We've all faced the situation... your baby wakes up in the middle of the night, feverish and coughing or your preschooler comes home from nursery clutching his stomach... and you wonder, "What would happen if I gave him the medicine he took last time?" While it may sound like a tempting option, especially when it seems like an inconvenient time to go to the doctor or even call, it's not a good idea.
What medicine should my child take?
Dr. Ahmed Darwish, pediatrician, stresses the importance of consulting a physician before giving your child, particularly two year olds and younger, any medication. He also emphasizes that just because a doctor prescribed a certain medicine for your child once, it doesn't mean that you can give it to your child at a later date. He relates, "I've had phone calls from parents who are very upset saying they gave their child medication and the child didn't get better. When I say, 'I haven't seen your child recently,' they say, 'I gave him the medication that you prescribed for him last time.' Of course the child isn't going to get better." Dr. Darwish calls attention to the fact that doctors look for slight differences in symptoms in order to prescribe the appropriate medicine for your child - a cough isn't just a cough, it can be dry, wet, due to an allergy or fall into other categories.
When you take him to the doctor, remind the physician of any medicines your child takes regularly because some drugs can be dangerous when combined with others. If you do give your child medicine without a prescription, make sure to read the pamphlet included with the medicine to find out if there are particular drugs that cannot be taken at the same time. This is particularly a concern if your child is continuously on medication for long-term conditions such as asthma or bedwetting.
Another major factor for concern when giving a child, or in fact anyone, medication is the expiration date. Dr. Darwish says, "Expiration dates are very important. You shouldn't use any medication after the last day of the month given on the package." Proper disposal of expired medication is also very important, he notes, "It's not enough to throw old medicines away in the trash. You have to pour them down the sink and if they are in pill form, dissolve them in water and pour them down the drain. If pills have a protective coating, you should crush them and then dissolve them in water." These measures are for other people's protection as well as your child's, as he explains that some people find expired medications in the garbage and resell them. Also, small children can take drugs out of the garbage and drink or eat them, a cause of household poisonings.
When buying medication, don't take it for granted that the pharmacist has looked at the expiration date. Never accept expired medication. Also, when purchasing drugs, make sure that you are given exactly what has been prescribed. Occasionally you might be given an adult preparation, for example, instead of a children's formula and this can lead to dangerous overdosing. If your pharmacist suggests a substitution of one medicine for another due to unavailability, it is best to phone your doctor and ask.
How can I get him to take it?
For most parents of young children, giving medicine can be a dilemma. The first time you encounter a firmly clenched mouth or a child screaming resistance, you are bound to wonder, "How on earth am I going to make this child take his medicine?"
When administering medicine, keep in mind the following pointers. Be firm. Children generally don't like taking medicine - but not taking it is not an option. Keep your voice calm but firm and offer acceptable choices. Your child can decide where he wants to take the medicine, what he wants to drink afterwards, who should give it, but he cannot refuse it. In the end, you may have to restrain the child to give it, especially if there's no alternative to the medicine.
Always use the measuring spoon or cup included with the medication - household spoons can vary widely in size, so don't depend upon them. Some parents like to use a dropper or syringe to give babies or resistant toddlers medication. If you want to try this, first remove and properly dispose of the needle, then aim for the back of the throat so that your child will automatically swallow. When your doctor prescribes medication, ask how strict you have to be about giving it at the scheduled times. For some drugs, like antibiotics, timing is vital and delay can prevent the drug from being effective.
Suppositories are often a convenient choice for small children who don't like medicine. When giving them, use a little bit of petroleum jelly as a lubricant.
Eye and nose drops can be a challenge. When giving them, you may want to get help - an extra pair of hands can help prevent accidents. For eye drops, pull the lower lid down and drop the medicine in.
What should I do if my child throws up the medicine?
If your child vomits his medicine, you need to take into consideration how important the timing of the dose is and why your child vomited in the first place. If the medicine in question is an antibiotic, try to give it again as soon as possible. If the timing of the dosage is not vital, wait for an hour or so before you try to give it again. If your child vomited because he couldn't keep anything in his stomach, call your doctor and ask if he should take medication to prevent vomiting (often this is available in suppository form). If he vomited because he was crying or the medicine tasted bad, try to figure out an alternative way to administer it, such as giving it with juice or a favorite food to mask the taste. When a suppository is expelled whole, try to give it again but make sure to use a lubricant, keep your child lying on his stomach for at least five minutes (turn on cartoons or sing songs to him to keep him occupied) and explain to him that he shouldn't try to go to the bathroom for at least half an hour.
A word on antibiotics
Antibiotics are not for every illness and should never be self-prescribed. Dr. Darwish comments on antibiotic use, "Some parents aren't satisfied unless the doctor prescribes an antibiotic. I might actually lose a patient if I don't give him one - but I can't prescribe something that a patient doesn't need." Overuse of antibiotics affects the overall effectiveness of them - when they are used properly, they are powerful bacteria fighting drugs, but when given improperly, they can actually reduce the body's capacity to fight disease. Dr. Darwish explains, "Most of the winter illnesses are viral and antibiotics are completely useless against viral infections." So, if your doctor says your child doesn't need an antibiotic, or any medicine, believe him! Sometimes the best medicine is hot chicken soup, bed rest and some orange juice!
Dos and Don'ts
• Mixing medicine with juice or a small amount of soft food is okay. Telling your child that medicine is candy or will taste good when it won't is not.
• Keep medicines out of reach of children. Even vitamins can be dangerous in large doses.
• Follow directions, both on the bottle and from the doctor. Some medicines should be kept in the refrigerator, some need to be shaken well each time, others need to be taken with food or before meals. This advice is given for a reason, so follow it.
• Follow up with cold water or a drink of juice.
• Don't give aspirin or aspirin-based products to children under 12, especially if they have cold or flu symptoms or chicken pox. Aspirin use has been tied to the rare but sometimes deadly Reye's Syndrome.
• When in doubt, call. A pediatrician is used to frantic parents calling him with questions - the best pediatricians are happy to accept legitimate questions for the sake of their patients' health.
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