Giving Medicine to Children: Important Safety Information

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Giving medicine in the right way can help your child feel better and get well. However, medicine information and labels can be confusing. Read on for information from the American Academy of Pediatrics about prescription and over-the-counter medicines, how to give medicine in the right way, and how to prevent medicine mistakes.

Ask questions

Before you give your child any medicine, be sure you know how to use it. You can ask your child’s doctor or pharmacist the following questions:

  • Why is the medicine needed?

  • How much medicine should I give?

  • When should I give the medicine? For how long?

  • Should I wake my child to give the medicine on time?

  • Can I give the medicine with food?

  • Are there side effects? For example, will the medicine make my child sleepy?

  • Can this medicine be given with other medicines, supplements, or herbal medicines that my child is taking?

  • Should I follow any special instructions?

If you forget to ask some questions or need more information later, call the doctor’s office and speak with the doctor or nurse. The pharmacist who prepares your child’s medicine can also help.

About medicine names

Medicines often have 2 names: a generic name and a brand name. For example, Tylenol is the brand name of the medicine acetaminophen, and Advil and Motrin are two brand names of the medicine ibuprofen. The active ingredients in generic medicine and brand name medicine are the same.

Prescription medicines

Medicine the doctor orders from a pharmacy is called prescription medicine. If possible, use the same pharmacy for all of your child’s prescriptions. Having a single source for all of your child’s medicines will allow your pharmacist to check for possible side effects.

Common prescription medicines include

  • Antibiotics. Used to fight bacterial infections such as strep throat, not viruses such as the common cold or influenza.

  • Ear drops. Used for some types of ear infections, ear pain, or earwax.

  • Eyedrops or ointment. Used for eye infections, allergies, or vision problems.

  • Inhalers. Used to treat asthma and breathing problems.

  • Nasal sprays. Used to treat stuffy or runny noses or allergies. (Also available without a prescription.)

  • Skin creams, lotions, or ointments. Used for skin infections, burns, rashes, or acne. (Also available without a prescription.)

Read labels

Prescription labels contain a lot of important information. Look at the label on the next page to see if you can find these items.

  • a.Prescription number. You may need this number for a refill or when filling out insurance forms.

  • b.Your child’s name. Make sure the medicine is for the right child! Do not share prescription medicines with anyone whose name is not on the label.

  • c.Medicine name. Does this match what your doctor told you?

  • d.QTY. Is short for quantity, or how much is in the whole package, such as total number of pills or amount of liquid medicine.

  • e.Expiration date. Is when the medicine becomes outdated or loses its strength. Medicines older than their expiration date should be safely thrown away. For disposal instructions, call Poison Help at 1-800-222-1222, or check the US Food and Drug Administration Web site at for information on the safe disposal of medicines.

  • f.Instructions. The instructions tell you how to give your child’s medicine. Here are some examples.

    • “Take with food.” Give the medicine during or after a meal.

    • “Take 4 times a day.” Give the medicine 4 times during the day—at breakfast, at lunch, at dinner, and before bed. This is different than “take every 4 hours.”

    • “Take every 4 hours.” Give the medicine every 4 hours. This adds up to 6 times in 24 hours—6:00 am, 10:00 am, 2:00 pm, 6:00 pm, 10:00 pm, and 2:00 am.

    • “Take every 6 hours as needed for pain.” Your child may have up to 4 doses of medicine over 24 hours, given at least 6 hours apart. You do not need to give the medicine if your child is not having pain.

    • “Take 2 pills by mouth 3 times a day.” This equals 6 pills over 24 hours, usually given in the morning, midday, and around bedtime.

    • “Take 5 mL by mouth once a day for 3 days.” Give close to the same time each day for 3 days.

    • “Two puffs every 4 hours as needed.” Once taken, this medicine cannot be taken again until 4 hours has passed. “As needed” medicines are not taken unless required for relief of symptoms.

  • g.Refills. The label will show how many times you can get a refill.

  • h.Special messages. The medicine may have a brightly colored safety label with special information or instructions for you to follow—“keep refrigerated,” “shake well before using,” or “may cause drowsiness.”

Over-the-counter medicines

Medicine bought in stores off the shelf is called over-the-counter or OTC medicine. Like with prescription medicines, it is important to follow directions carefully because OTC medicines can be very dangerous to a child if not taken in the right way. You need to read and understand the instructions before giving OTC medicines to your child.

All OTC medicines have the same kind of label. Look on the box or bottle where it says “Drug Facts” for information about what it is, how to use it, the ingredients, and what side effects to look for. The label will also include a chart that tells you how much medicine to give your child. If you know your child’s weight, use that to find the correct dose for your child. If you do not know your child’s weight, use your child’s age. Always check the label to make sure it is safe for your child to use. If you are not sure, ask your child’s doctor.

Common reasons to use OTC medicines include

  • Fever, pain. Acetaminophen and ibuprofen can help your child feel better if your child has head or body aches or a fever. They can also help with pain from injuries such as a bruise or sprain and from soreness caused by a needle shot.

    Acetaminophen comes in liquid and chewable forms and also as a rectal suppository if your child is vomiting and can’t keep down medicine taken by mouth. Ibuprofen comes in concentrated drops for infants, liquid (in the form of syrup or elixir) for toddlers, and chewable tablets for older children.

    With ibuprofen, keep in mind that infant drops are stronger (more concentrated) than syrup for toddlers. For example, more medicine is in 5 mL of infant drops than in 5 mL of syrup for toddlers. Never give the same amount of infant drops as you would syrup.

    Always look carefully at the label on the drug and follow the directions. Each type of drug has different directions based on the age and weight of a child. You may need to ask your doctor about the right dose for your child. For example, you will need to ask your doctor how much acetaminophen is the right dose for a child younger than 2 years.

    Make sure you do not overdose your child by giving too much acetaminophen. Acetaminophen is an ingredient in many OTC and prescription medicines (eg, pain relievers, fever reducers, cough/cold medicines). If your child is taking more than one medicine, read the ingredient list to prevent double dosing.

    Note: Aspirin is another medicine taken by adults for aches and fever. However, never give aspirin to your child unless your child’s doctor tells you to. Children who take aspirin may get a serious illness called Reye syndrome.

  • Cold and cough. The American Academy of Pediatrics recommends that OTC cough and cold medicines not be given to infants and small children because they have not been proven effective and can be harmful. Discuss other ways to treat cold symptoms with your doctor, such as saline nasal sprays or drops for children and bulb suctioning of the nose for babies.

  • Allergy, itching. Antihistamines can be used to treat your child’s runny nose, itchy eyes, and sneezing due to allergies. They can also help reduce itching from chickenpox, insect bites, and other rashes including hives.

  • Stuffy nose. Your doctor may advise you to use saline nose drops or spray for a stuffy nose.

  • Rash, itching. Hydrocortisone cream or ointment is used for itching from bug bites, skin rashes such as poison ivy, and eczema.

  • Wound, cuts, and scrapes. Antibiotic ointment is used to prevent or control infection in wounds, cuts, and scrapes.

  • Constipation. Many OTC treatments are available for constipation, including stool softeners, laxatives, enemas, and suppositories. Call your doctor for advice if your child is having hard stools or pain or blood with bowel movements, because some constipation medicines can be too harsh for infants and children.

Liquid medicines

Liquid medicines must be measured carefully. Always use the dosing device that comes with the medicine or that your doctor or pharmacist tells you to use. Never use teaspoons, tablespoons, or other household spoons to measure medicine.

Four types of dosing devices are available: droppers (for infants), syringes, dosing spoons, and medicine cups. For liquid medicines, a syringe is the most accurate way to measure the correct dose.

The units of measure on a dosing device may be marked “tsp,” “tbsp,” or “mL.” One tsp (teaspoon) is equal to 5 mL (milliliters), and one tbsp (tablespoon) is equal to 15 mL. The strength of the medicine may be recorded as milligrams (mg) contained in each pill, capsule, or amount of liquid. For example, amoxicillin 250 mg/5 mL (250/5) means 250 mg of amoxicillin are in 5 mL of liquid.

When to call the doctor

Call your doctor for the following reactions to medicine:

  • Allergy. Signs of allergy include rashes such as hives, itching all over, breathing difficulties, and swelling. Stop giving the medicine if your child shows any sign of allergy and call your doctor.

  • Side effects. Common side effects of medicines include mild upset stomach or diarrhea. Call your doctor if your child has severe diarrhea or is acting different (eg, confused, hard to wake up, agitated). Also, call your doctor if your child vomits or spits medicine out. Before giving your child more medicine, talk with your doctor or nurse about the amount of medicine needed to replace the missing amount.

If your child refuses to take medicine or spits it out, call you doctor to see if the medicine can be ordered in another form or flavor. Some children like chewable tablets; others like liquid. Sometimes your doctor can change the medicine to one that tastes better to your child.

What you need to know before giving medicine

Read all of the medicine directions and make sure you understand

  • Dose. Be sure you know how much medicine to give your child. Over-the-counter medicines may have dose instructions based on your child’s weight and age. If you are not sure how much to give, call your doctor or ask the pharmacist.

  • Timing. How often are you supposed to give the medicine? Should you give the medicine with food or on an empty stomach? What if a dose is missed?

  • How long (duration). Make sure you understand how many days your child should take the medicine (eg, 10 days).

  • Side effects. Are side effects (eg, nausea, diarrhea, drowsiness) listed for the medicine?

  • Precautions. Are any reasons listed not to take the medicine? Some medicines should not be taken with others. Some medicines should not be taken if a person has certain medical conditions. If you are not sure if your child should take the medicine, call your doctor or ask the pharmacist. Make sure you can see and read the label by using good lighting. If you need glasses, wear them.

What to do for medicine mistakes

If you think your child has swallowed any medicine or substance that might be harmful, stay calm and act fast.

Poisoning from medicine can happen from

  • Taking too much medicine

  • Taking medicine too often

  • Taking the wrong medicine

  • Taking someone else’s medicine

Call 911 or your local emergency number right away if your child is unconscious, not breathing, or having convulsions or seizures.

Call the Poison Help number anywhere in the United States at 1-800-222-1222 if your child is breathing and conscious. A poison expert in your area is available 24 hours a day, 7 days a week. You will be told what to do for your child and whether you can watch your child at home or need to go to the hospital. Add the Poison Help number 1-800-222-1222 to all cell phone contact lists.

How to prevent medicine mistakes

  • Keep medicine up high, out of reach and out of sight. This includes medicine stored in the refrigerator. Also, keep medicine in a locked cabinet or container, if possible.

  • Keep medicine in the container it came in before you opened it.

  • Use child safety caps on medicine.

  • Do not call medicine “candy.”

  • Avoid taking your own medicine in front of children. Children love to imitate.

  • Many different medicines contain some of the same ingredients. This can lead to overdosing if they are given together. Check the label to make sure you are not giving more than one medicine with the same ingredient.

  • For liquid medicines, use the dosing syringe, spoon, or cup that came with the medicine.

  • Be sure your doctor knows all of the OTC, prescription, and herbal medicines your child takes.

  • Bring all medicines, or a list of all medicines, that your child is taking to each doctor’s appointment.

A warning about herbal medicines and home remedies

Some parents feel that herbal medicines or home remedies are safer because they are natural. Herbal medicines contain chemicals from plants and can cause some of the same side effects as prescription and OTC medicines. Herbal products do not have to be safety tested in the same way that OTC and prescription medicines do, so it can be difficult to know exactly what an herbal medicine contains or how much. Let your child’s doctor know about any herbal medicine your child is taking. Some herbal medicines are not safe to take with other medicines.


Here is a summary of important ways you can keep your child healthy and safe.

  • Get the facts on medicines your child takes; ask questions.

  • Know why your child is supposed to take prescription medicine.

  • Know how to find information on prescription labels.

  • Read all directions before giving your child medicine.

  • Be sure you know the correct dose of medicine for your child and how to measure the dose if it is a liquid.

  • Talk with your doctor before using or continuing herbal medicine.

  • Call the Poison Help number at 1-800-222-1222 for medicine mistakes.

  • Store medicines safely out of reach.

Products are mentioned for informational purposes only. Inclusion in this publication does not imply endorsement by the American Academy of Pediatrics.

Listing of resources does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication.

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Copyright © 2009 American Academy of Pediatrics, Updated 03/2015 All rights reserved.