Ever wondered about the risks of self-medicating a sick child?


You’ll probably agree that there’s little worse than the hacking sound of a child’s cough or the terrifying heat of a toddler fever. Plus, coughs and fevers often come on inconveniently: late at night or when you can’t possibly get to a doctor.

In times like these, you rely on late-night pharmacies or whatever’s in your medicine cabinet. But, to medicate little ones safely, remember: kids aren’t just small adults.

Research shows that the most common over-the-counter (OTC) medicines given to children are analgesics (for pain) and antipyretics (for fever), especially paracetamol, and other cough and cold medicines. These are also the most common preparations that parents usually buy from the pharmacy and already have at home, in addition to vitamin and mineral supplements (Siponen, 2014).

Not to scare you, but if you’re using OTCs, it’s important to be aware of the risks. Here are some guidelines:

What’s the worst that can happen?

While some OTC medicines can relieve your child’s symptoms, not all products are recommended for children. For example, warns Truven Health Analytics (THA):

  • large amounts of paracetamol can cause liver damage and liver failure;
  • an overdose of cough and cold medicine can cause seizures and other life-threatening side effects;
  • an overdose of nonsteroidal anti-inflammatory drugs (NSAIDs) can cause stomach bleeding; and
  • alcohol overdose can increase the risk of liver damage and stomach bleeding.

What are the causes of over-dosage?

Here are some ways in which you could run the risk of over-dosage (THA):

  • Giving too much medicine at once;
  • Using the incorrect measuring device;
  • Giving more than one type of medicine at the same time;
  • Giving extended-release medicine too often;
  • Sharing adult medicines with children.

13 tips for safely treating kids with OTCs

  • Know how much your child weighs and carefully read all labels and inserts (WebMD). If they’re confusing, ask a pharmacist for the important points.
  • Be clear on how much to give and how often.
  • Ideally, use the cup, syringe, spoon, or dropper that comes with the medicine. If there isn’t one, ask your pharmacist for one (THA, 2016).
  • Be aware that different medicines may contain the same active ingredient. Because this is what makes the medicine work, it’s always listed at the top of the insert. A medicine for a cold and one for a headache could contain the same active ingredient, so if you’re treating a cold and a headache with two medicines, you could be giving twice the normal dose (USFDA).
  • Don’t give aspirin to children under 12, because of the risk of developing Reyes Syndrome – a rare but serious condition that causes swelling in the liver and brain.
  • Remember that, because the effects of extended-release medicine last longer than regular medicine, it doesn’t need to be given as frequently (THA).
  • Be aware that medicine comes in different forms. There are often different preparations for children, and adult medicines should never be shared.
  • Keep all medicine in its original package and container (WebMD).
  • Find out what vitamins, supplements, foods, or drinks shouldn't be mixed with – or consumed around the same time as – your child's medicine.
  • Don't take your own medicine in front of kids, as they may copy what you do.
  • Never call medicine "sweeties" to get kids to take it.
  • Teach your child that medicine should only be given to a child by an adult.
  • Put the toll-free Poison Help number (0861-555-777) into your phone. You can also put it on your fridge and next to the landline telephone, where caregivers can see it. Remember, the Poison Help Line is not just for emergencies; you can also call with questions about how to take medicine or give medicine to children.

Is medication always the answer?

Not every situation warrants a visit to the doctor; for instance, your child may experience a symptom that’s unpleasant but doesn’t require a day off school. In that case, your pharmacist is always available to answer questions and to help you to appropriately and responsibly self-medicate.

From a psychological point of view, two health researchers, Doctors Jensen and Zeltzer (Jegtvig), are concerned that excessive use of OTC medications can train children to believe that's the only way to deal with health symptoms.

"Parents need to be aware that if they give medication every time their child complains about a symptom, their child will learn that the only way to get relief is through medications," says Zeltzer. She adds, “If children feel there are no other alternatives when they don't feel well, they won't learn self-management skills.”

In some cases, experts suggest that bed rest, drinking water, staying indoors or ignoring the symptom may be as effective (Jegtvig). But ultimately the ‘best’ method of treating a sick child depends on you, the child’s parent or caregiver, so follow your intuition and get professional advice if and when you need it.


Jegtvig, S. Self-medicating moms more likely to give kids pain meds, Reuter Health 2014. Accessed 8 March 2017.
Siponen, S. Children’s Health, Self-Care and the Use of Self-Medication: A Population-Based Study in Finland, University of Eastern Finland 2014. Accessed 8 March 2017.
Truven Health Analytics (THA), Nonprescription Medication Overdose In Children, drugs.com, 2016. Accessed 8 March 2017.
U.S. Food and Drug Administration (USFDA), Medicines, Children, and the Care Every Child Deserves, 2013. Accessed 8 March 2017
WebMD. Children’s Health: Giving Over-the-Counter Medicines to Children. Accessed 8 March 2017.

Supplied by Bespoke Communications on behalf of The Self-Medication Manufacturers Association of South Africa (SMASA).

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