Consult Your Doctor
One night a few summers ago, when my 18-month-old daughter's mosquito bites were making her itchy, cranky, and sleepless, I went to a 24-hour pharmacy to buy antihistamine. It wasn't until I got home that I read the package instructions: for children under 6, consult physician. By then it was after 10:00 p.m., and I didn't want to bother her doctor. So I guessed and gave Dina a teaspoonful. As it turns out, the amount was right, but that didn't keep me from getting a warning from my pediatrician when I called the next day: Just one extra dose of an antihistamine could make a child of Dina's weight (20 pounds) sluggish. Four times that dose could heavily sedate her.
Doctors say many well-intentioned parents slip when giving medication. The mistakes listed here can prolong a child's illness, cause bothersome side effects, and even sabotage treatment.
Measurements
"A few months ago, I started to give a patient medicine using a standard measurement cup," recalls Cheston Berlin, M.D., F.A.A.P., chairman of the American Academy of Pediatrics' committee on drugs and a pediatrician at Hershey Medical Center in Hershey, Pennsylvania. "Her mother asked me to use a kitchen teaspoon instead, since that was how she gave her daughter medicine at home." Kitchen spoons or cooking measuring utensils should never be used, says Dr. Berlin, because they don't provide accurate measurements — a child may get too little or too much of the drug. Whenever you give your child liquid medication, be sure to use marked spoons, cups, or syringes.
Gauge by Weight
Dosages for most nonprescription children's drugs are based on a child's weight, not his age, says Joseph Greensher, M.D., F.A.A.P., professor of pediatrics at Winthrop University Hospital in Mineola, New York. Two teaspoons of the pain reliever acetaminophen should bring down a 55-pound eight-year-old's fever within an hour, but it will take three teaspoons to budge the thermometer if he weighs 75 pounds. Always note your child's new weight at each doctor visit, advises Dr. Greensher. And because not all over-the-counter children's medications list dosage information by weight, check with your pharmacist or doctor.
Check Your Doses
Matthew, my one-year-old, gets a different antibiotic every few weeks to treat his chronic ear infections, and the dose is usually a teaspoonful. So it wasn't until I'd given him a few doses of his most recent antibiotic that I happened to check the label and realized I'd been giving him a quarter of a teaspoon too much. In this case the extra amount caused more intense side effects — gas and diarrhea. But with pain relievers a few extra doses over several weeks could lead to possible liver or kidney damage. Check all labels carefully
Keep tabs on expiration dates, too, especially with drugs that your child takes only once in a while. "A mother called me recently to tell me that the drug her child takes occasionally for painful heartburn wasn't working," recalls Marilyn Bull, M.D., F.A.A.P., director of developmental pediatrics at Riley Hospital for Children in Indianapolis. "The problem was that the drug has a shelf life of only thirty days, and the mother hadn't remembered to refill the prescription."
What to Look For
Anyone who has tried to give medication to a fidgety child knows that sometimes both adult and child can end up wearing a lot of it. But enough may have entered the youngster's system, and giving another full dose could be dangerous. The same applies to children who vomit within an hour of downing medicine. In both cases, it's best to call your pediatrician, who can advise you on whether — depending on the drug — it's okay to give another dose.
Follow Through
Your child is feeling better, but you've still got a half bottle of antibiotic left. Your instinct may be to shelve it. After all, you wonder, why spend money on more if you need it a few months later? But, says Laura Prager, M.D., F.A.A.P., a pediatrician with Kaiser Permanente in Redwood City, California, most prescriptions, especially antibiotics, are meant to be used in full. If you don't give your child the entire dose, the illness could recur.
If your doctor switches your child from one type of refrigerated liquid antibiotic to another halfway through, don't store the first kind for future use; refrigerated antibiotics tend to lose their potency after two weeks. You can save unused tablets or capsules, but don't give them to your child unless you have your doctor's approval, says Dr. Prager.
Don't Use Old Medication
"I recently examined a child whose parents had started him on his sister's leftover antibiotics because they thought he might have had a recurrence of strep throat," says Jerome Paulson, M.D., F.A.A.P., an associate professor of health-care sciences and pediatrics at George Washington University Medical School in Washington, D.C. "By the time I saw him three days later, there was no way to accurately diagnose him because the drug had either cleared up the infection or wasn't necessary in the first place."
Giving a child an unnecessary antibiotic also increases the chance that the bacteria will develop a resistance to it. If that happens, the drug may not work when the child does need it.
Quality, Not Quantity
Parents sometimes assume that if a drug does not work right away they need to give a little more. With many drugs, including antibiotics, it can often take three to four days before your child will start to feel better, points out Dr. Prager. An extra teaspoonful won't speed up recovery and could cause serious side effects.
Questions to Ask Your Doctor
Ask the doctor if it's okay to skip nighttime doses. Sometimes it is more important to wake a child than to let him sleep. And make sure baby-sitters, relatives, and other people who look after your child know how and when to administer the medication.
Mistakes
A frantic parent once called Dr. Greensher in the middle of the night because she had grabbed adult cough syrup in the darkness and given it to her seven-year-old instead of his antibiotic. "This can happen during the day too," says Dr. Greensher, "especially if a busy parent is in a rush." To be on the safe side, call the doctor should such a mistake occur.
Never Assume
"Parents shouldn't just assume that a drug is working," says Dr. Greensher. "Ask the doctor when your child should show signs of improvement and about potential side effects." If you're in any doubt, don't hesitate to call. Your pediatrician may need to give your child a different medication.
How to Give Medication
It's tempting to slip medicine into food or drink to make it more palatable. "But this can prevent drugs from being absorbed," says Howard Mofenson, M.D., F.A.A.P., a pediatric pharmacologist at Winthrop University Hospital in Mineola, New York. Some key precautions:
- Most antibiotics should be taken an hour before or an hour after meals. Those that can be taken with meals include sulfa drugs, commonly prescribed for ear infections, and new types of erythromycin and amoxicillin.
- It's best to give drugs with water. Carbonated beverages can inhibit absorption, as can milk when downed with tetracycline, fluoride drugs, and drugs for pediatric heart conditions. Doctors say it's fine, however, to pour some chocolate syrup into a dose of liquid medicine.
- DON'T TAKE WITH FOOD includes juice, although a half ounce or less usually won't degrade the drug.
- If a drug can be mixed with food, use just enough to mask the taste — a teaspoon of applesauce, yogurt, or ice cream should do the trick. If a portion is too large, a child may not finish it and won't get the full dose.
No comments:
Post a Comment