By the time you’ve raised your own kids, you might think you’ve seen it all. But babysitting your grandkids in today’s world can feel like a whole new ballgame. From food allergies to screen time rules, pediatric nurse practitioner Dr. Carly Thomas, DNP, APRN, CPNP-PC, has seen how even the most loving and experienced grandparents can get caught off guard. Here’s her expert advice on how to keep your grandkids safe and thriving while in your care.
“I love written instructions and a plan or routine for grandparents to follow,” says Dr. Thomas. “It builds confidence and keeps the child’s care consistent.”
Start with Allergies: The #1 Thing to Ask
“The most important thing to ask is about your grandkids’ allergies,” says Dr. Thomas. “These will depend on their age and can change as they grow.”
Food allergies are far more common today than they were a generation ago, and the top offenders might surprise you. According to data from Kids With Food Allergies, milk is the most common allergen in children, affecting 1.9%. Other important allergens to be aware of include:
- Peanuts (2.2%)
- Tree nuts like walnuts and cashews (1.2%)
- Shellfish (1.3%)
- Eggs, wheat, soy, and sesame
The good news is that anaphylactic reactions are rare in infants. Research shows that early introduction of potential allergens between 4 and 6 months of age may reduce the risk of developing severe reactions later on. Still, if your grandchild has a known allergy, the parents will usually have a clear list of what to avoid.
“Allergens won’t come as a surprise; parents should already know what to avoid and share that with you,” says Dr. Thomas.
Medication Mistakes to Avoid
Over-the-counter medications may seem like a safe fallback, but not all are appropriate for young kids. Dr. Thomas advises being especially careful with dextromethorphan, a common ingredient in cough suppressants.
“Even in adults, coughs are your body’s way of protecting the airway,” she explains. “Suppressing a cough can increase the risk of pneumonia, especially in kids and older adults.”
The American College of Chest Physicians does not recommend cough suppressants for children, particularly for colds. Studies show they are ineffective at treating the underlying issue and may increase health risks.
Simple Safety Steps to Take at Home
If your grandchildren visit your home, a few quick updates can make it a safer space.
Dr. Thomas recommends keeping children’s Zyrtec (cetirizine) on hand if your grandchild is 6 months or older. For children between 6 months and 2 years, a 2.5 ml dose can help relieve allergic reactions to food, bug bites, or pollen.
She also strongly advises removing choking hazards like button batteries, which are extremely dangerous if swallowed. And as warmer weather approaches, she notes one more safety tip: never allow children to ride on lawnmowers or play nearby while one is in use. So skip the lawnmower rides. “They’re just not worth the risk,” she adds
Another smart item to have on hand? A reliable digital thermometer. Monitoring a child’s temperature can help you decide when to call the doctor or seek emergency care. According to the American Academy of Pediatrics, a normal body temperature for children ranges from 97°F to 100.4°F (36.1°C to 38°C). A fever is generally defined as a temperature of 100.4°F (38°C) or higher. If a child under three months has a fever, or if a fever lasts more than 24 hours in a child under two, it’s important to contact a healthcare provider.
When a Child Gets Sick: Have a Plan
Children inevitably get sick, but being prepared makes all the difference.
“Ask the parents for a game plan,” says Dr. Thomas. “Know who to call, and what their preferences are. And when in doubt, 911 or the nearest children’s emergency room is always a safe option.”
It’s helpful to have a printed care guide nearby that includes:
- Emergency contact numbers
- Medication schedules
- Dietary restrictions
- Symptoms to watch for
- Addresses for local urgent care or pediatric ERs
Having these details at your fingertips helps you respond quickly if something unexpected happens.
Communication Is Key
Whether your grandchild has a specific bedtime routine, needs an inhaler, or follows a special diet, staying aligned with the parents helps ensure consistency and reduces stress for everyone.
“I love written instructions and a plan or routine for grandparents to follow,” says Dr. Thomas. “It builds confidence and keeps the child’s care consistent.”
Following the family’s routine also gives your grandchild a sense of comfort and familiarity while in your care.
Screen-Free Is Best for Young Children
It might be tempting to hand your grandchild a phone or tablet for a few moments of quiet, but Dr. Thomas urges grandparents to think twice.
“Please do not use screens with your grandchildren,” she says. “The AAP doesn’t recommend any screen use before age two. After that, only one hour per day of educational content is suggested, and not on individual devices.”
She encourages activities that engage imagination and connection instead: reading, playing, going outside, building with blocks, talking, or drawing together.
“These are the moments that help your grandchild grow and thrive in every area,” she adds.
A Little Preparation Goes a Long Way
Being a grandparent is one of life’s greatest joys. And stepping in to babysit, even for just a night, can strengthen your bond beautifully. With a little preparation and good communication, you can support your grandchild’s health, safety, and development while creating special memories together.
About the Expert
Carly Thomas, DNP, APRN, CPNP-PC, earned her Doctorate in Pediatric Nursing Practice from the Medical University of South Carolina and is certified as a Pediatric Nurse Practitioner by the PNCB. She is passionate about parental education, newborn care, clinical research, and preventive medicine. In her free time, Carly enjoys going to the beach with her sister, reading, attending church, boating, walking her dogs (Boaz and Dooby), doing CrossFit, and exploring new places with her fiancé, David.
Citation:
Sharma S, et al. “Cough.” StatPearls, 2023. NCBI Link
American Academy of Pediatrics. “Fever and Your Child.” HealthyChildren.org, 2021.
