This post is sponsored by CHOC Children’s
Navigating what medications to administer at home can be stressful. Most parents want to have their medicine cabinet stocked appropriately, but knowing the right products is not always as easy. I talked with Dr. Rei Tosu, a pediatrician from CHOC Children’s, to hear an expert opinion on what parents should have on hand in their family medicine cabinet.
My first question was about thermometers, as the technology and variety of thermometers seems to have changed so much in the past decade. I was curious if some of these new-fangled external ones actually work. Dr. Tosu believes the most reliable is the traditional old-school thermometer that can be used in the mouth, under the arm, or in the bottom, as they give the most accurate numeric read. These are especially recommended for babies that are younger than three months old when getting an accurate read is really important. “Ear thermometers are pretty good and can be a substitute to have for older kids” she says. “The other external types, like those that go on the forehead, are a little more variable. But that being said, if you have a thermometer at home that you consistently use, you can get an idea as to whether or not the temperature is elevated. As kids get older, the actual temperature becomes less important than just knowing if they have a fever or not.
I also asked about what pain relievers and fever reducers she recommends. How do we know whether to reach for Tylenol or Advil or Aspirin? Dr. Tosu says that Aspirin is never recommended in kids. She says that Tylenol (Acetaminophen) and Advil/Motrin (Ibuprofen) are both fine, but a little bit different. “Tylenol is a little bit easier on the stomach, so if your child has any stomach issues at all with an illness, I would stick with the Tylenol versus the Motrin,” she says. “If they’re sick and they’re not eating at all, and their appetite is really low, so they don’t have much in their stomach or they have a stomach virus with a fever, I would not do Ibuprofen. I’d stick with Acetaminophen. But on the other hand if it is more of an injury, joint pain, or a muscular pain things, Ibuprofen has an anti-inflammatory effect, so it takes care of the pain while it also reduces the inflammation. In this case, Ibuprofen is a much better choice than the Acetaminophen.”
Cold remedies can be really confusing for parents, because there are so many combinations, with varying ingredients. I asked Dr. Tosu what we want to reach for when our child has a common cold, and what we want to avoid. She cautioned against buying multiple medications with multiple ingredients, some of which may overlap because you could inadvertently overdose your child. “You really want to think about the symptoms they have and target it,” she said. “There are some medications that are single ingredient only, like Benadryl or Diphenhydramine. If it’s mainly a runny nose or post-nasal drip, Benadryl is a single ingredient so it just takes care of that. There are cough medicines that are single ingredient also, that’s just as a cough suppressant without any decongestants or fever reducers. Typically, the best bet is to get single ingredient cold medicines so you’re targeting the specific symptoms and you won’t end up overdosing on any single ingredients.” She also urges parents to look at all of the active ingredients in any medication to avoid doubling up. I also asked about knowing when to use a cough suppressant, and she explained that you don’t want to suppress a cough all the time. “Sometimes it’s part of an illness. If the cough is persistent, and you get no relief during the day or you can’t get to sleep at night because you’re coughing so much, those are the times you want to consider using a cough suppressant.”
Moving along to wound care, I asked Dr. Tosu her advice on what to use to clean scrapes and cuts.sheadvised that the first step is to physically clean if it’s dirty. “It could be water, it could be saline,” she said. “If you’re at the park and you don’t have access to any medications, even just water from your water bottle could work. If you have your hands on an antiseptic wash, even better.” In terms of the best ointment for wound care, Dr. Tosu recommends an antibiotic ointment for preventing an infection. “It’s probably not infected from the injury but because there’s a break in the skin, you’re more prone to getting an infection. Typically, even if you have a cut, the child is still going to be playing outside and going to school. In that case, I would put a band-aid on a wound just to avoid getting another injury and getting that already open wound dirty again. But at night, at home when they’re resting and not outside, it’s fine to keep it open.”
In regards to what to administer when our kids have diarrhea, Dr. Tosu cautions against overuse of anti-diarrheal medicines. While they stop the body from having diarrhea, you are also stopping the body from trying to get a virus out. “By trying to stop it, you’re counteracting what the body is doing. The body’s trying to go, the medicine’s trying to stop it. They’re working opposite from one each other. You don’t have to go to the bathroom as often and you won’t have as much diarrhea, but you’ll end up with more cramps.” She says to use sparingly, for example when you are in a situation where you can’t be running to the bathroom every 20 minutes. “But typically for kids, if they have significant diarrhea, they’re at home, and they have access to the bathroom, for the most part I would avoid anti-diarrhea medicines.”She does suggest probiotics as a way to help with the discomfort and healing of diarrhea.
I was curious to get her thoughts on brand names, because there are generics of just about every medication on the market. Dr. Tosu believes it does not matter… If the active ingredient is the same and the amount of active ingredient is the same, it will have the same effect.
In regards to skin issues . . . when a child has an itchy rash or itchy skin, Dr. Tosu addressed when to reach for a Benadryl cream versus a hydrocortisone cream. Dr. Tosu explained that Benadryl is an anti-histamine, which can take down the itching, whereas hydrocortisone is a steroid cream, which acts as an anti-inflammatory. They both work to decrease the itching and decrease the inflammation, but hydrocortisone would be more appropriate for eczema or other rash conditions versus Benadryl which would be better for bug bites or other irritations that are not chronic.
I inquired about the myriad of homeopathic medicines and treatments out there, and Dr. Tosu is of the opinion that some are great and some are not. “The thing with homeopathic alternative medicine is that a lot of them have not gone through studies, so it’s hard for us to say how it works and why we recommend it,” she says. “Now having said that, there are very safe things that people have used for generations that probably have some benefit and definitely don’t have adverse effects. So that is fine to use in place of or in addition to medicines. For example: using honey to suppress a cough.” In regards to essential oils, Dr. Tosu does not recommend any in particular and cautions that kids metabolize things differently. “You can’t just half a dose and give it to a child. And with essential oils, it’s relatively new, with not a lot of studies to support the use or look at the side effects, so I would be very careful.”
Her last tip for the medicine cabinet? Old school vaseline. “Petroleum based ointments, are good to have around. They are non-medicated obviously, but great for really dry skin and lips, cuts, and skin irritations.”