How to Give Medicine to Children

by Food and Drug Administration (FDA)

"Open wide ... here comes the choo-choo."

When it comes to giving children medicine, a little imagination never hurts.

But what's more important is vigilance: giving the medicine at the right time at the right dose, avoiding interactions between drugs, watching out for tampering, and asking your child's doctor or the pharmacist about any concerns you may have.

Whether it's a prescription or over-the-counter (OTC) drug, dispensing medicine properly to children is important. Given incorrectly, drugs may be ineffective or harmful.

Read the Label

"The most important thing for parents is to know what the drug is, how to use it, and what reactions to look for," says Paula Botstein, M.D., pediatrician and acting director of the Food and Drug Administration's Office of Drug Evaluation III. She recommends that a parent should ask the doctor or pharmacist a number of questions before accepting any prescription:

• What is the drug and what is it for?
• Will there be a problem with other drugs my child is taking?
• How often and for how long does my child need to take it?
• What if my child misses a dose?
• What side effects does it have and how soon will it start working?

It's also a good idea to check the prescription after it has been filled. Does it look right? Is it the color and size you were expecting? If not, ask the pharmacist to explain.

Check for signs of tampering in any OTC product. The safety seal should be intact before opening. Also, parents should be extra careful to read the label of over-the-counter medicines.

"Read the label, and read it thoroughly," says Debra Bowen, M.D., an internist and director of FDA's medical review staff in the Office of OTC Drugs. "There are many warnings on there, and they were written for a reason. Don't use the product until you understand what's on the label."

Make sure the drug is safe for children. This information will be on the label. If the label doesn't contain a pediatric dose, don't assume it's safe for anyone under 12 years old. If you still have questions, ask the doctor or pharmacist.

Children are more sensitive than adults to many drugs. Antihistamines and alcohol, for example, two common ingredients in cold medications, can have adverse effects on young patients, causing excitability or excessive drowsiness. Some drugs, like aspirin, can cause serious illness or even death in children with chickenpox or flu symptoms. Both alcohol and aspirin are present in some children's medications and are listed on the labels.

Younger and Trickier

The younger the child, the trickier using medicine is. Children under 2 years shouldn't be given any over-the-counter drug without a doctor's OK. Your pediatrician can tell you how much of a common drug, like acetaminophen (Tylenol), is safe for babies.

Prescription drugs, also, can work differently in children than adults. Some barbiturates, for example, which make adults feel sluggish, will make a child hyperactive. Amphetamines, which stimulate adults, can calm children.

When giving any drug to a child, watch closely for side effects.

"If you're not happy with what's happening with your child, don't assume that everything's OK," says Botstein. "Always be suspicious. It's better to make the extra calls to the doctor or nurse practitioner than to have a bad reaction to a drug."

And before parents dole out OTC drugs, they should consider whether they're truly necessary, Botstein says.

Americans love to medicate — perhaps too much. A study published in the October 1994 issue of the Journal of the American Medical Association found that more than half of all mothers surveyed had given their 3-year-olds an OTC medication in the previous month.

Not every cold needs medicine. Common viruses run their course in seven to 10 days with or without medication. While some OTC medications can sometimes make children more comfortable and help them eat and rest better, others may trigger allergic reactions or changes for the worse in sleeping, eating and behavior. Antibiotics, available by prescription, don't work at all on cold viruses.

"There's not a medicine to cure everything or to make every symptom go away," says Botstein. "Just because your child is miserable and your heart aches to see her that way, doesn't mean she needs drugs."

Dosing Dilemmas

The first rule of safety for any medicine is to give the right dose at the right time interval.

Prescription drugs come with precise instructions from the doctor, and parents should follow them carefully. OTC drugs also have dosing instruction on their labels. Getting the dosage right for an OTC drug is just as important as it is for a prescription drug.

Reactions and overdosing can happen with OTC products, especially if parents don't understand the label or fail to measure the medicine correctly. Similar problems can also occur when parents give children several different kinds of medicine with duplicate ingredients.

"People should exercise some caution about taking a bunch of medicines and loading them onto a kid," Botstein says.

Pediatric liquid medicines can be given with a variety of dosing instruments: plastic medicine cups, hypodermic syringes without needles, oral syringes, oral droppers, and cylindrical dosing spoons.

Whether they measure teaspoons, tablespoons, ounces, or milliliters, these devices are preferable to using regular tableware to give medicines because one type of teaspoon may be twice the size of another. If a product comes with a particular measuring device, it's best to use it instead of a device from another product.

About the Author

www.fda.gov
FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.