From years in a largely pediatric-based practice, I recommend a must-have list of medications for your home cupboard. I will give you a list of these common pediatric drugs and doses you can easily calculate.
“Children terrified me twenty years ago.”
A sick child, however, would trigger a primal fright-flight response. I’m embarrassed that my instinct was to run and hide, not heal.
“Shortly before I left my Johannesburg practice in 2019, a youngster with possible meningitis needed a referral to a specialist. I asked his mom, who had three children under four years old, who her pediatrician was. She answered, “You are.”
What changed? How did my 2001 community service paediatric-ward-hell morph into a majority kiddie-based practice?
“The success of your GP practice will not rely on your clinical skills but the candy selection you have in your drawer.”
Dr D van der Hoydonk
I was told this when I started my GP practice in 2004. It is only partly true.
My mentor, Theo Louridas, taught me how to approach a young patient.
To establish trust, you must speak to the child as if the parent were not in the room.
Smile, and introduce yourself in a friendly and soothing tone. Go down to their level and show genuine interest in their name, age, and what brought them to you. The guardian can always fill in the gaps later.
This technique made all the difference. My child-phobia transformed into rewarding relationships, some spanning 17 years.
Toddlers became high school graduates. 10-year-olds grew up, married, and brought their children to see me.
Disclaimer: Some medical conditions may have medication restrictions. Always check with your doctor that these medications are safe for your child.
These six common pediatric drugs and doses will get you through difficult hours until a doctor’s appointment.
These are available over the counter without a prescription.
- Paracetamol syrup
- Paracetamol suppositories
- Ibuprofen syrup
- Probiotic drops
- Nasal saline spray
- Nasal decongestant spray
Dosage guidelines on the package are often vague. For example, Children 1 to 5 years old take 5 to 10 ml every 4 to 6 hours. I will give formulas for paracetamol or ibuprofen to calculate an optimal dose.
This video link has tips on how to give your child medication.
Common pediatric drugs and doses for must-have-at-home-meds
1. Paracetamol syrup (120mg/5ml)
If you have nothing else in your medicine kit, have this.
Paracetamol is your baseline medication for pain and fever. It is generally very safe.
You can give it on an empty stomach and when your child is mildly dehydrated.
Calculate the dose: ((your child’s weight) x 10 / 24) every 6 hours
- Example: 7 kg x 10 / 24 = 2.9 = 3ml every 6 hours
- Example: 12kg x 10 / 24 = 5 = 5ml every 6 hours
- Example: 22kg x 10 / 24 = 9.1 = 9ml every 6 hours
Please note this dose is based on 120mg/5ml.
If there is breakthrough pain or fever before the next 6-hour dose, you can add ibuprofen. Please read my post on fever management in children and the ibuprofen section on how to do this safely.
2. Paracetamol suppositories (125mg or 250mg/suppository)
Dosage: > 3 months to 1 year old, 125mg suppository every 6 hours; > 1 year to 5 years old, 250mg suppository every 6 hours
Instead of paracetamol syrup, you can use a paracetamol suppository. They are interchangeable.
Many parents freeze and want to run away at the thought of giving their child a suppository.
Suppositories are fantastic when
- your child hates the taste of the fake-strawberry-flavored syrup and spits it back at you, or
- has vomited once and might not keep the syrup down.
Ask your nurse or doctor to help you the first time if you are unsure. If you can get over the fear, it can be life-changing. Many parents then ask, “Why don’t they make antibiotics in suppository form?”
Keep suppositories in the fridge. In warm weather, they get soft and are difficult to insert.
3. Ibuprofen syrup (100mg/5ml)
Disclaimer: Not for use in children < 3 months old or < 6kg in weight. Avoid using for children who are vomiting, not eating, or not drinking.
Ibuprofen is great for pain that requires an anti-inflammatory. Good examples are teething or injuries. Use it with paracetamol to treat fever.
Calculate the dose: ((your child’s weight) x 5 / 20)) every 6 hours
- Example: 7 kg x 5 / 20 = 1.75ml every 6 hours
- Example: 12kg x 5 / 20 = 3 ml every 6 hours
- Example: 22kg x 5 / 20 = 5.5ml every 6 hours
Please note this dose is based on 100mg/5ml.
Please read my post on fever management in children. This will give you confidence to treat fevers at home.
4. Probiotic drops or junior tablets
Probiotics are safe and are helpful to have at home for the following acute reasons:
- For acute diarrhea, give a dose after every loose stool.
- They help reduce colic.
- They might reduce regurgitation or reflux.
- Use them for oral thrush and candida nappy rash.
- Start at the first signs of constipation together with increased water intake.
Two South African brands that I recommend are Reuterina and ProB2.
5. Nasal saline spray
This is very handy for allergies and around the cold and flu season. It flushes the nose and clears germs, allergens, and mucous. It keeps the inside of the nasal passages moist and healthy, helping to fight infection.
Dosage: 1 to 2 sprays into each nostril three times a day or as necessary.
“After softening the mucus, you can follow up your saline spray with a nasal suction. The only one I recommend is the NoseFrida.”
6. Nasal decongestant spray (Oxymetazoline HCL/Xylometazoline HCL)
If you’ve tried flushing with the saline and are not winning, the nose is still blocked. It is helpful to have a decongestant spray available.
Infants and children have different strengths of decongestant sprays.
Dosage: 1 to 2 puffs in each nostril three times a day maximum or as necessary. MAXIMUM OF 5 DAYS
This is important to have on hand for the following reasons:
- Babies infants are obligate nasal breathers; they cannot suck bottles or breastfeed with blocked noses.
- Babies, infants, and toddlers can get earaches with a blocked nose.
An anatomy lesson. The middle ear is an air-filled chamber with a tube that leads into the back of the nasal passage. The eustachian tube gets swollen and blocked when kids get a cold or snotty nose. This causes fluid and pressure to build up in the middle ear. The pictures in this Mayo Clinic post beautifully illustrate this.
If kids wake up at night, cry, or appear in pain when lying down and have a blocked nose, give a dose of decongestant nasal spray immediately. It opens up the nose, unblocks the eustachian tubes, and relieves pressure in the middle ear.
If this happens for two nights in a row, see a doctor.
I hope that you find these medication recommendations useful and that they help to make your parenting experience easier.
