Welcome to pediatric OTC recommendations, this section is intended for children up to 12 years old and does not replace any recommendation made by your child's health care provider. Click on specific section to get more information and age appropriate recommendations from newborn to 12 years old. If you do not see what you are looking for, please call your child's health care provider for a recommendation or ask us!
Click here to see common over-the-counter medications for children
If you think your child has been exposed to or ingested a medication or other chemical call poison control at 1-800-222-1222
Cough and Cold
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
Home Remedies for cough and cold
A good home remedy is safe, inexpensive, and as beneficial as OTC medicines. They are also found in nearly every home.
Here is how you can treat your child’s symptoms with simple but effective home remedies instead of medicines:
Runny Nose: Just suction or blow it. And remember, when your child’s nose runs like a faucet, it’s getting rid of viruses. Antihistamines (eg, loratadine, cetirizine, fexofenadine) do not help the average cold. However, they are useful and approved if the runny nose is caused by nasal allergies (hay fever). See allergy section below.
Blocked Nose (congestion): Use nasal washes.
Use saline nose spray or drops to loosen up dried mucus, followed by blowing or suctioning the nose.
Instill 2 to 3 drops in each nostril. Do one side at a time. Then suction or blow. Teens can just splash warm water into their nose. Repeat nasal washes until the return is clear.
Do nasal washes whenever your child can’t breathe through the nose. For infants on a bottle or breast, use nose drops before feedings.
Saline nose drops and sprays are available in all pharmacies without a prescription.
Sticky, Stubborn Mucus: Remove with a wet cotton swab.
Medicines: There is no medicine that can remove dried mucus from the nose.
Coughing: Use homemade cough medicines.
For Children 3 Months to 1 Year of Age: Give warm, clear fluids (eg, warm water, apple juice). Dosage is 5 to 15 mL 4 times per day when coughing. Avoid honey because it can cause infantile botulism. If your child is younger than 3 months, see your child’s doctor.
For Children 1 Year and Older: Use HONEY, 2 to 5 mL, as needed. It thins secretions and loosens the cough. (If honey is not available, you can use corn syrup.) Recent research has shown that honey is better than drugstore cough syrups at reducing the frequency and severity of nighttime coughing.
Coughing Spasms: Expose your child to warm mist from a shower.
Fluids: Help your child drink plenty of fluids. Staying well hydrated thins the body’s secretions, making it easier to cough and blow the nose.
Humidity: If the air in your home is dry, use a humidifier. Moist air keeps nasal mucus from drying up and lubricates the airway. Running a warm shower for a while can also help humidify the air.
Treatment Is Not Always Needed
If symptoms aren’t bothering your child, they don’t need medicine or home remedies. Many children with a cough or nasal congestion are happy, play normally, and sleep peacefully.
Only treat symptoms if they cause discomfort, interrupt sleep, or really bother your child (eg, a hacking cough).
Because fevers are beneficial, only treat them if they slow your child down or cause some discomfort. That doesn’t usually occur until your child’s temperature reaches 102°F (39°C) or higher.
If treatment is needed for coughs and colds, home remedies listed above may work better than OTC medications.
Newborn to 4 years old:
1) Saline nasal spray or drops (great for congestion in ALL ages and use prior to Nose Frida or bulb nasal suction administration)
2) Nose Frida or Bulb Nasal Suction
3) Cool Mist Humidifier at bedtime
1 year old to 4 years old:
1) Honey cough syrup: 5mL every 2 to 4 hours
2) Plus the products listed for newborn to 4 yo.
2 years old to < 6 years old:
1) Phenylephrine nasal drops for nasal congestion: 0.125% solution 2 to 3 drops in each nostril no more than every 4 hours for a maximum of 3 days.
2) Brompheniramine and phenylephrine liquid for sinus congestion/cold symptoms (1mg brompheniramine and 2.5mg of phenylephrine per 5mL: Give 5mL by mouth every 4 hours as needed (max: 30mL in 24 hours)
3) Plus any of the products listed from newborn to 4 years old.
4 years old to 6 years old:
1) Mucinex liquid or Robitussin for cough (Guaifenesin; expectorant): 50-100mg every 4 hours as needed; Maximum of 600mg in 24 hours)
2) Delsym cough suppressant: 2.5-7.5mg every 4 to 8 hours; extended release is 15mg by mouth twice daily (Max: 30mg in 24 hours)
3) Plus products listed above
6 years old to <12 years old: (or any of the products listed above)
1) Mucinex or robitussin liquid for cough (Guaifenesin; expectorant): 100-200mg every 4 hours as needed; Maximum: 1,200mg in 24 hours)
2) Delsym cough suppressant: 5 to 10mg every 4 hours or 15mg every 6 to 8 hours; extended release is 30mg by mouth twice daily (Max: 60mg in 24 hours)
3) Phenylephrine nasal spray for nasal congestion: 0.25% solution 2 to 3 sprays in each nostril no more than every 4 hours for a maximum of 3 days.
4) Brompheniramine and phenylephrine liquid for sinus congestion/cold symptoms (1mg brompheniramine and 2.5mg of phenylephrine per 5mL: Give 10mL by mouth every 4 hours (max: 60mL in 24 hours)
Click here to find out what causes allergies and asthma in children
Click here to find out detailed information about allergy medications for children
Minor allergic reaction
6 years old to <12 years old:
1) Benadryl 12.5-25mg by mouth every 4 to 6 hours; max of 150mg in 24 hours
2) Topical Benadryl (2 years old and older) to skin reactions
3) Calamine lotion (2 years old and older) for poison ivy/oak
4) Poison Ivy cream and Wash (2 years old and older)
(Runny nose, sneezing, watery eyes)
Newborn to 6 months old or older:
1) Cool mist humidifier
2) Nose Frida
6 months to <12 months old:
1) Zyrtec (1mg/1ml syrup) 2.5mg (2.5ml) once daily
12 months to <2 years old:
1) Zyrtec (1mg/1ml syrup): 2.5mg (2.5ml) once daily, may increase to 2.5mg (2.5ml) twice daily OR 5mg (5ml) once daily
2 years old to 5 years old:
1) Zyrtec: Initial: 2.5mg (2.5ml) once daily, may increase to 2.5mg (2.5ml) twice daily OR 5mg (5ml) once daily
2) Claritin: 5mg by mouth once daily
3) Allegra: Suspension 30mg by mouth every 12 hours; max of 60mg (can be used in up to 11 years old)
4) Cromolyn: Nasal spray- 1 spray in each nostril 3 to 4 times daily (2 years old and older; adult dosing)
6 years old to <12 years old:
1) Zyrtec: Refer to adult dosing; 5mg to 10mg by mouth once daily (max 10mg per day)
2) Claritin: Refer to adult dosing; 10mg by mouth once daily OR 5mg by mouth twice daily (RediTabs)
3) Allegra: Oral disintegrating tablet: 30mg by mouth every 12 hours (max of 60mg per day) NOT adult dosing
4) Benadryl (immediate relief) 12.5-25mg by mouth every 4 to 6 hours; Max of 150mg in 24 hours (also for runny nose and sneezing due to common cold)
Pain and Fever
Find out how to properly check your child's temperature (remember if less than 3 years old; rectal is the most accurate)
Fever: Information for Parents
The most important things you can do when your child has a fever are to improve your child’s comfort by making sure they drink enough fluids to stay hydrated and monitor for signs and symptoms of a serious illness. It is a good sign if your child plays and interacts with you after receiving medicine for discomfort.
Call your child’s doctor right away if your child has a fever and
Looks very ill, is unusually drowsy, or is very fussy
Has been in a very hot place, such as an overheated car
Has immune system problems, such as sickle cell disease or cancer, or is taking steroids
Has had a seizure
Is younger than 3 months (12 weeks) and has a temperature of 100.4°F (38.0°C) or higher
Fever rises above 104°F (40°C) repeatedly for a child of any age
Also call your child’s doctor if
Your child still “acts sick” once his fever is brought down.
Your child seems to be getting worse.
The fever persists for more than 24 hours in a child younger than 2 years.
The fever persists for more than 3 days (72 hours) in a child 2 years of age or older.
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.
Newborn to 6 months old:
1) Acetaminophen (infant drops)
6 months old to <12 years old:
2) Ibuprofen Infant formulation (6 months to 23 months old), children's liquid (2 years old to 11 years old) and chewable tablets (6 years old to 11 years old) Recommended over acetaminophen for teething pain because it has anti-inflammatory properties and longer duration of action
Watch for signs of dehydration which occur when a child loses too much fluid and becomes dried out. Symptoms of dehydration include a decrease in urination, no tears when baby cries, high fever, dry mouth, weight loss, extreme thirst, listlessness, and sunken eyes.
Keep your pediatrician informed if there is any significant change in how your child is behaving.
Report to pediatrician if your child has blood in his stool.
Report to pediatrician if your child develops a high fever (more than 102°F or 39°C).
Continue to feed your child if she is not vomiting. You may have to give your child smaller amounts of food than normal or give your child foods that do not further upset his or her stomach.
Use diarrhea replacement fluids that are specifically made for diarrhea if your child is thirsty.
Try to make special salt and fluid combinations at home unless your pediatrician instructs you and you have the proper instruments.
Prevent the child from eating if she is hungry.
Use boiled milk or other salty broth and soups.
Use "anti-diarrhea" medicines unless prescribed by your pediatrician.
1) Pedialyte (electrolyte replacement)
2) Loperamide ( only as directed by physician)
In some cases, your child's doctor may prescribe medicine to soften or remove the stool. Never give your child laxatives or enemas unless your child's doctor says it's OK; laxatives can be dangerous to children, if not used properly. After the stool is removed, your child's doctor may suggest ways you can help your child develop good bowel habits to prevent stools from backing up again.
OTC Options your child's doctor may recommend:
1) Glycerin suppository (2 years old to < 6 years old: One suppository once daily as needed or as directed by physician)
2) Colace (as directed by physician)
3) Miralax (as directed by physician)
4) Metamucil (as directed by physician)
Because each child's bowel patterns are different, become familiar with your child's normal bowel patterns. Make note of the usual size and consistency of her stools. This will help you and your child's doctor determine when constipation occurs and how best to treat it. If your child doesn't have normal bowel movements every few days or is uncomfortable when stools are passed, she may need help in developing proper bowel habits.
Encourage your child to drink plenty of water and eat higher-fiber foods.
Help your child set up a regular toileting routine.
Encourage your child to be physically active. Exercise along with a balanced diet provides the foundation for a healthy, active life.
Getting enough fiber in your diet
The AAP recommends that people between the ages of 2 and 19 years eat a daily amount of fiber that equals their age plus 5 grams of fiber. For example, 7 grams of fiber are recommended if your child is 2 years of age (2 plus 5 grams).
When to Call the Pediatrician:
If your child can’t retain any clear liquids or if the symptoms become more severe, notify your pediatrician. She will examine your child and may order blood and urine tests or X-rays to make a diagnosis. Occasionally hospital care may be necessary.
Until your child feels better, remember to keep your child hydrated, and call your pediatrician right away if your child shows signs of dehydration. If your child looks sick, the symptoms aren’t improving with time, or your pediatrician suspects a bacterial infection, he may perform a culture of the stool, and treat appropriately.
1) Emetrol 2 years old to 12 years old: 5-10mL every 15 minutes until distress subsides (do NOT take for more than 1 hour; 5 doses)
Note: This section is for skin conditions that can be treated with an OTC, please check out Common Skin conditions in children to read about many other skin conditions and treatment.
If a diaper rash develops in spite of your efforts, begin using an oil-based barrier (ointment) to prevent further irritation from the urine or stool. The rash should improve noticeably within forty-eight to seventy-two hours. If it doesn’t, consult your pediatrician.
1) Zinc oxide
2) Petrolatum jelly
Eczema is the most common skin condition among children
How to Prevent Flare-Ups of Eczema:
One of the most helpful things you can do is to prevent flare-ups before they happen.
Keep your child's skin moisturized. Moisturizing should be a part of your child's daily treatment plan.
Use fragrance-free moisturizers. Cream or ointment is more moisturizing than lotion.
After a bath, gently pat the skin with a towel and then apply moisturizer to the damp skin.
Apply moisturizer at least once a day or more often if needed. Moisturizer should be applied to the face and entire body.
Avoid irritants. People who are sensitive to scratchy fabrics or chemicals in soaps and detergents should
Wear soft fabrics such as 100% cotton clothing.
Use mild, fragrance-free body cleansers.
Take short baths with room temperature water.
Use mild laundry detergent with no dyes or perfumes.
Skip using fabric softener in the dryer.
Remind your child not to scratch. Scratching can make the rash worse and lead to infection. Also, the more your child scratches, the more itchy the area will be. Keep your child's fingernails short and smooth, and try to distract your child from scratching.
Ask your child's doctor if allergies could be a cause of the eczema. Sometimes allergies, such as ones to food, pets, pollens, or dust mites (in bedding), can trigger the rash or make it worse. If your child's eczema is caused by an allergy, avoid the trigger, if possible.
Ask your child's doctor about other things that can trigger a flare-up. These things include overheating or sweating and stress.
Your child's doctor may recommend medicines to help your child feel better and to keep the symptoms of eczema under control. The type of medicine recommended will depend on how severe the eczema is and where it appears on the body. Eczema medicine can be given in 2 ways:
Applied to the skin (topical)—Available as creams or ointments.
Taken by mouth (oral)—Available in pill or liquid form.
Before you give your child any medicines, be sure you know how to give them. Talk with your child's doctor if you have questions or concerns about giving your child medicines.
NOTE: Eczema is a chronic skin problem, so it can come and go. It requires ongoing management by you, your child, and your child's doctor. If your child's eczema is not improving, talk with your child's doctor about your concerns.
Over-the-Counter Medication Options for Eczema and Dry Skin
1) Topical steroids (hydrocortisone creams or ointments)—May help relieve itchy skin and decrease inflammation. They work best for mild eczema.
2) Steroid-free topical itch relief (diphenhydramine)—May give fast relief of dry, itchy skin with few side effects. Some of these medicines contain alcohol, which can cause a burning sensation.
3) Mild laundry detergent
4) Mild soap for bath time
5) Skin Moisturizers with colloidal oatmeal or dimethicone
If your child has a scaly round patch on the side of his scalp or elsewhere on his skin, and he seems to be losing hair in the same area of the scalp, the problem may be a contagious infection known as ringworm or tinea.
This disorder is caused not by worms but by a fungus. It’s called ringworm because the infections tend to form round or oval spots that, as they grow, become smooth in the center but keep an active red scaly border.
All indicated for 2 years old and older:
1) Miconazole apply twice daily for 2 weeks
2) Clotrimazole apply twice daily for 4 weeks
3) Tolnaftate apply twice daily for 4 weeks
Warts are tiny, firm bumps on the skin caused by viruses from the human papillomavirus (HPV) family. Warts are contagious and commonly found in school-aged children. They rarely occur in children younger than 2 years. Treatment can take up to 12 weeks.
Infants to 2 years old:
1) Training toothbrush
2) Training toothpaste (non-fluorinated)
2 years old and older:
2) Electronic toothbrush
3) Toothpaste (fluoride)
Stings, Bites and Allergies
Stinging Insects: Remove the stinger as soon as possible with a scraping motion using a firm item (such as the edge of a credit card). Put a cold compress on the bite to relieve the pain. If trouble breathing; fainting; swelling of lips, face, or throat; or hives over the entire body occurs, call 911 or your local emergency number right away. For hives in a small area, nausea, or vomiting, call the pediatrician. For spider bites, call the pediatrician or Poison Help (1-800-222-1222). Have the pediatrician check any bites that become red, warm, swollen, or painful.
Animal or Human Bites: Wash the wound well with soap and water. Call the pediatrician. The child may need a tetanus or rabies shot or antibiotics.
Ticks: Use tweezers or your fingers to grasp as close as possible to the head of the tick and briskly pull the tick away from where it is attached. Call the pediatrician if the child develops symptoms such as a rash or fever.
Snake Bites: Take the child to an emergency department if you are unsure of the type of snake or if you are concerned that the snake may be poisonous. Keep the child at rest. Do not apply ice. Loosely splint the injured area and keep it at rest, positioned at or slightly below the level of the heart. Identify the snake if you can do so safely. If you are not able to identify the snake but are able to kill it safely, take it with you to the emergency department for identification.
Allergy: Swelling, problems breathing, and paleness may be signs of severe allergy. Call 911 or your local emergency number right away. Some people may have emergency medicine for these times. If possible, ask about emergency medicine they may have and help them administer it if necessary.
Skin Cuts and scrapes
Make sure the child is up to date for tetanus vaccination. Any open wound may need a tetanus booster even when the child is currently immunized. If the child has an open wound, ask the pediatrician if the child needs a tetanus booster.
Bruises: Apply cool compresses. Call the pediatrician if the child has a crush injury, large bruises, continued pain, or swelling. The pediatrician may recommend acetaminophen for pain.
Cuts: Rinse small cuts with water until clean. Use direct pressure with a clean cloth to stop bleeding and hold in place for 1 to 2 minutes. If the cut is not deep, apply an antibiotic ointment; then cover the cut with a clean bandage. Call the pediatrician or seek emergency care for large or deep cuts, or if the wound is wide open. For major bleeding, call for help (911 or your local emergency number). Continue direct pressure with a clean cloth until help arrives.
Scrapes: Rinse with clean, running tap water for at least 5 minutes to remove dirt and germs. Do not use detergents, alcohol, or peroxide. Apply an antibiotic ointment and a bandage that will not stick to the wound.
Splinters: Remove small splinters with tweezers; then wash until clean. If you cannot remove the splinter completely, call the pediatrician.
Puncture Wounds: Do not remove large objects (such as a knife or stick) from a wound. Call for help (911 or your local emergency number). Such objects must be removed by a doctor. Call the pediatrician for all puncture wounds. The child may need a tetanus booster.
Bleeding: Apply pressure with gauze over the bleeding area for 1 to 2 minutes. If still bleeding, add more gauze and apply pressure for another 5 minutes. You can also wrap an elastic bandage firmly over gauze and apply pressure. If bleeding continues, call for help (911 or your local emergency number).
1) Antibiotic Ointment
3) Gauze Pads
4) First Aid Kits
Most small, blistering burns can treated and cared for at home. If you have any questions about whether a burn can be taken care of at home, discuss with your doctor.
Here's what to do:
Cool the burn. Run cool running water over the burn for about five minutes. This helps stop the burning process and decreases pain and swelling. Do not put ice on a burn. Do not rub a burn, because this can worsen the injury. Do not break blisters as this can increase the risk of infection at the burn site.
Cover the burn. Cover the burned area with a clean bandage that will not stick to the burned site. This helps decrease the risk of infection and decreases pain.
Protect the burn. Keep the burn site clean with gentle washing with soap and water. Do not apply any ointments to the burn site unless instructed by your pediatrician. Never apply butter, greases, or other home remedies to a burn before discussing with your pediatrician, as these can increase the risk of infection as well.
Simple Rules to Protect your Family from Sunburns
Keep babies younger than 6 months out of direct sunlight. Find shade under a tree, an umbrella, or the stroller canopy.
When possible, dress yourself and your children in cool, comfortable clothing that covers the body, such as lightweight cotton pants, long-sleeved shirts, and hats.
Select clothes made with a tight weave; they protect better than clothes with a looser weave. If you're not sure how tight a fabric's weave is, hold it up to see how much light shines through. The less light, the better. Or you can look for protective clothing labeled with an Ultraviolet Protection Factor (UPF).
Wear a hat with an all-around 3-inch brim to shield the face, ears, and back of the neck.
Limit your sun exposure between 10:00 am and 4:00 pm when UV rays are strongest.
Wear sunglasses with at least 99% UV protection. Look for child-sized sunglasses with UV protection for your child.
Make sure everyone in your family knows how to protect his or her skin and eyes. Remember to set a good example by practicing sun safety yourself.
Sunscreen can help protect the skin from sunburn and some skin cancers but only if used correctly. Keep in mind that sunscreen should be used for sun protection, not as a reason to stay in the sun longer.
How to Pick Sunscreen
Use a sunscreen that says "broad-spectrum" on the label; that means it will screen out both UVB and UVA rays.
Use a broad-spectrum sunscreen with a sun protection factor (SPF) of at least 15 (up to SPF 50). An SPF of 15 or 30 should be fine for most people. More research studies are needed to test if sunscreen with more than SPF 50 offers any extra protection.
If possible, avoid the sunscreen ingredient oxybenzone because of concerns about mild hormonal properties. Remember, though, that it's important to take steps to prevent sunburn, so using any sunscreen is better than not using sunscreen at all.
For sensitive areas of the body, such as the nose, cheeks, tops of the ears, and shoulders, choose a sunscreen with zinc oxide or titanium dioxide. These products may stay visible on the skin even after you rub them in, and some come in fun colors that children enjoy.
How to Apply Sunscreen
Use enough sunscreen to cover all exposed areas, especially the face, nose, ears, feet, hands, and even backs of the knees. Rub it in well.
Put sunscreen on 15 to 30 minutes before going outdoors. It needs time to absorb into the skin.
Use sunscreen any time you or your child spend time outdoors. Remember that you can get sunburn even on cloudy days because up to 80% of the sun's UV rays can get through the clouds. Also, UV rays can bounce back from water, sand, snow, and concrete, so make sure you're protected.
Reapply sunscreen every 2 hours and after swimming, sweating, or drying off with a towel. Because most people use too little sunscreen, make sure to apply a generous amount.
Sunscreen for Babies
For babies younger than 6 months: Use sunscreen on small areas of the body, such as the face, if protective clothing and shade are not available.
For babies older than 6 months: Apply to all areas of the body, but be careful around the eyes. If your baby rubs sunscreen into her eyes, wipe her eyes and hands clean with a damp cloth. If the sunscreen irritates her skin, try a different brand or sunscreen with titanium dioxide or zinc oxide. If a rash develops, talk with your child's doctor.
When to Call the Doctor
If your baby is younger than 1 year and gets sunburn, call your baby's doctor right away. For older children, call your child's doctor if there is blistering, pain, or fever.
How to Soothe Sunburn
Here are 5 ways to relieve discomfort from mild sunburn:
Give your child water or 100% fruit juice to replace lost fluids.
Use cool water to help your child's skin feel better.
Give your child pain medicine to relieve painful sunburns. (For a baby 6 months or younger, give acetaminophen. For a child older than 6 months, give either acetaminophen or ibuprofen.)
Only use medicated lotions if your child's doctor says it is OK.
Keep your child out of the sun until the sunburn is fully healed.
1) Sunscreen (broad-spectrum); non-oxybenzone
Sun Burn Relief:
4) Moisturizers for dry, peeling skin
Check out these links to help with sleep from newborn to school aged children. You will also find many other relatable articles when you follow the links below.
Non-OTC Pediatric Information
For information on sprains and fractures, eye injuries, head injuries, burns and scalds, nosebleeds, tooth injuries, convulsions and seizures, poison and pediatric CPR please go here
For information on vaccinations go here
All the information in this section was composed from healthychildren.org, this site is a great tool to get information on all topics related to your child (mental health, proper eating, sleep, immunizations, diseases, congenital disorders and many many other topics)