a placebo effect than anything else.
“What we recommend is giving kids over the age of one year a teaspoon of honey before bed,” he says. This reduces nighttime coughing and helps kids sleep so their bodies can fight off the cold. Health Canada does not recommend you give children younger than 12 months honey due to the risk of botulism. Sulowski also recommends using a cool-mist humidifier to help clear congestion.
4. Benadryl (diphenhydramine)
Not recommended for: Children under two. [Editor’s note: In October 2019 the Canadian Society of Allergy and Clinical Immunology published a statement saying Benadryl shouldn’t be used at all to treat allergy symptoms because it—and other ‘first-generation’ antihistamines—pose unnecessary risks to your child’s health.]
Children’s Benadryl is not recommended for children under two years old. Sulowski says some doctors may prescribe it in certain situations for children under two—but rarely for babies under six months. “One of the main side effects is it makes your child sleepy,” says Sulowski, and this sedating effect puts kids at increased risk of dehydration because they are too sleepy to drink. If a child is sleeping for most of the day, it can also mean that parents are missing other symptoms that need treatment. For example, your child might have an infection and be losing consciousness, but you think they are just sleepy from the Benadryl.
Benadryl should only be used to make kids comfortable–so they can sleep or aren’t severely itchy. It shouldn’t be used solely for a rash that isn’t bothering the child, for example. “Benadryl is not a cure, it is just for symptom relief,” says Sulowski. If your child is still playful and able to function, it’s better not to give medication. If your child has a rash, you can try a simple baking soda and Epsom salt bath to soothe your child’s skin instead, says Sulowski.
There are two types of rashes that require your kid to be seen by a doctor. “If a rash on your child’s skin looks like bruising or looks like red dots that do not blanch with gentle pressure, then you should seek medical attention,” says Sulowski. “Rashes that don’t blanch with gentle pressure can be signs of petechiae or purpura.” This can mean blood is trapped under the skin and can indicate more serious conditions, Sulowski says.
5. Gravol (dimenhydrinate)
Not recommended for: General use; especially not for children younger than two
“Gravol is not a medication we’re using anymore,” says Sulowski. “It works, but it makes kids sleepy,” he says, and if they’re sleeping, they aren’t consuming the fluids they need to stay hydrated.
For severe vomiting when your child can’t keep fluids down, doctors will offer a prescription medication called ondansetron that shuts off the vomiting centre in the brain for eight to 14 hours. It doesn’t make kids sleepy, so they can keep drinking fluids. If your child is vomiting but not severely enough to see a doctor, the solution is simply to keep them comfortable and hydrated until the infection passes. Sulowski recommends electrolyte drinks such as Pedialyte or watered-down juice to keep kids hydrated if they are over six months of age. For babies younger than six months who are vomiting, continue to hydrate them with breast milk or formula and go to the doctor for a checkup
6. Nasal drops like Otrivin (xylometazoline)
Not recommended for: Babies or young children
Sulowski doesn’t recommend nasal drop medications because they dry out the nasal passages. Instead, a good old-fashioned aspirator a.k.a snot sucker will help relieve your little one’s stuffy nose. “Kids hate it, but it helps,” says Sulowski. He suggests sucking out the nose before a feeding so your baby can breathe as they drink or eat.
A saline solution is another safe option to help clear the nasal passages in conjunction with nose suctioning and a cool-mist humidifier. The key with a runny nose is to make your child as comfortable as possible, not to make it go away with medication.
7. Teething gels like Orajel (benzocaine)
Not recommended for: Teething babies at any age [Editor’s note: In early 2020, teething gels were no longer available in Canada, although they had not been officially recalled. In the U.S., these products were banned outright for children under two by the Food and Drug Administration in May 2018.]
Although many teething gels are readily available over the counter, Sulowski warns against using them. Since you apply the gel in the mouth, your baby could be swallowing the solution. If your baby consumes too much of the drugs that numb the gums—often lidocaine or benzocaine—it can be harmful and can have serious effects such as seizures or methemoglobinemia, where the blood can’t carry oxygen through the body effectively. For this reason, The US Food and Drug Administration advises parents not to use benzocaine teething gels on children younger than two.
Although it can be miserable for everyone, it’s not worth risking your child’s life for some temporary comfort. “Teething is a phase and it will pass,” says Sulowski. Instead of teething gels, opt for cold teething rings or a cold cloth for your baby to chew and suck on. We have lots more safe teething remedies that you can try here.
8. Senokot (senna glycoside)
Not recommended for: Any babies or children
When your child is severely constipated, you may seek quick relief. Senokot for kids is available over the counter, but Sulowski doesn’t recommend it for children because it causes muscle cramping, and there are much better alternatives.
Instead, he prescribes Lactulose for babies younger than six months or products containing PEG 3350 (MiraLAX or Lax-A-Day) for children over six months. These are not dependency-forming drugs. In severe cases, these medications can be used for three to four weeks or longer, during which time Sulowski says parents can adjust their child’s diet to include more fibre and less sugar. That should help in the long run.
Babies younger than six months who are constipated should be seen by a doctor to ensure something more serious isn’t happening. The constipation could be a sign of an issue like dehydration.
And remember that in babies, there is a huge range of normal when it comes to poop. “An old saying, I was taught was: ‘Seven poos in one day or one poo in seven days is all acceptable when it comes to babies,’” Sulowski says.