The medicine bottle says for children under two to consult their pediatrician…..

My son is not 2 years old yet, but he weighs 30 pounds. The medicine bottle says for children under two to consult their pediatrician. Are the medication guidelines more based on weight or my child’s age?

It seems that almost every medication on the market for children states: "Children under 2: Consult with your pediatrician." One common question I hear often is, what is the difference between the infant preparations of acetaminophen (Tylenol) and ibuprofen (Motrin and Advil) vs. the children preparations for the same medication? Is it ok to give a one year old who weighs 24 pounds the children version?

For your standard fever reducer medications, the doses are weight based, so it is ok to use the children's version for infants and toddlers under 2. One caveat I would add is that it is crucial to pay attention to the dosing recommendations for weight on the bottle. It is extremely important to not use the directions of the children's preparations for the infant medications, as that could lead to a very large medication overdose. The infants preparations are extremely concentrated, due to the fact that most small infants aren't accustomed to drinking anything other than milk.

I generally recommend switching to the "children" preparations when the child is 22 lbs (10 kg), because at that point the child can take 5 mL (or one teaspoon) of the children's ibuprofen or tylenol. Even though the dose of each medication is different, the volume of medication is the same for either medicine. In my opinion, this was genius in manufacturing, and designed to reduce medication errors.

To clarify, the appropriate dose for a 12 month, 22 lb child would be 5 mL of children's acetaminophen (160 mg) or 5 mL of children's ibuprofen (100mg). Again, it is extremely important to not use these dosing recommendations with the infant drops, because that would lead to 5 times the correct dose being given.

It is not wrong at all to use the infant drops for a 12 month, 22 lb baby - again, as long as the dosing recommendations on the bottle are followed, the child will receive the right amount of medicine. I recommend changing to the children's preparation simply because you'll get more medication for your money. Those infant drops run out fast when you need to use 2 full dropperfuls for each dose!

If this confused you even more, feel free to comment with your question and I'll reply ASAP!