Q&A: ‘Over-the-Counter’ Pediatric Medications
By Space Coast Daily // May 29, 2014
Q & A WITH DR. KIM HUNGER
BREVARD COUNTY • MELBOURNE, FLORIDA — Parents are often stunned when their child shows the first sign of an illness.
We ask ourselves: What should I do now? Should I call the pediatrician immediately? Should I access care from the nearest walk-in clinic? Is there an over the counter (OTC) medication that I can give my child?
Space Coast Daily is delighted to welcome Dr. Kim Hunger, a Clinical Pharmacist at Holmes Regional Medical Center, to address some of the most frequently asked questions and common concerns that parents have when faced with a sick child.
Dr. Hunger relates that as a pharmacist, she receives calls pertaining to these concerns from friends/family on many occasions.
“Now that I am a ‘mom,’ I have a special personal and professional interest in helping other parents choose remedies when their child is overcome by the common cold. There are many different OTC medications that can be safely used in pediatrics, but ensuring children receive the best possible medication and dose is of utmost importance.”
Space Coast Daily: With the multiple products on the market it can get a bit confusing exactly how to manage a child’s fever. What do you recommend?
Dr. Hunger: Treating a pediatric fever can be difficult, since many children develop an elevated temperature with multiple viral illnesses (common colds).
Ibuprofen (i.e. Advil® Motrin®) and acetaminophen (i.e. Tylenol®) are two commonly used OTC drugs for fever and are available in both “infant” and “children” formulations.
Parents should carefully select the appropriate formulation for their child because there are different concentrations that are uniquely dosed. The infant formulation should be used for children under two years of age. Acetaminophen may be used starting at 2 months of age and up, while ibuprofen is reserved for those infants who are at least six months old.
Space Coast Daily: A child with a high fever or one that doesn’t immediately respond to therapy can be very alarming for a parent. How is this situation best managed?
Dr. Hunger: An effective way to control a higher fever (101’F- 103.5’F) in a child is by alternating acetaminophen and ibuprofen. In this situation, acetaminophen may be given every four to six hours, while ibuprofen is given every six to eight hours.
Alternating the two drug products allows for optimal fever control, which will improve a child’s ability to remain hydrated, consume vital nutrition and have a general sense of well being.
If this regimen fails, the child should see their pediatrician or primary care physician.
Space Coast Daily: That ability for a child to remain hydrated during an episode of febrile illness is critical. What is the optimum approach to ensuring hydration in these cases?
Dr. Hunger: Fluid intake is essential in a child with a fever and/or common cold. Children, especially infants, are most susceptible to dehydration, which can lead to electrolyte imbalances and a decreased appetite.
An oral rehydration solution (ORS) like Pedialyte® (comes in assorted flavors and also freezer pops) is recommended by the Center for Disease Control to treat mild to moderate dehydration, as well as prevent dehydration in a child who is having multiple episodes of vomiting or diarrhea.
It is important to give a child frequent small volumes of an ORS while they are acutely ill, and then encourage an age-appropriate diet once rehydrated.
Gatorade® and other sports drinks alone do not contain the necessary electrolytes to effectively treat dehydration; but still may be given to children who are not dehydrated especially in combination with a salty snack like crackers if the child is old enough and able to consume food.
Space Coast Daily: Another common ailment affecting children and infants with the common cold or nasal allergies is congestion. What decongestant do you recommend as safe and effective in the pediatric age group?
Dr. Hunger: There are several nasal decongestants such as Afrin® (use only studied in children 6 years or older), as well as the oral decongestant Sudafed® (use only studied in children at least 2 years of age).
It is important to use nasal decongestants for no more than 3 days as drug-induced congestion referred to as “rebound” may occur.
Children under the age of two don’t have many options, but one recommendation is to use nasal saline drops for infants/toddlers. Placing one to two drops in each nostril can help nasal secretions thin, opening up your child’s airway.
A nasal bulb syringe may also be useful in aspirating congestion from a child’s nose.
Space Coast Daily: As both a parent and a clinical pharmacist, please share with our readers your insight into the fundamental principles to be mindful of when treating our sick children.
Dr. Hunger: Children rely on their parents to make the right decisions for them when they are in pain, sick or hungry, as they are unable to provide for themselves. As a mother of a 4 year old boy and 21 month old girl, I have had an opportunity to experience each of the discussed topics personally.
Having a sick baby can be frustrating, but with the help of informed parents and the health-care team, our children demonstrate their innate resilience and quickly overcome a mild illness.
The most important thing to remember when medicating children with an OTC medication is safety. Before administering any medication, the name, strength, and dose should always be double checked. At times this may be difficult, especially if you are holding a screaming baby at midnight.
However, medication safety is extremely important, because a medication-related error will only complicate your child’s illness and delay recovery.
And, of course, any questions or concerns regarding your child’s health should be directed toward their pediatrician or primary care professional.
Kim Hunger is a clinical pharmacist at Holmes Regional Medical Center, a mother of a 4 year old boy and 21 month old girl, and a wife. She earned a bachelor’s degree in Biology from FAU in 2001 and her doctorate in pharmacy from UF in 2007. Outside of her profession, she enjoys triathlons, running, cycling, boating, her 2 golden retrievers, and spending time with family.