By Raied (Ray) Dinno and Saad Dinno
Administering medication to a child can be one of the most difficult tasks a parent faces. It can become downright daunting when a child is on multiple types of medication that must be dispensed at varying times of day.
It does not have to be hard, however, and we want to share some of the advice we regularly give to parents in our pharmacies.
Is it safe?
One of the most common questions we are asked is about the safety of over-the-counter pain relievers and cough and cold medications for children. This is definitely a topic you want to add to your checklist for your next pediatrician’s visit. Doctors vary in their approaches, so you will want general guidelines about using these medications when your child is sick. For children younger than 2, no medication should be administered without first checking with the doctor.
It is important to note that most coughs and colds will run their course, and your child will recover naturally. There is very little science supporting medications and supplements that say they treat cold symptoms. Even if a medication provides symptomatic relief, there is no medication that treats or cures the common cold itself. We wish there was!
If you do use over-the-counter medications, it is very important to precisely measure dosages and follow the schedule for administering them. The package label is very important because the companies that manufacture the medications understand best how they are to be used. Make sure to check with a pharmacist if you are administering more than one cough/cold medicine to ensure the spacing between doses is appropriate and that there is no duplication of medication among the multiple products.
Measurement can be very difficult because liquid medications are often administered by teaspoon or tablespoon, and it is important to understand that there are major variations in the size of kitchen utensils. You should only use the measuring tool that comes with the medication to ensure the dosage is precise. It is very important to pay attention to details. The difference, for instance, between 0.2 mg and 2 mg (or 2 mg vs. 2 mL) is enormous, and children can potentially overdose from medications.
If over-the-counter medication is not working effectively and your child’s symptoms do not respond to the medication within two days, or get worse, it is important to get back in touch with the doctor.
Can you make that sweet like syrup?
Prescription medications for a child can be challenging as well.
Often children need a dose or a form that is not commercially available. For example, since small children have difficulty swallowing pills or are bothered by the taste, a flavored, liquid solution can be given more easily. Pharmacists who specialize in compounding can convert pills into a variety of flavored forms that are more pleasing to children, which can possibly include liquids, lollipops, and gummy bears.
Regardless of form, some medications simply do not work the same in children as they do in adults and will not have the same therapeutic benefit. Before any prescribed drug is taken, it is important to ask your pediatrician how they expect the drug to work and what you, as a parent, should be looking for while your child is on the medication.
Stick to the schedule
An even bigger challenge to administering medication to children is staying on schedule. This can be extremely difficult given the busy lives of families and the fact that children move between school, activities, and home — but it is important. Missed doses can result in “peaks and troughs” that can affect your child’s behavior and well-being. For pills, you can use a pill organizer, available at any pharmacy, which is a plastic tray with compartments for each day of the week, and morning and afternoon, to ensure medications are given on time. Keeping track of doses can be harder for liquids. Keeping a calendar in a central location, for example, a refrigerator door, and marking when the last dose of medication was given can help multiple caregivers keep track, eliminating extra or missed doses.
When medications are given to a school or camp nurse to administer, they should be given in the original prescription container, so the nurse can reference the dose and schedule. Pharmacies can give you a second (or third) labeled bottle, and you can pour the amount of medication you wish to provide to a school or camp for administration.
At home, medications should be kept out of a child’s reach in a cool, dry place with a stable temperature. While many people store medication in a bathroom, this is not the best location because of excessive heat and humidity and temperature fluctuations. If your child is on a medication that requires refrigeration, it is important that the medication stay refrigerated, even when travelling. Placing a vial of medication in a cup of ice will not necessarily ensure the right temperature range.
If you are injecting a medication into your child, it is important that you receive the proper training from a clinician. This training should not only include the best technique for administering a medication, but how to handle and store it, as well.
Administering medication for a child of any age is not to be feared. But by following basic guidelines and using good judgment, your child will get the therapeutic benefit they need with little disruption to their lives — and yours.
Raied (Ray) Dinno, R.Ph, and Saad Dinno, R.Ph., FACA, FIACP, are co-owners of Acton Pharmacy, West Concord Pharmacy, and Keyes Drug in Newton.