A Parent Playbook Resource

Live Q & A with Erika Caouette

Recorded August 12, 2021

Parent Playbook - Erika Caouette
Erika Caouette, BSc, RPh.


Erika is a pharmacist/Owner of Mortar + Pestle Compounding Pharmacy in Toronto. She is also married, and a proud mother of three very active kids. When she’s not busy meeting and counselling her patients, Erika can be found on a run, yoga mat, or ski hill!

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Full Transcript

Recorded August 12, 2021

My name’s Erica.

I am a pharmacist and co-owner of mortar and pestle compounding pharmacy in the Blore floor, west village, high park area, but we service all of the GTA with our extensive delivery network. And we’re we have a presence online. So please don’t hesitate to ask me any medication, pharmaceutical questions, but I’m also the mother of three young children.

So I’ve had my fair share of experience with dealing with medications, different remedies with my own kids. So any questions at all, don’t hesitate to ask. Thank you so much for spending the evening with us tonight. I know it’s a little bit later than usual, but just needed a bit more time to put the kids down to sleep. So I’ll let some people join.

Then if you have any questions, you can put them in the question box. I will try to get to all of them while everyone is taking a moment to join. I was actually going to speak a little bit about the, or my medicine travel kit, just because lately I’ve been getting a lot of questions at the pharmacy, from my patients and the parents around about one.

Now that we’re starting to travel it, or some are starting to travel again, what they need to bring, if they’re going overseas, are they getting on an airplane? What to bring, what to pack? If you’re heading up north to the cottage is you’re trying to enjoy the last couple of weeks of summer. What is good to bring with you?

What to have to kind of answer to any of your kids’ needs. So I think I was going to just review what I personally keep in my medicine travel kit. And then I can answer any questions as we go along. If you have any medication or kids questions, I’m happy to answer them. So if you want, if you’re just joining, if you want to just type in a little,

hello, let me know who you are. If you have any kids, what their ages are, that’ll just help me to kind of adapt what I’m saying to maybe that age category as well. So I’ll go ahead and get started with what I was going to plan. What I was planning on talking about, which is my medicine kit. First of all,

obviously since pandemic, there’s been a little bit of changes or additions to my travel kit, obviously because of COVID. We now include a couple of masks in each of our travel kits. I’ve added a lot of hand sanitizer. Of course, I use some sprays in some gels. I have also added personal hand soap. I always now travel with a small hand soap.

I’ve been caught in a couple of places where there was no more soap or the kids weren’t big enough or tall enough to reach the soaps. So now I have my own and we can kind of help them that way. And the last thing is sanitizing wipes. Most of you, if, if you have, you know, small children, you might still have the baby wipes I’m out of the diaper baby phase.

And so sanitizing wipes is what I’ve added to my travel kit. Since COVID obviously it’s, I use it to sanitize surfaces, but also if ever there’s kind of a spill, I can use them for that as well. So Diane has just joined us. You have a three-year-old boy welcome. That’s like a fun age group. I find they’re so mobile and learning so much.

They’re like little sponges. So if you have any questions, let me know in terms now, just in, in my travel bags, I’ll give you some tips that I personally use and that I’ve kind of found helpful. So my travel bags, I keep two sets of bags, sorry, one for the kids, which I use a colorful bag. And I use a separate one for the adults,

medications that I, that I travel with, the reason being the minute I know there’s something that pertains to the kids. Then I can just grab the one bag that I have everything’s in one bag, and I know where to find everything. And then the adults is a separate bag. It’s just makes it easier to respond to everyone’s needs a bit quicker.

The first thing I include in my travel bag, a are things for pain and fever, and those are often Tylenol or Advil, Tylenol, and Advil. I carry both of them every, every time I go away or in my travel bag, I’ll explain to you why, first of all, Tylenol and Advil are both effective for any fever or pain.

So one or the other we’ll do the Advil allows for a longer relief because it, it asks for about six to eight hours versus the Tylenol, but only asks for about four to six hours. So the advantage of the Advil is that often I’ll use it at bedtime so that the child can have a longer relief of the fever, but it is a bit more irritating for the stomach.

So we have to make sure that we give it with food. Also, always check with your healthcare professional or your pediatrician or the doctor that follows you. There are instances where Advil may not be indicated. So then you can obviously take the Tylenol depending on the age category. I will tell you a Tylenol, Tempra, acetaminophen are all the same thing,

Advil, ibuprofen, or Motrin, or the antiinflammatory, all of the same things. So they’re synonyms of each other. When we speak about Tylenol, acetaminophen or Tempra, and we’ll show you what I’m talking about. So this is the brand name, Tylenol, again, acetaminophen or temper or the same. This is the baby version. I will give you a little trick.

I tend to always just stock the baby version. Even if I have older kids, I’ll tell you why it is more concentrated and therefore I just have to give less liquid for the same therapeutic effect. The dose is always calculated based on the weight of the child. So another little tip before you leave on vacation, give your pharmacist a call or your pediatrician to call and get the dose that you should be giving the child based on their actual weight.

The reason being anything that’s on the packaging is actually very conservative and may not be enough to really relieve any type of fever. And so if you get the wait before leaving, I keep a little cheat sheet in my bag. And that way I know exactly what I need to give to each of my kids based on their weight. And again, you can use the infant one for any age group.

It is the same as the children’s Tylenol. It is just more concentrated, the advantage to Tylenol as well or Advil. Actually, they both are available in liquid form, but also in tablet form. So if your child is old enough to take tablets that can give you another option instead of a liquid option, the Advil looks like this. So again,

Advil, Motrin, or ibuprofen are all synonyms of each other. Again, I use the infant one for the same reason, and it’s just more concentrated and therefore I can travel with a smaller size, but have it for the whole duration of the trip. And I know I have enough to relieve any pains or fever for the, for my kids. And I have three kids,

all of which are older than infant. And this is still what I keep in my travel kit. Just so it’s a smaller format to travel with. So it’s a good tip to have an often, they come with the syringe, the administration syringe. So you don’t have to worry about bringing anything else. Everything is in your bag. You have the concentrated version.

So you have less to travel with and then just get your dosage based on the weight with your pharmacist or doctor. And you’re all set to go. The other thing that we sometimes forget, but I always recommend putting in your travel bag is a thermometer because how can you treat the fever? If you don’t know if your child actually has a fever, so you can find some age appropriate ones.

If you have a younger one, like something that’s less intimidating, if not just a regular digital one, this will allow you to at least take the temperature. So if your child feels warm, you’re not just going based on the feeling, but you can take the temperature and then be able to give the appropriate medication if needed. The second thing I keep in my travel medicine bag is anything for allergies.

So the one you might, you may know is Benadryl, again comes as a liquid or a chewable. I have the chewable on hand because my kids are a bit older. It says six up any child that can chew, you can feel free to use it just to make sure you know, they know how to chew properly. So it’s not a choking hazard.

The liquid one is also available. So you can always travel with the liquid one. The advantage of Benadryl for a sudden allergy is that it has a quick onset. The only thing is it’s a short acting. So sometimes after 46 hours, you may see the allergy flare up again. And also another downside is it can cause drowsiness. So I often keep this for end of day,

if possible, if the child is obviously not having a very serious allergic reaction, let them have their day, and then you can give it at the end of the day. So I always travel with Benadryl. The other thing I like to have on hand is a react. And, and the reason why I like the reactant over any Claritin or areas is the fact that this one is a rapid Mount.

It’s the only one that’s available as a rapid melt. So it basically dissolves in their mouth, sorry, that’s not true Claritin. And now has a rapid melt as well, but the reactant can be quite useful for several things. One it’s good for seasonal allergies. It can be used for if ever you go someplace and your child seems to be reacting to like any dust or mold or anything like that.

Then you can start using it. It’s one tablet, every 24 hours, alternatively, it can be used also for bug bites. My kids tend to react extremely strong to mosquitoes or any insect bites instead of giving them allergies or sorry, instead of giving them Benadryl right away, which will make them drowsy. I tend to give them a reacting that way.

Yes, it’ll take longer to kick in, but at least they’re not going to be drowsing. We can still enjoy our day as a family on vacation. I just have a question from Diana saying, is there something else besides Benadryl or allergist was recommending against it? And I forget why she doesn’t like it as much as, as much anymore, maybe because of the drowsiness.

Yes, you’re right. Diana that’s one of the reasons Benadryl does tend to cause quite a bit of drowsiness. It’s also a very short acting. If it’s a quick onset, like an allergic reaction that just happened, you can still use the reactant. As I said, the reactant is the one that resembles the most of Benadryl in terms of a molecular shape or its chemical composition.

So it will still act fairly quickly, not as quickly as the Benadryl and it causes less drowsiness. The rapid melt, you know, is a 10 milligram tablet. In some cases, again, check with your pediatrician, check with your pharmacist. You can give a half of a tablet, which would be the equivalent of five milligrams for a younger child.

I do believe the reacting is also available as a liquid form. So you could travel with the liquid form as well. And it does last for 24 hours. Meaning it’s it’s ongoing effect is over 24 hour period to reduce the histamine levels in the blood. So that could be an alternative to the Benadryl, even for a, you know, quick onset reaction.

The other thing I will tell you, if you know, anyone has NFL, ACTIC allergies or reactions, we want to make sure you travel with your two EpiPens and before leaving, please make sure you check your expiring dates on the EpiPens. As sometimes we forget we haven’t used them in a couple of years. Actually we hope we don’t have to use them in a couple of years.

You want to make sure you’re always traveling with up to date medications. The last thing for allergies that I like to keep in my medicine bag is the nasal sailing wash. So I know a lot of my patients use kind of hydrocephalus or the neti pot at home, which is great, but sometimes traveling, it’s not super easy to use. And so with at least a little sealing solution,

you can do nasal rinses at night. These are just a mist. You can spray a couple sprays, have the child blow his nose. If the child is still quite young, you can easily still use the saving solutions with the nasal aspirator, which is great to evacuate any type of nasal congestion in younger, small babies or younger younger kids. Diana just asked for car sickness is gravel best.

And how long does it take for drowsiness to wear off? I was just getting to nausea, vomiting and nausea, actually section of my little travel bag. So yes, Diana, absolutely. For car sickness, both gravel or Benadryl where we’ll work again, you can give the chewable the liquid. I will tell you from experience, my kids quickly moved away from liquid as it is not very good tasting.

So the chewable tablets often to an up one tablet is enough and the liquid would be five ML. So a small teaspoon, but under two years of age, obviously you want to always consult with your doctor. The drowsiness can take a little bit of time to wear off. I’ve actually had kids, parents of some kids call me and said, you know,

up to four to six hours later, there’s kids is still kind of out of it. So unfortunately it just depends how quickly kind of the child metabolizes or digests the medication if you wish, but it can linger. And some kids tend to be a little bit groggy after the gravel effect for, you know, maybe up to six hours after, but it is effective for motion sickness.

It can be taken preventatively. Meaning if you know, your child constantly has a car sickness, which one of my kids did hasn’t happened recently, but did. And so we would give it in prevention to avoid kind of the mess you can be given about an hour before traveling. Cause it tends take about 30 to 60 minutes to have its full effect.

So you can give it about an hour before traveling. The other thing with motion sickness, if ever your child seems to be expressing nausea while driving, sometimes it’s just best to stop on the side of the road, have the child get out of the car, walk around, sometimes lying on their back, closing their eyes for a few minutes can really help them,

can really ground them and help them through the motion sickness. I’m also called compress on the forehead can help and then you can hopefully get back on the road and avoid a bigger mess in terms of vomiting and nausea. Again, gravel can be used. Tablet is enough for children anywhere from two to six, under two years of age, do you want to consult your doctor?

It can still be used, but we want to make sure it’s not hiding something else. Or the symptoms are not associated to something else. And with any type of motion sickness, if ever there’s vomiting or any vomiting or nausea due to flu, we want to make sure we give the child electrolytes. So one other thing, and Diana, that might be helpful as well in terms of car sickness.

I always keep electrolyte solutions in my travel kit and they’re usually in Pedialyte sachets. These are the ones I choose. Again, none of these, I just brought some of the boxes from the pharmacy, but these are not sponsored. I’m just giving you the brands. If you find alternatives, totally fine. Just any electrolyte solutions. The sachets are easy to work with because you can just dissolve them in a glass,

in a water bottle for the kid, for the child and they can just sit on it. So the point is not to drink the entire thing at once because that can actually provoke more vomiting. It’s just a drink, you know, a sip or two every 10, 15 minutes just to maintain hydration. And I actually use these a lot. I use them on really,

really hot days. If the kids I’ve had have been outside and I’m afraid they may not have hydrated enough during the day, I actually pop these in their water bottle at the end of the day and they just sit the electrolytes and sometimes I will avoid any type of, you know, diarrhea associated dehydration. So it’s always, I leave the minute I use one or two sachets.

I replenish my bag to make sure I always have them on hand. When we’re traveling. I use them all the time. Now I don’t just wait for a motion sickness or nausea or vomiting. I use them at large. And again, if you have any other questions, please feel free to ask. I’m kind of monitoring them a little bit on the side there as we go along.

So that’s what I keep for any type of nausea, vomiting or motion sickness. The gold standards is probably mostly the gravel. There are some bracelets that you can keep that have pressure points. Sometimes that can work for motion sickness. Any ginger or kind of remedies can work, can sometimes work for nausea and for nausea and vomiting, but they’re not very effective for car sickness.

So car sickness it’s really to try and either give the gravel. If we know gravel or Benadryl. If we know that there is a risk of car sickness, if not, you can try the bracelets. I have heard some parents tell me that it worked for them. I have another question saying Eric, Hey Erica, my child will not take liquid Tylenol.

Any tips? Yes, that is a very good question. So in terms of liquid Tylenol, it is available first of all, in many different flavors. So I always tell my patients if you’ve tried one, which is usually the great dye-free cause that’s the go-to try a different flavor. The other thing is, as I mentioned before, acetaminophen, Tempra and Tylenol are all synonyms of each other.

Therefore you can go with a different brand. For example, Tempra makes I believe a banana and cherry flavor and the solution is more watery. This one is more of active suspension. So it’s a bit of a thicker liquid, which is better for infants because it stays in the mouth and they don’t spit it out as easily. But the Tempra is available as a different as a more liquidy solution.

And so sometimes in changing the aspect of the solution and in changing flavors, the child may receive the medication may agree with the medication better. So one first tip try different flavors. Secondly, the Tylenol is available as a suppository. Yes, it may seem daunting, but in some cases, especially in younger infants, if you’re able to insert a suppository,

if there’s no other way to give the Tylenol, that can be a good option. So a suppository is something that is inserted rectally. Obviously you want to unwrap it properly. And then you can put a little bit of Vaseline on it or just warm it between your hands and you insert the suppository rectally, and that can allow to control any fever or pain.

If the child is not able to take it by mouth and another tip or things that we’ve tried in the past is taking the chewable. Tylenol obviously always consult with your doctor and with your pharmacist in terms of the dosage, but we can crush the tablet. If the child is at the age of eating and put it in yogurt or applesauce, sometimes in a bite of,

in a bite of jelly. And then that way they can have the medication and the flavor or the taste is masked by the sweetness of the apple sauce or the jelly or the yogurt. So those are different options or tips in trying to get the child take a liquid medication, but always refer. You can check with your pharmacist and see what other alternatives are available in the market.

There’s also, I work in a compounding pharmacies. So sometimes we can make it into a gummy. I will say some medications are hard to mask. The taste is still stays bitter, but there are different options available. So always check with your pharmacist. Next, I have a question saying, what can I use to help with bug bites in my two year old,

we were out hiking this weekend and he got several bites. Yes, that’s a great question. And that’s also something I keep in my travel bag at all times. So the number one thing for bites is kind of treating it locally. So often if the bites are itchy, you can put a bit of ice on it that can help relieve a bit of itchiness.

The second thing is a hydrocortisone. So I keep the hydrocortisone 1% in my travel bag at all times, hydrocortisone is good to reduce any redness, inflammation, itchiness, or reduce the local reaction that is happening at the bite area. You can also, as I mentioned before, give, if the child is of age, obviously check with your pediatrician or your pharmacist,

but sometimes reacting or Benadryl can help relieve the allergic reaction happening at the site of the bite. Again, Ben and Joel, if it causes drowsiness, keep it towards the end of the day. Otherwise reacting causes a lot less drowsiness and you could give it during the day allowing kind of the swelling of the bug bite to go down. I also tend to give the Benadryl at bedtime to make sure the child’s not itching during the night because subconsciously they may itch the bunk bite during the night.

And it will actually increase the local re like redness and inflammation reaction. So if we can keep them from itching and during the night, then the bug bite may heal a little bit faster. There are other things on the markets such as the Benadryl cream or the after bite. I’m personally not a huge fan. Some actually some children can react to the Benadryl as a cream.

I think the, the statistic is like 15% of skin types can react to the Benadryl as a cream. And so I tend to stay away. I find if I’m going to have one thing in my medicine cabinet, it’s really the hydrocortisone, which helps with all skin rashes, exzema patches, dry patches, but can also be used for bug bites. So I hope that answered that question.

The last thing that I keep in my medicine bag is kind of my first mini first aid kit, if you wish. So it begins with alcohol swabs. So I keep alcohol pads or alcohol swabs, many of them, because one, I can just obviously clean any wound with it. It’s also good to clean services. It’s alcohol, 70%. So the alcohol swabs are readily available and always in a hole in a large amount in my medicine bag or travel kit.

So alcohol to make sure I can disinfect. Then we have the Polysporin, which I keep all the time in my medicine bag and also in my medicine cabinet at home. But I always have a second one that stays in my travel medicine bag. There are different Polysporin is out on the market and you will see when you go into the first aid aisle,

there are many different colored boxes. So there’s the red, the black, the blue, the green, and then there’s the kids probably scoring. I will tell you, they, they all have the anti bacterial kind of prevention of infection role. If you want to keep one on hand for the whole family, which was what I opt for, you can just buy the green,

which is the appointment-based or the blue one, which is the cream base. The kids. Yes, it is for kids, but essentially you don’t have to use the kids one. You could use the regular Polysporin if you just want it to keep it to one product for the whole family. The difference between the ointment, I tend to keep the appointment in my,

in my, in my bag, which is the green box, just because white men has a longer time of contact with the skin. However, it does not absorb as fast. Therefore like it’ll leave kind of an oily kind of shiny. It’s more of a Vaseline based product. The cream will be absorbed much quicker and won’t leave. We’ve kind of that Vaseline.

So silky oily finish. So it’s totally up to you. It’s often just a preference of which you’d like to use, but either, or could be used for the entire family, not a problem at all. And then the last thing I can for my, in my mini first aid kit are the band-aids. And of course the band-aids you want to make sure you get them in all shapes and sizes,

but also get the characters that the child will love using so that, you know, there’s a fun aspect to treating the wound. If you wish the last thing that we often forget, but I do keep in my medicine in my little travel bag are tweezers, and those can be useful too, for removing any like splinters or anything that may need to breathe them maybe in a war.

But also now that you know, we’re coming to the end of the summer, but it was, it is tick season still. So if ever, unfortunately you are, you have a tick, then you’re able to use tweezers to remove it. There are other instruments that can be used as well, but at least with tweezers, you can do a lot of first aid things.

So that is one thing that a thermometer, my two medical kind of devices that I keep in my, in my travel bag. One more question I have, can I give my child gravel, the four car ride or airplane ride to prevent motion sickness? Yes, absolutely. As I mentioned before, prevention of motion sickness, if you know that the child is prone to,

you know, vomiting on car rides on plane rides, you can give Benadryl or gravel and it can be given about an hour before the travel time. The reason being, if you give it too, too soon before the departure, it will not have a time to have its effect before the motion is in place. And so the child can still get sick.

So usually an hour before traveling is, would be the recommendation for giving any gravel or Benadryl on a car ride or on a plane ride. Obviously sometimes the drowsiness or sleepiness effect is desired. So know that, that, that is one of the downside. The child may be quite sleepy or groggy during the car ride. And sometimes lingering after, as we mentioned,

it can last up to four to six hours. The length of the time that the medication is acting, its peak is usually within an hour or two, but then it’s just the time that the medication is kind of coming out of the, of the system of the child system. Again, if you have any other questions, please don’t hesitate to ask away,

I’m checking them as I’m kind of giving you my take on my travel medicine bag. The last thing I think there’s one last thing that I haven’t covered as I’m looking at my products here on the side is a sunscreen. So one thing that I keep in my medicine bag, it are sunscreen samples. And the reason being is in the event that my bags get lost on the airplane,

or, you know, travel is delayed or like you have a full car packed and you decide to stop on the side of the road for a swim, for example, in a river, at least I know I have some sample size sunscreen in my travel bag, always there as a second as an emergency supply. And I can use it in sunscreen,

at least the important portions, like the face and the exposed areas of the kids in the event that I need to go outside and I don’t have access to my full sunscreen. So I always keep sunscreen in my medicine travel kit, kind of as an emergency supply. One thing that we should mention that I should mention, sorry, is the, these medicine travel kits like these little bags that I prepare and make for,

for travel should always be kept in either a carry on or in your purse, easily accessible so that you have them and you all like you’re able to access them quickly, but you also have them on you, especially if you’re flying medicines should always be in your carry on never in your checked luggage, just in case the luggage doesn’t make it through or is lost on the airplane.

Then at least you have access to your medication. And this goes without saying, and this medication kit is meant for any over the counter things to kind of just answer to your family’s needs. It does not account for any regular medications that you may be on or you or your children may be on. So that should always be packed first. And that should again,

be packed in a purse, carry on and not in your checked luggage, just in case something happens. You have it on you. And especially if you’re traveling overseas or in your country where you don’t know what the medication situation is always trying to travel with everything you need, both over-the-counter and your regular medication, because you never know what they will have there.

They may have it under different names, different brands. It might be very hard to recognize. And so at least if you have your own things, you’re able to just answer to your family’s needs quickly. And with confidence, another little tip that I will share with you as you see, not everything I’ve showed you in their boxes, all fits in healed properly.

So what I tend to do, and this is a trick that I use personally, but I also do this for friends. I put everything in smells, Ziploc bags. So I usually tend to take all of my, all of the medication out of their boxes. Put in as a thought bag, you can call the pharmacist and get all your kind of dosages based on the weights of each child.

And what I do is in my, in my bag, I put my cheat sheet with the medication. Therefore something happens, let’s say there’s an allergic reaction. I don’t know. My child got licked by a dog, starts swelling. It’s red, it’s itching. I can tell he’s allergic to dogs. Now we know you got liked by a dog.

Now he’s reacting. I can go in my little, my little medicine bag. I pull out the Ziploc with a Benadryl right there. It says, you know, for as rhe one tablet, I give him one tablet. I can wait the four to six hours. If it’s not better, I can repeat again. But I have my little cheat sheet for each medication.

This allows me to put everything into a small bag that I can keep in my purse and have everything at hand in case anything happens. The other thing is for some of my patients, I will cut this out and put it in the bag as well, so that they can see very quickly what the medication is. I do the same thing for my Advil and Tylenol.

So I tend to put them in a Ziploc bag with the syringe. They often come with a dosing and again, the same thing for each child. I put the dosage on a, on a piece of paper in the Ziploc bag. That way I know exactly how much to give based on the weight and that I will change, you know, once or twice a year,

based on how quickly, like based on their, their weight or their next pediatrician appointment. When I get there their weight, if it’s a small baby, then that weight needs to be checked or those cars need to be changed more often because obviously they’re, they’re changing in weight every month and that will change the dosage of Tylenol or Advil that we give.

So that’s a little tip. That’s allowed me to fit everything in one bag. It’s a small bag. I’ve had some, some of my parents come in with massive Ziploc bags of every single liquid possible. And it’s really, sometimes it just takes, you know, a second pair of eyes to kind of be able to change things and put, make things easier for you to use.

And I promise you can probably fit everything you need in this little bag, at least for a weekend away, know that you can answer to your family’s needs. I think that’s all I had. If anyone has any more questions or I think that’s all the tricks in my bag. Otherwise, if you have any other questions, please don’t hesitate. I’m looking over.

Otherwise you can always reach me through the mortar and pestle website, or you can always give me a call or email. I’m happy to answer any questions that you may have on medications or how to give medications or how your child’s responding to medications, anything at all. So thank you so much for spending the evening with me. I hope you found this helpful,

and it was such a pleasure to be here with you tonight.


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