Wednesday, January 10, 2018

Baby's Medicine Cabinet

Hi! This post has been in the works for a while... I want to share information, but I also don't want to seem like my way is the best or the only way, as it is not! Many new parents are unsure what to do when baby gets sick. I'd encourage every parent to always consult your pediatrician! If you  have a question, call the office and a nurse should call you back and answer any questions you have. But I hope this post is helpful and perhaps makes the new parent a little more confident!

This post is going to talk about what I do with my kids. As a nurse, I lean toward traditional medical remedies but I also medicate my children as little as possible. 

Read on for my tips about handling common baby/toddler illnesses!

***The post below is not intended to diagnose or treat your child. If you have any questions about your child's health condition, always contact your pediatrician or other qualified healthcare professional.*** 


The most common causes of fevers in babies are vaccinations (24-72 hours after receiving shots) and ear infections. Less common causes include respiratory infections, urinary tract infections, and stomach viruses.

My kids tend to develop fevers exactly 24 hours after receiving immunizations. I'm not going to talk about vaccines here...I immunize my children on my own alternate schedule (which my pediatrician approved). If you are interested in a post, please comment and let me know.

Checking Baby's Temperature - I recommend a rectal thermometer. There are a lot of temperature gadgets on the market. I know parents who have the skin thermometers and they tell me they get a different reading every time, but technology is always improving. Ear thermometers are not recommend for use on babies because their ear canals are too small. An axillary (armpit) temperature can be taken with a regular digital thermometer, but you must add one degree to the reading to get baby's true temperature and you have to make sure you get the thermometer up in the armpit and hold the arm down snug over it. These methods can be used, but if baby feels hot to you and you are getting a normal or low temperature reading, a rectal temperature is the sure way to assess baby's true temperature.

I like Vick's Baby Rectal Thermometer. As a nurse, I'm comfortable using any regular thermometer to take a rectal temperature, but this one has some perks. Foremost, I like it because it is a weird shape which means I will never confuse it with my other thermometers and pop it into my kid's mouth some day! (You should always wash your thermometer after use.) I think for the new parent who is not used to taking rectal temps, this thermometer is reassuring because the shape prevents you from inserting it too far. To take a rectal temp, hold up baby's legs like you are wiping their butt and insert the tip of the thermometer not more than an inch. You can put a little vaseline on the tip of the thermometer, but it should slide in easily without any lube and baby will not mind.

What I do with my kids... I am comfortable treating a fever up to 102.9 degrees at home. If my baby had a fever higher than 103 degrees with an unknown cause, I would medicate him (Acetaminophen or Ibuprofen depending on age) and take him to an urgent care or emergency department. I would also contact my pediatrician for recurring fevers lasting longer than 24 hours.

Medication Tip: Milligram = mg and Milliliter = ml. Liquid medications are sold as milligrams per milliliter (mg/ml).

Acetaminophen (Tylenol)

Acetaminophen is the only fever-reducing drug recommended for birth to six months of age. It is dosed based on baby's weight. Here is a Fabulous Chart from Baby Center.

There used to be this wonderful product called Infant Tylenol. The dosage was 80 mg per 0.8 ml. It came with a dropper. I administered this to many a baby over my years as a nurse. Imagine my surprise when I bought Infant Tylenol as a new mom and discovered the dose is now 80 mg per 2.5 ml. There is a big difference in trying to get a baby to swallow 0.8 ml and trying to get a baby to swallow 2.5 ml. Alas, that is the current dosage and it is unlikely to change.

TIP - The thing to realize is that Infant Tylenol and Children's Tylenol are now the exact same product. The only difference is that Infant Tylenol comes with a marked oral syringe while Children's comes with a cup. So if you need/want the syringe, spring for the Infant version. But once you have the syringe you can buy the Children's version which comes in a larger quantity for a better price. 

Acetaminophen can be given every 4-6 hours, not to exceed 5 doses per day.

My preferred way of giving Acetaminophen to a baby is by suppository. The brand FeverAll makes 80 mg suppositories. I have found them on Amazon, at my local CVS, and at the pharmacy in the building where my pediatrician's office is located. To insert the suppository, hold up baby's legs like you are wiping their butt, push the suppository in gently, hold their butt cheeks together for 10-20 seconds, and fasten up the diaper. Only insert the tip of your finger to push it in, not past your first knuckle. You can put a little vaseline on the tip of the suppository, but it should slide in easily without any lube and really (I promise!) baby will not mind.

What I do with my kids... For a 40 mg dose, I would simply cut the suppository in half with a pair of scissors. It's not an exact dose, but then neither is measuring out the liquid (make sure to shake liquid bottles very well!) and it's what nurses do in clinical practice. 

Ibuprofen (Advil or Motrin)

After six months of age, ibuprofen can be used. Infant's Advil/Motrin are is still on the market and are 50 mg per 1.25 ml (compared to Children's Advil/Motrin which are 100 mg per 5 ml). I actually still give my toddler the infant stuff because I have bottles on hand and it is less to swallow. Ibuprofen can be given every 6-8 hours.

What I do with my kids... I prefer ibuprofen to tylenol to treat fever after immunizations. There is also a soreness component with immunizations (their little legs hurt!) and ibuprofen has anti-inflammatory properties which are more efficient in treating muscle soreness than acetaminophen.

For recurring fevers of a known origin (such as Hand, Foot, and Mouth Disease in a toddler), I would alternate Tylenol and Ibuprofen every 3-4 hours which will provide optimal fever control. 

Cold, Cough, and Runny Nose

Infants typically do not develop a fever with cold symptoms. If baby has a fever, consider other sources such as an ear infection (which can commonly accompany a cold) or an upper respiratory infection such as pneumonia and seek out the advice of your pediatrician.

Easy home remedies I use with my kids:

Saline Spray - I like Little Remedies for baby and Boogie Mist for toddler.

Saline Wipes - My toddler likes Boogie Wipes which gently remove crusties from around the nose.

Snot Sucker - a bulb syringe (the hospital should send you home with one) or the NoseFrida. If your baby hates having their nose sucked out, try swaddling their arms down. My first hated it, but my second baby actually laughed afterwards!

Warm Bath - a warm bath will loosen mucous. Wipe baby's face with a warm washcloth too. It can be especially efficient to give a warm bath, use saline spray, and then suck out baby's nose.

Cool Mist Humidifier - We have Vicks. I used this a lot during my first son's first cold which he had during the summer. I found it made his room a little cool. 

Chest Rub - I like Honest Company Breathe Easy, the scent is not overpowering.

Moisturize - I apply just a tiny amount of Aquaphor around the base of baby's nose (not in the nose!). It prevents chapping and helps keep the skin moist and in good condition.

Here is a pic from each of my boys' first colds...

Stomach Bugs

I blogged about Henry's first bout of viral gastroenteritis (stomach bug/flu) in my very first Five on Friday post. Henry was 20 months old and I was 37 weeks pregnant with Lucas. We were so fortunate that his first stomach bug wasn't when he was younger. I would definitely seek advice from your pediatrician if baby is less than 6 months or if 6-12 months with vomiting over 12 hours. You want to continue breast/bottle feedings and watch closely for dehydration. The first sign of dehydration is no wet diapers. Later signs are dry mucous membranes (lips and tongue), no tears while crying, and lethargy - in which case you should get medical advice ASAP. 

Fevers with vomiting are also tricky because oral medications are typically not tolerated. Fever is a less common side effect of a short-term stomach bug. In general, the more symptoms your child has, the more concerned you should be. Vomiting alone and diarrhea alone are challenging but vomiting + diarrhea + fever is a triple threat and I would definitely consult with my pediatrician.

But for the toddler with sudden onset of vomiting or diarrhea, stomach viruses are more about just letting the bug run it's course. Henry started vomiting at night, so we weren't trying to push fluids on him. He finally slept in our bed, with a towel under him, after he stopped dry heaving, poor baby! Once your child has vomited, keep a stack of towels and a basin close at hand to catch future messes. If no vomiting for 4-6 hours, you can introduce fluids. Water is best, but if vomiting continues my choice is unflavored/uncolored Pedialyte. Offer small sips over several hours and if tolerated you can start some food. If vomiting reoccurs, wait 4-6 hours and start again with sips of liquids. For first foods, applesauce and toast or crackers are easy choices. White rice cooked in low-sodium chicken broth until it is very well done (just add extra broth and allow it to simmer longer than the package recommends) is also easy to digest and adds a boost of nutrition.

There is a lot of differing advice online and in baby books about timing and when to re-start fluids and food and what to feed. Let your child be your guide! Watch them closely! Are they behaving normally? Do they want to play, are they having wet diapers, etc...? And, of course, call your pediatrician's office with any questions!

Also, don't forget to take care of yourself and other family members! Wash your hands frequently, avoid touching your own face, and isolate the sick child from other children. 


It's easy for me to say because Henry never fussed about teething and Lucas only currently has 2 teeth...but I don't recommend any over the counter teething remedies. Chilling a silicone teether or wet washcloth for baby to chew on can provide some natural relief. 

But - Tylenol or ibuprofen for baby over six months can provide some pain relief. Orajel (benzocaine) is a reasonably safe topical which has been on the market for years, but also contains "filler" ingredients such as artificial color. Many of the homeopathic "natural" remedies contain unregulated and little tested ingredients such as Belladonna. Read ingredient labels carefully and check with your pediatrician. Just because something is marketed and sold, does not mean it is safe for your baby. 


Most gas pains, especially in a young baby under 3 months, are simply baby getting used to their digestive system. Sometime around 4 weeks, baby starts grunting and wiggling around and just generally seems displeased with their digestion. These pains will usually resolve themselves. If you are breastfeeding, it's unlikely that your diet is the cause. But formula intolerance (usually diary) can cause gas pains and should be discussed with your pediatrician. Bottle feeding in an upright position and burping often can help.

Many babies, especially babies under 3 months, are fussy. Check out my post on Witching Hour Madness. The first 3 months with baby tends to be the most difficult and fussiest time. Try soothing measures: walking and rocking, position changes, bicycling their legs (gently), gentle massage, or a warm bath. 

True colic is relatively rare and is identified by continuous, excessive crying unresponsive to soothing measures for more than 3 hours a day and more than 3 days a week. Colic is technically not gas, but can be worsened by gas pains. 

The pharmacy product for gas is simethicone (Mylicon) which is available over the counter. There are "natural" herbal products on the market, such as Gripe Water, but again, read labels carefully and discuss with your pediatrician.

Skin Issues

I hate to do this to you ;-)... But check out my post on Baby Skin Problems. It talks about all my recommended home remedies and seeking advice from your pediatrician.

I think that wraps up the most common health problems and I hope you found this post helpful! The above comments are not meant to be a comprehensive review of any of these common baby/toddler health issues. 

Some great resources include:

I love comments, please comment! 

If you find anything in this post to be incorrect, please let me know. I strive to make sure the info I present is accurate.


  1. This is AWESOME! We were super lucky in that my son only had one super minor cold his first year, but he just got his first ear infection this week and it was the worst! He just started Montessori School a few hours a day and I know he'll probably get sick more now,so I'll definitely refer to this post!

    1. Sounds like he has been doing great! I just really hope to delay the never-ending cold I know some kids experience until after breastfeeding is over! I felt so bad for Lucas when he had a little stuffy nose and was trying to breastfeed. I'm sure the perks of fun in your son's school class will outweigh any cold symptoms...but maybe not stomach virus symptoms LOL, vomiting is the worst ;-)