health > medicine cabinet

MEDICINE CABINET

By Dr. Catherine Gant

A few simple remedies and effective medical equipment will mean that you are always prepared for minor medical problems when they arise.

Check the medicine cabinet regularly to ensure that nothing has expired.

Keep medicines in a cool, safe place out of direct sunlight and where children cannot reach them.

Remember – keep updating preventative strategies as your child grows. Can they reach that bleach cupboard now? Is the kettle lead in reach?

Make sure that you know what to do in common emergency situations. Can you save a choking child? Do you know how to treat burns? Read through our first aid section.

ESSENTIALS

Essential medicine cupboard supplies for babies and children include:

Paracetamol

Paracetamol is marketed under several different brand names but the label should tell you that it contains paracetamol and how much. The Americans call paracetamol ACETAMINOPHEN. Paracetamol has two actions: it reduces fever and is a pain reliever. It is available in many different formulations including syrups, suppositories and chewable tablets for children.

It is safe if given at the recommended doses but giving too much can cause liver damage several days later and paracetamol overdose is one of the reasons people need liver transplants. This is why paracetamol is now sold in small packs, bottles and sachets to try and reduce the risk of accidental or deliberate overdose.

Because of this it is very important not to exceed the stated dose and to take medical advice before giving it to children under six months of age, babies who have been premature or babies who are small for their age. For young children and babies a medicine dropper (like a syringe without a needle) may be more accurate than a spoon to measure small volumes of syrup. Also be aware that different brands and different formulations of the same brand may contain different concentrations of paracetamol, so it is important to double check the label on the bottle before giving any to your child.

If an overdose is suspected a simple blood test can determine the level of paracetamol in the body. There are drugs that can prevent the harmful effects on the liver if they are given within the first few hours, which have some effect after that up to a day later, so always get prompt emergency medical advice if an overdose is suspected. It is also important to check the ingredients of ‘cough and cold’ remedies; these often contain paracetamol as well so giving them with paracetamol could result in the child getting a double dose of the drug.

It is a myth that paracetamol makes a child sleepy. The sugar in the syrups can have the effect of reducing pain in babies and may calm them, and the effect of paracetamol in reducing pain and fever may make a fractious, ill child calm enough to sleep. Paracetamol is commonly given for earache, viral infections with fever, sore throats and minor injuries. As a general rule you shouldn’t use paracetamol for more than 24 hours without seeking medical advice. Always read the label and all the enclosed literature and don’t forget that fever can be a sign of meningitis.

Ibuprofen

Ibuprofen is a non-steroidal anti-inflammatory drug, one in a class of drugs often nicknamed NSAIDs. They have the painkilling and fever reducing effects similar to paracetamol, plus they also reduce swelling and inflammation. They are therefore particularly good for pain from swelling (e.g. trauma) or ear inflammation causing pain. NSAIDs can irritate the lining of the stomach and should preferably be taken after food or milk. Parents of children who suffer with febrile convulsions sometimes find that the fever-reducing effects of ibuprofen are faster than paracetamol. Medical advice should be sought before using ibuprofen if your child has asthma, heart, kidney or liver problems. Like paracetamol it is available in different strengths and formulations. Always read the label and enclosed literature.

Thermometer

All parents should have a thermometer that they are happy with in their medicine cabinet. Old-fashioned mercury thermometers are accurate if used properly – the temperature should not be taken under the tongue until the child is old enough to be trusted not to bite it. Ear thermometers are accurate and quick but expensive. Rectal thermometers are accurate and quick for parents competent in using them; if your child suffers with febrile convulsions it may be worth asking your GP to show you how to take temperatures this way as it measures the child’s core (central) temperature which can be a more accurate guide to the likelihood of a fit occurring. The strips that are placed on the forehead are not as accurate as other methods but are easy to travel with and give an indication of fever.

Tweezers

All parents should have tweezers for removing splinters, stings etc.

Scissors

All medicine cabinets should contain scissors for cutting dressings to size, trimming broken nails etc. Always keep out of children’s reach.

Antiseptic

For bathing cuts and grazes and cleaning grit and dirt out of wounds. You should have some in liquid form and a cream.

Plasters

Get some in different types – the rolls that can be cut to size are often useful. Some children are allergic to certain types of plasters and if this is the case your pharmacist can recommend a hypoallergenic tape. Some parents like to have gauze and bandages as well.

Ice

Burns carry on causing tissue damage for some time after the heat source has been removed. To prevent this, keep the area cold by holding an ice pack against it or holding it under running water until the pain is gone. It is always worth keeping ice or an icepack in the freezer as immediate treatment can reduce the severity of the burn. While you are holding the ice pack against the burn you can call the doctor. Always seek medical advice immediately if the skin is broken, if the hands, face or areas around joints are affected or if the burn is anything other than very minor. Always be careful with small children or babies when you are applying ice packs not to let them get cold.

Hot and Cold Packs

These can be useful to relieve muscle aches (warm) or swelling (cool).

Bruising Remedies

Many parents use arnica cream for bruising of unbroken skin. This is not a licensed drug and you should ask advice before using it.

Wasp Sting, Bee Sting and Mosquito Bite Remedies

Many parents like to keep creams for stings. There is a special vacuum kit available for removing wasp stings.

Diarrhoea Remedies

Oral rehydration therapies are excellent for treating diarrhoea. They can be bought ready-mixed in bottles or in a powder form, which must be mixed exactly according to instructions. All parents should keep oral rehydration therapies in their cabinet.

Worm Pills

Read our section on worms. Symptoms of worm infestation, which is very common, include tummy ache and itchy bottoms or vulva particularly at night. The treatment is a pill, which is available from your pharmacist. The whole family including child carers should be treated. Each family member and child carer takes one pill and the treatment often needs to be repeated after a week, as re-infection is very common. To try and prevent re-infection, it is essential to wash hands and scrub nails after touching the anal area and before eating. The treatments are often not recommended for children less than two years of age – always check the packet and take medical advice for young children and babies with worms. Buy worm treatments when they are needed.

Head Lice Remedies

Also known as nits. Read our section on head lice for advice on diagnosis and combing eggs out of the hair. There are several different shampoos and mousses available to treat head lice; some need to be left on for up to 12 hours. Pay particular attention to the hair at the nape of the neck and around the ears. The nits (egg cases) will need to be combed out of the hair as well using a special nit comb (and lots of conditioner on wet hair). The shampoos and hair treatments are more efficient than just combing. Special combs are available that buzz when they come in contact with the eggs. (you can buy one from Wellbeing.com, the Boots online store, featured in our Retail Health section).

THINGS TO AVOID OR BE WARY OF

Aspirin

Also known as salicylic acid, aspirin is not currently recommended for routine use in children because of the risk that it may cause liver inflammation. It is another type of NSAID. Occasionally doctors may prescribe it for rheumatoid conditions and to affect blood clotting (for example in Kawasaki’s disease). It is still present in some teething gels so check the label and ask medical advice before using these.

Nipple Creams

Nipple creams for breastfeeding mothers probably do not have much effect on cracked nipples. They may contain peanut oil (often labelled as arachis oil or groundnut oil) and there is some concern that early exposure in children may lead to peanut allergy.

AND FINALLY…

Vitamins

Your doctor or paediatrician will reassure you that if your child has a healthy diet they don’t need vitamin supplements. It is much more important to make sure that your child has a balanced, healthy diet which includes enough fat to absorb the fat-soluble vitamins.

If you are worried about your child’s diet talk to a dietician before considering supplementation. Poor diet is one of the commonest preventable causes of serious disease in adult life and it is important to lay down good habits while your children are young.

Some vitamins in overdose can be very dangerous so never give more than the dose recommended on the bottle and make sure that the dose is meant for children. Don’t combine different preparations without taking medical advice as you may inadvertently give too much of one vitamin.

Keep vitamins out of reach: they often taste and look like sweets and are very tempting and dangerous for young children, particularly if they are not in childproof bottles. Breakfast cereals and other foods are often supplemented with vitamins. Mothers who are thinking of becoming pregnant or are pregnant should take folic acid at the recommended dose.