Toronto mom Armi Armesto is cautious about giving over-the-counter drugs to her baby and preschooler. “I don’t want to over-medicate,” she says. “That’s my number-one fear.” Armesto was paying attention last fall when concerns over the safety of non-prescription cough and cold medicines for children made headlines. At the time, Health Canada reported “life-threatening adverse events, including unintentional overdose” in children under the age of two who had been given these products. “I only give three-year-old Skyler something if he’s suffering and I wouldn’t give four-month-old Emma anything. She’s too young,” says Armesto.

Vancouver public health nurse Radhika Bhagat wholeheartedly agrees. “The younger they are, the more cautious we are of giving them anything other than mother’s milk or formula,” she says, pointing out that nearly all drug safety studies are done on adults, not children or infants. In fact, the Canadian Paediatric Society (CPS) recommends not giving over-the-counter drugs to children under the age of three, unless your doctor recommends it.

The only exceptions, says Dr. Michael Rieder, chair of the society’s drug therapy committee and a pediatric pharmacologist with the University of Western Ontario, are two medications used for fever and mild to moderate pain — acetaminophen and ibuprofen.

Cabinet must-haves

Pain relievers Acetaminophen is the active ingredient in various name brands, including Tylenol, Tempra and Panadol. Ibuprofen is found in Advil and Motrin. The CPS recommends parents use these drugs only for pain or fever greater than 38.5°C. If your baby is under six months, consult a doctor before trying any medication. Do not give children products with acetylsalicylic acid (such as Aspirin) as it has been associated with Reyes syndrome, a sickness that can cause brain and liver damage.

Good-to-haves

Diaper rash cream Dr. Rieder recommends a simple barrier cream such as petroleum jelly. For babies with eczema, parents can also use a cream that contains 0.5 percent hydrocortisone, a steroid hormone used to treat inflammation.

Antihistamine Dr. Rieder says if you need to use an antihistamine to ease allergy symptoms (itching), a liquid is preferable to allow for much more accurate dosing.

Antibiotic ointment These topical creams help keep minor wounds or stitches from developing infection. If your baby is allergic to any antibiotic you should avoid drugs of the same class (e.g., if she is allergic to one sulphonamide, avoid all sulphonamides). If in doubt, ask your physician or pharmacist.

Saline drops Salt-water drops help soften mucus and can be helpful for babies whose stuffy noses make feeding and breathing difficult. Use drops that contain saline only, says Dr. Leigh Anne Newhook, a pediatrician with Janeway Children’s Health and Rehabilitation Centre in St. John’s. She recommends following up with a hand-held nasal aspirator to suck out the mucus.

Electrolyte solution Dr. Newhook also recommends new parents have an oral rehydration solution on hand in case of gastroenteritis, in order to prevent dehydration due to excessive vomiting or diarrhea. The solution is a mixture of water, salts and sugar and can be bought at most drug stores.

Not necessary

Gas relievers These products, including those meant for colic, simply don’t make a difference. “Nothing works for colic,” says Dr. Rieder.”The only thing that works for colic is time.”

Teething gels If your baby is in pain because of teething, ibuprofen and acetaminophen are still your best bets. Some moms also swear by camilia drops as a homeopathic alternative.

Sharon Oosthoek is a freelance writer who vividly recalls anxious phone calls to her doctor about medicating her babies.

when your child is sick

• Read dosage recommendations carefully to make sure you are not over or under-medicating your baby.
• Do not give your baby two medications at the same time without consulting your doctor.
• Talk to your doctor before using a natural health product. Administered improperly, they can interact with other drugs, even nonprescription ones.