No medicine for babies?

October 15, 2009 12:41 PM

I'm expecting a baby in a few months and have questions about medicating infants and toddlers. I always thought you give babies motrin when they're teething really badly, baby allegra when they have sinus infections, etc. However, all my friends seem to either be dead-set against baby Motrin or use it very, very sparingly. What's the cause for alarm?

To be clear, I'm not going to give my baby dramamine when he won't sleep, and I know not to give him Benadryl and cough medicines until he's much older. But I got lunch with my friend who has a teething toddler yesterday, and the kid was clearly miserable--grouchy, drooling, gnawing on everything, biting her fingers, and apparently hadn't slept for more than two hours in two days because her eye teeth (the most painful teeth to appear) were coming in. I asked my friend if Motrin helped and she acted like I'd advised administering arsenic. She said she never gives her baby any pain medication for teething. Another friend has a baby with a severe sinus infection that puts her at risk of an ear infection. The pediatrician gave the mother an Rx for baby allegra for the congestion and then advised her to mix up some amoxicillin if the baby started running a fever. When I checked up the next day, the friend's baby was indeed running a fever, so the mother had given her amoxicillin but not allegra, even though the congestion got worse. The doctor hadn't advised her to stop the allegra dosage either, but my friend felt uncomfortable giving both meds.

This might be too wordy, but I guess I'm just curious about my friends' aversion to baby meds. Will giving a baby Motrin for teething mess up his ability to handle pain later? I'm someone who eats fistfuls of Tylenol when I have a headache and am a big fan of Western medicine (maybe because my mom gave me too much Motrin when I was little ? :) so I'm interested to know why other parents are squeamish about meds that ease teething pain or congestion.

Of course, I'll ask my pediatrician about this when I see her next, but clearly , but I wanted to ask a forum of people who are not my well-meaning but highly judgmental friends, in case they report me to child services!

posted by anonymous to health & fitness (26 comments total)

I'm not a parent or a doctor but I thought that some children's pain relievers were linked to SIDS? I also remember a childhood friend of mine being given some fever reducer/pain reliever when she had the chicken pox and something not good happened. No recollection of what the "not good" was but I remember a conversation with my mom about the connection between the meds and the resulting affliction. Though this would have been the 80s so there might be some outdated stigma attached to those types of drugs in children.
posted by countrymod at 12:48 PM on October 15

We certainly gave Motrin/Tylenol (alternating, when needed) as soon as our guy was old enough, but we were inducted into baby medicine early, when he needed Zantac for his reflux.

I don't know what your friends' issues are, but unless there are other medical issues/allergies/etc going on, I would and do give my kids pain medicine, as indicated by age and weight.

If I were your friend, I'd ask my doctor about my concerns instead of just not medicating my kid, but again, Oppressed by Western Medicine over here.
posted by chesty_a_arthur at 12:51 PM on October 15

IIRC Motrin is only for 6months and older. I have never used it, but I have given both my babies Infant Tylenol if they seemed to be in pain and couldn't sleep, or if they had a high fever. I think it should be used sparingly, but personally I think its OK to use when necessary.

Lots of people are wary of giving kids baby medicine because it doesn't seem to have been tested very well (can't really do controlled trials on infants I guess) which led to the childrens' cold medicine withdrawal fiasco recently. I would be wary of Allegra if the kid was under 1 year old, since antihistamines can make you drowsy, which would put a baby at higher risk of SIDS.
posted by Joh at 1:01 PM on October 15

I'm a big, big fan of Western medicine, as it saved my life a couple of times, and I do medicate my kids when it's necessary and when it's advised by their doctor, who I trust. He gives me a lot of credit for knowing my kids best, and he makes me a part of the decision-making team, so there's that. But yeah, once they were old enough or it was medically necessary, meds were given, including Motrin Jr. and the like. As a matter of fact, my daughter (9) just got over the H1N1 flu and piggybacking Motrin and Tylenol for her RAGING fever made her much more comfortable.

Find a pediatrician you trust and who "feels" right to you and follow his/her advice (as well as sometimes following your gut instinct).
posted by cooker girl at 1:04 PM on October 15

I use Hyland's Teething Tablets for my kiddo and they are amazing. But when push comes to shove, Baby Tylenol and Motrin are awesome.

Perhaps your friend has yet to deal with a baby with a serious virus, but for me (and my baby pals) at least, that's when our "sparing" use of Tylenol and Motrin went out the window.

I also don't use OralJel for teething due to its toxic properties and the possibility of chocking, oh and cuz it numbs baby's mouth and that making nursing harder.
posted by k8t at 1:06 PM on October 15

Motrin should really be used for reducing high fevers in older babies and toddlers, Tylenol for aches and pains associated with teething. I understand not wanting to use fever-reducers for low-grade fevers (99-100 or 101, depending on the baby's behavior) because those fevers generally arise to fight off infection, so suppressing them also suppresses the baby's natural and healthy response to illness. I am definitely pro-Motrin in the event of glassy eyes, limpness and fevers over 103.

I've never really understood the alarm over baby Motrin and Tylenol (aside from the fear of Reye Syndrome associated with giving asprin to children) so I'll be interested in seeing the responses. If pediatricians prescribe meds, why wouldn't you give them to your kid? I've been at the doctor's office while the pediatrician recommends baby Motrin and the parent still won't use it, which I personally think is nuts if the kid can't sleep, eat or get a moment's peace. I sort of thought that upper-class organic people were irrationally anti-medication for no reason, but this wouldn't be the first time I'm wrong.

Also, it seems like you're discussing toddlers more than babies, who are generally beyond the dangers of SIDS at that age (though not always).
posted by zoomorphic at 1:14 PM on October 15 [1 favorite]

I tend to be a research-loving, medicine-hesitant, what-doesn't-kill-you-makes-you-stronger Mom. Thus:

Motrin/Tylenol - I give Motrin for pain to my babies 3+ months old. I tend to use Tylenol for fever, but basically I use whichever of these is on hand and I use them if the baby is in obvious discomfort or begins to have trouble sleeping. I continue using it only if it seems to have an effect (that is, if the whining, crying, moaning, or trouble sleeping doesn't stop with medicine, then there's not much point to continuing it). I don't see how exposure to pain relief would mess up your ability to handle pain. (I know what you mean by your question, but I'm not sure that's the right question to be asking anyway). Note: There was just a recall of Infants Tylenol, so some people may be gun-shy about infant pain relievers in general?

Allegra - this is an antihistamine, I believe? That brand name isn't familiar to me, but casual research shows it's only recommended to children 2 years and older. In general I don't give antihistamines unless the alternative is dire (allergic reaction, for instance). Other approaches seem to work as well or better, and antihistamines for more than 4-5 days start causing some of the symptoms they're supposed to cure. Plus, they can make kids irritable.

Amoxicillin - an antibiotic. I don't understand using this if the baby's running a fever unless you know the cause is bacterial and the fever is high and sustained (my rough guide: 102-103+ and not brought down a degree or two by gentle bathing or Motrin/Tylenol within 1-2 hours). Sinus infections are hard to diagnose as bacterial or viral. And my understanding is that they don't benefit much from medication unless they go on for 3+ weeks.

Ear infections - I have read studies that say the duration or severity of an ear infection isn't lessened with medication. My kids haven't had ear infections, but our current pediatrician did not think medication worth it for run-of-the-mill ear infections (and she is the medical adviser for the public school system, so fairly pragmatic and mainstream).

I guess it would make sense to ask your friends what it is about the particular cases that makes them resistant to using the medications. That would give you a better idea. If they truly are judgmental, you can mask your disbelief by putting on a tone that communicates "Please dish and induct me into your world of experienced mothering by telling me your medication secrets."
posted by cocoagirl at 1:30 PM on October 15

Giving your child one of the approved medications for age won't oversensitize or numb him for pain later on. You do have to watch out for Reyes Syndrome and kidney issues if you give the wrong one or wrong dosage. ALWAYS CALL PEDIATRICIAN FIRST. Never self medicate under assumption on dose or what is allowed.

My son had to be put on Prevacid at 3 months old. I was floored they would do this. I looked up studies that said it wasn't 100% approved in his age group. But the section chief of gastro and surgery said that it's been off labeled safely for years. I still wasn't happy about it BUT it did cure his acid reflux.

The other shocker to me was Pepto. DO NOT give it to infants. It too can lead to Reye. Who knew?

Our son is teething now and I give him infant Tylenol before bed. Nothing during the day because I don't want to over do it. Instead we do Hyland's Teething Tablets (3 of them). They seem to help. Other than that we do the teething rings, cold washcloths, etc.

It is what it is when it comes to teething. Ask a pediatrican first, do your own research and ask questions second.


Sorry I don't understand this logic "And my understanding is that they don't benefit much from medication unless they go on for 3+ weeks."

The prescription for children is usually 10 days. My son was on Zithromax for 10 days at 2 months old. Amox for 10 days at 7 months old. Three weeks seems an awfully long and uncessary time frame. Most meds are 7-10 days depending on treatment, dosage, and age.
posted by stormpooper at 1:41 PM on October 15

I am not anti-medicine, but I am completely shocked by the quantity of baby drugs some people seem to go through. If you jump to painkillers for "teething," your tot will be medicated for a ridiculous percentage of infancy and toddlerhood...

The infant section of the drugstore is pretty scam-heavy, which is to blame for my own wariness and I think a number of other parents'. "Teething tablets" are homeopathic -- read: sugar pills (lactose) and babies like sugar. "Gas drops" are probably not doing anything useful.

You might find you simply don't need this stuff, too. I have a 26mo, an almost full bottle of infants' Motrin to throw away, a thermometer collecting dust, and I'm still not sure what the "nasal aspirator" thing is for. A sickly kid would be a different story, but a normal, healthy kid just doesn't need as much stuff as is advertised.
posted by kmennie at 1:44 PM on October 15 [3 favorites]

I'm just chiming in regarding those 'fistfuls of tylenol' you say you take. Acetaminophen can be very dangerous, and result in liver toxicity, in amounts not much higher than the typical safe dose. You should be aware of the risks of taking multiple pills at a time, despite their 'safe' image.
posted by thegreatfleecircus at 1:48 PM on October 15

I'm someone who eats fistfuls of Tylenol
Slightly off topic, but it can be extremely dangerous to take more than the recommended dose of Tylenol. The difference between the effective dose and the fatal dose is pretty small. Eight extra-strength Tylenol a day can cause liver failure in a healthy adult. The danger is even greater for children. Please, be careful with your own health.
posted by decathecting at 1:50 PM on October 15 [1 favorite]

>Sorry I don't understand this logic "And my understanding is that they don't benefit much from medication unless they go on for 3+ weeks."

I wasn't clear. I meant that most doctors I know won't jump to antibiotics unless the infection seems to be going on at least three weeks and the baby is really uncomfortable.
posted by cocoagirl at 1:55 PM on October 15

I don't recall how much acetaminophen and/or ibuprofen we gave our kids as infants, but generally teething is more of a crank, low-grade thing as opposed to balwing, crying pain. If it gets very bad you could give it to a kids for that, but I don't think it ever really got to the point where it was necessary for our kids. Why are some people crazy dogmatic about how they treat their kids? Who knows.
posted by GuyZero at 2:05 PM on October 15

I'm still not sure what the "nasal aspirator" thing is for.

It's for sucking mucous out of an infant's nose when they're severely congested and/or have a sinus infection. Most kids probably don't need it, our daughter did. Yeuch.
posted by GuyZero at 2:06 PM on October 15

We have used baby tylenol maybe 5 times in a year for really really bad teething pain (mainly because we feel that sleep is v. important, and if she isn't getting sleep her little brain isn't developing properly :) ). We use motrin for fevers, as our kid seems to respond very well to it. Plus, ibuprofen is a better anti-inflammatory, anti-pyretic than tylenol. When baby had a raging fever that wouldn't come down we piggy-backed the two (which is fine, they work through different mechanisms, so you are not going to get a drug interaction).

Just another data point
posted by gaspode at 2:07 PM on October 15

We've always given Motrin/Tylenol to baby llama for teething pain, as soon as we sense it's coming on, she gets drooly, crabby, biting her hand. I guess some people don't give it. To each their own. Sure made baby llama's life better (and ours).
posted by A Terrible Llama at 3:40 PM on October 15

Since you'll be talking to your pediatrician anyway, I find it very helpful that ours sends us home from every visit with a form that lists our child's weight and the proper dosage for various pain-killing medications in liquid and pill form. It's something we can keep in the medicine drawer until needed so we're not second guessing the "Ask a doctor" dosage on the bottle.
posted by saffry at 3:42 PM on October 15

We used infant Tylenol to bring down fever. Our daughter caught several colds as an infant and they always seemed to be accompanied by a low-grade fever. I assume she also had some pain during these illnesses (I caught them from her and I was achy), so again, the infant Tylenol helped. Why let her suffer, just because she can't talk?

We used infant Tylenol and infant Motrin very occasionally for teething. No cold meds, these have been taken off the market for anyone under age 2.

Really didn't use anything else, and luckily, didn't need to. I am not a proponent of using meds for the slightest complaint, but... I've known some babies who had to have surgeries or chemotherapy, and I figure if the doctors can scale meds down and give them to those infants, certainly my kid can handle a dose of Tylenol once in a while.
posted by Knowyournuts at 4:29 PM on October 15

Okay. Baby Zizzle would get these weird three day fevers that baby's get --- weird because there were no other symptoms that we could determine. And of course these weird fevers he'd get (temps above 101 which until four months of age is of concern, after four or five months, a temp of 103 is of concern) would happen on the weekend, you know, when no one was in the office. So what do we do? We call the doc who happens to be on call and what does the doc say? Give him the Motrin. But what the doc doesn't say is how much for the dosage because Baby Zizzle was under six months of age. The box has a dosage for six months and above and/or by weight. So what do we do? We call the pharmacist --- totally underused resource you should use. So, this is getting long --- what does the Motrin do? Well, it lowered the weird fevers within an hour and within two Baby Zizzle's temp was normal. So, yeah. We use Motrin and in this house we're pretty big fans of it for fever purposes (baby + fever = misery for all involved, even if there are no other symptoms that one can determine) --- though we did use it with appropriate caution when he was little and now that he's 10 months, we don't worry so much about it.

According to some new research (which I get from our ped, so you may want to check with your own), Motrin has been found to be better for babes than Tylenol --- something about it not affecting the digestive system as much or that it can be used regularly without harming the digestive system whereas Tylenol requires some more caution. Or something.

For teething, we don't use it so much, but that's mostly because Baby Zizzle hasn't had toooooo many teething issues. Once in a while we give it to him before bed if it seems he's really in a lot of pain and just will not sleep without some help. But not often. The teething, I think, really depends on how the baby handles it. Baby Zizzle was extra fussy for three days before his two bottom teeth popped up in two days and that was it. Same thing for his top two teeth. We'll see how it goes once the others begin coming through. What seemed to work best for him, though, was something cold to chomp on --- so, like, giving him some cold applesauce on a metal spoon was a great thing! The other thing that sometimes worked for him was an ice cube in a mesh eater thing.
posted by zizzle at 6:06 PM on October 15

Just to be clear - the thing with Reye syndrome is only associated with aspirin, and I was surprised to learn recently that the link is not as clear as all the warnings would have one believe. (Of course I'm not recommending you test this.)

On choice of baby medicines, I feel better keeping Motrin around than Tylenol - Poison Control once informed me it's much harder for a toddler to OD on it. (whew)
posted by lakeroon at 7:45 PM on October 15

"I wasn't clear. I meant that most doctors I know won't jump to antibiotics unless the infection seems to be going on at least three weeks and the baby is really uncomfortable."

IANAD
But I think you're getting a lot of bad information from your friends. If it's a serious bacterial infection a baby could be dead by the time 3 weeks rolls around. Ignore what your friends say. For accurate information ask your doctor and/or pharmacist about different medications and when/how to administer them correctly. Also, as some of the other posters mentioned don't eat fistfuls of tylenol and don't self medicate or stop/adjust medication unless the doctor tells you to.

As far as teething, some babies don't have a horrible time of it and they get along just fine with things other than medicine. A lot of babies are perfectly happy to chew on a cool and lightly damp wash cloth.
posted by GlowWyrm at 9:30 PM on October 15

IANAD. But I think many parents are concerned about NSAIDS and ulceration and bleeding of the gut. However, my own doctor assured me that this isn't a concern for most kids.
posted by acoutu at 11:08 PM on October 15

Re. not jumping to antibiotics: I don't think anybody is suggesting that for life-threatening infections, but "Watchful Waiting Proves an Acceptable Alternative to Antibiotics for Many Parents of Children With Ear Infections"
posted by kmennie at 5:17 AM on October 16

kmennie,

There is a huge problem with the misuse and overuse of antibiotics. I will not deny that. People getting antibiotics for viral infections, people not taking antibiotics the full 7-10 days, etc. However, in the article you mentioned, if you will look at the original study you will see that the children treated with antibiotics had a faster resolution of symptoms, fewer doses of pain medication, and a higher rate of normal tympanic membranes and tympanograms during the study. Also, 34% of the wait and see group ended up being placed on antibiotic therapy anyway.

It's really a trade off. The final results seem to be the same. However, as someone that had severe earaches as a child and remembers the pain well, if my child had an ear infection, I would give them antibiotics if they were prescribed. I'd also feel really guilty if I followed the wait and see plan only to have my child go through several days of feeling horrible with no improvement and then require antibiotic therapy. I'd rather cut to the chase, get my child on antibiotics, and have the symptoms resolved faster. Some people are of the tough-it-out school of thought and others are of the please-just-get-rid-of-my-symptoms school of thought. If the end results are equal, I guess it all depends on which school of thought you fall into. When it comes to myself, I am more of a tough it out kind of person. But when it comes to my kid I'm more of a whatever works the quickest kind of person.

To the OP:
See? There will never really be total agreement on anything when it comes to parenting and everything that goes with it. And, that's actually a good thing. :)
posted by GlowWyrm at 6:47 AM on October 16

> I use Hyland's Teething Tablets for my kiddo

As mentioned above (and favorited), Highland's are sugar pills. Any improvement you see in your baby comes from distracting them with their introduction to refined sugar. And timing that to coincide with the arrival of teeth sounds cavalicious.
posted by NortonDC at 9:15 AM on October 16

My kids' pediatrician's office stresses not giving fever reducers to <4 month olds until calling them first (because a fever could signal meningitis, which can quickly become life-threatening). Not what you're asking about, but thought I'd toss it in for consideration.
posted by dreamphone at 3:59 PM on October 16 [1 favorite]