Is Pepto-Bismol Safe for Kids?

Many adults remember a time when Pepto-Bismol was the first thing they reached for whenever anyone in the family, including kids, had an upset stomach, nausea, or diarrhea. However, for safety reasons, Pepto-Bismol is no longer recommended for kids under age 12.

Instead, a children's version of Pepto-Bismol is available for kids aged 2 to 11. Alternatively, you might try a natural method to address their symptoms. Here's what you need to know about the dangers of using Pepto-Bismol for kids.

The Dangers of Salicylates

Regular Pepto-Bismol is a concern for children because its main ingredient is bismuth subsalicylate, a derivative of aspirin (acetylsalicylic acid or ASA).

Medications containing ASA are associated with Reye's syndrome, a rapidly progressing brain disorder that isn't fully understood. The condition typically develops in people recovering from a viral infection. Most of the cases seen in children involved the use of aspirin to treat common illnesses such as influenza and chickenpox.

Symptoms can start with lethargy, nausea, and hyperventilation but quickly progress to vomiting, seizures, and even coma. Although Reye's syndrome is uncommon, it is a serious condition. If it's not diagnosed and treated effectively, death can occur within a few days.

Today, the Food and Drug Administration (FDA) advises against the use of bismuth subsalicylate in children under 12 because of the risk of Reye's syndrome. The warning extends to any adult formulation of bismuth subsalicylate, including oral suspensions, chewable tablets, and caplets.

Children and teenagers who have or are recovering from chickenpox or the flu should avoid Kaopectate due to the risk of Reye's syndrome. Meanwhile, oil of wintergreen should be avoided in all children and teens as its central component (methyl salicylate) is not meant for ingestion, even in diluted preparations.

Alternatives to Pepto-Bismol

If your child has indigestion, nausea, vomiting, or diarrhea, there are alternatives to regular Pepto-Bismol that may help. These options include a children's version of Pepto-Bismol, as well as natural remedies like changing your child's diet. Consult your child's pediatrician if these symptoms persist.

Children's Pepto

In response to the FDA warning, the manufacturers of Pepto-Bismol created a children's formulation. In it, bismuth subsalicylate is replaced by calcium carbonate. Pepto Kids Chewables are bubble gum-flavored chewable tablets. This formulation is approved for use in children over the age of 2.

Dietary Changes

For upset stomach and diarrhea, most pediatricians suggest offering your child a BRAT diet consisting of bananas, rice, applesauce, and toast. These foods are not only less challenging to the stomach, but they also have a binding effect that may help relieve diarrhea.

For symptoms of indigestion, focus on dietary changes to relieve the stomach of any irritation. Serve bland foods such as crackers, dry toast, gelatin, and applesauce. Provide clear fluids to sip, avoiding sugary beverages and acidic juices.

Cut out any greasy foods, chocolate, and heavy spices until the symptoms are fully resolved. Offer smaller meals more frequently rather than three regular meals per day.

Hydration

With nausea and vomiting, the main focus should be on keeping your child hydrated. Ensure that your child regularly sips water or an electrolyte replacement drink until their stomach settles. Flavored ice pops are also a nice way to encourage fluids.

Gradually offer bland foods and clear broth once your child is able to eat. Avoid home remedies like warm milk or rice water, which are not appropriate replacement fluids.

Natural Remedies

There are also a number of natural remedies that many people swear by. Brewed teas made with ginger, peppermint, chamomile, fennel, or licorice may help relieve symptoms of an upset stomach. (All are free of caffeine.)

If you want an alternative to an over-the-counter antacid, try mixing a teaspoon of baking soda into a mug of warm water. Even a little warm water with lemon juice has been known to do the trick.

When to Call a Doctor

If diarrhea, nausea, or vomiting are severe or accompanied by any of the following, see a doctor immediately:

• High fever (104 or higher)
• Fever lasts more than 24 hours in children under age 2
• Fever lasts more than 72 hours in children over age 2
• Reduced urination
• Lightheadedness
• Blood

Diarrhea or vomiting that lasts for more than 24 hours should always be considered serious and in need of urgent care.

A Word From Verywell

Having an upset stomach is common in kids. It's understandable to want to reach for the closest thing that can help your child feel better fast. But if your child is under age 12, that shouldn't be adult Pepto-Bismol.

Instead, try the children's version of Pepto-Bismol or natural methods of easing their discomfort, and never hesitate to contact your child's pediatrician. Based on your child's age, they can guide you on what steps to take to ease your child's symptoms.