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Mistakes Giving Medications To Children Are Avoidable

By Stephanie Felzenberg

Parents, family, and caregivers devote themselves to the welfare of children. Yet, even with love and devotion, 80 percent of deaths of children under five-years of age are avoidable. More then half of those deaths are caused by mistakes in the administration of medications given to benefit the child. An even greater number of children are injured or suffer serious side effects from inadvertent errors of common health aids found in most homes.

Before giving any medication, whether prescription or over-the-counter, (OTC), child care providers must know the weight, age, allergies, and sensitivities of the patient. Plus, it is vital that caregivers know what and when other medications and foods have been ingested by the child. An up to date list of medications and dosages should always be available. A great way to record food and medications given to children is with a daily log kept in a visible place for all adults, (parents, family, baby-sitters, and nannies), to use and communicate with one another.

Before administrating any prescription medication to a child, the caregiver must assess the child's needs: know what to give, why the child needs it, how to contact the professional that is prescribing it, when to give it, how to store it, where to refill it, and at what cost the medication can purchased. Be aware of probable side effects and how to manage them if they occur. Know whether to give the medication until it is finished or only until symptoms abate. Keep the phone number of the prescribing physician and pharmacy visible in the event of questions regarding reactions or directions.

Since each person has a unique chemical composition, side effects and each individual's reaction to a medication cannot be anticipated. Unexpected reactions must be reported to a licensed medical provider. No medications that have expired should be given to anyone at any time. Do not follow the advice of a friend, neighbor, or grandparent, however well meaning, regarding the treatment for a child. Seek the best advice from a trained professional and not merely from a convenient source.

OTC preparations pose a special challenge for child care providers. They require no prescription, are widely available, and are relatively inexpensive. Yet, they can be hazardous if used inappropriately. Child care providers must carefully read and understand the labeling found on every package.

The following categories are found on every medicine package label:

Active Ingredients: The first panel on the label lists the active ingredients and their purposes. This section provides the chemical name of the active chemical and how it is intended to work for the patient.

Uses/Indications: This section explains which symptoms the active ingredient is supposed to treat.

Warnings: The warnings section alerts the caregiver to conditions, or people, that should not use the particular medication without the specific advice of a physician.

Directions: The directions explain the dosage and administration of the medication. Always use a manufacturer provided measuring device and not a kitchen teaspoon, tablespoon, or dropper. Household goods vary widely in size and cannot be depended upon for proper dosage.

Other Information: Other information listed often notes proper storage and gives pertinent information about how and when the product should be taken.

Inactive Ingredients: The inactive ingredients listed on the medication label are the chemicals in the compound that are presumed to have no effect on the body. Dyes, preservatives, fillers, and food colors are among the compounds listed on this part of the label. A child may be allergic or sensitive to any of these ingredients, even though they are called "inactive."

Kids are not small adults. Do not dilute or reduce the dosage of adult products and dispense them to children. Pediatric oral medications are often sweetened to make the palatable. However, they are not candies and like all medications, should be kept out of the reach of children.

Adult medications that are especially dangerous to children are analgesics, anti-depressants, sleeping pills, and tranquilizers. Safety caps should be used and tightly secured, whether prescriptions or OTC preparations.

Some common ailments and popular products used as treatments may cause problems for children. Runny noses, stuffed noses, and post nasal drips are among the conditions that prompt a doctor to prescribe an antihistamine or a decongestant, or a combination of the two. Dry coughs and incessant coughs typically require expectorants and/or cough suppressants. Some common side effects include:

Antihistamines generally cause fatigue, loss of appetite, and dryness of the mouth and throat. Overuse can cause respiratory failure and weight loss.

Decongestants can cause nervousness, sleeplessness, and heart palpitations.

Expectorants can cause nausea and vomiting.

Suppressants can cause chest pain and lethargy.

Paradoxical side effects may occur at anytime. That means that for a small minority of patients, what normally causes lethargy, may cause excitation in a particular patient.

Any instance of overdose of any medication requires prompt emergency medical care. Be aware that any sudden change in behavior or health requires medical attention. The side-effects cited in this article are representative only and not nearly a complete list of all possible problems medications can pose for children.

Parents may give certain herbs to children due to the inaccurate belief that they are all natural and cannot hurt, and might help, children.

The most popular herb is Echinacea. According to the German government, only one of the four species of Echinacea is useful as a cold preventative. That form is not even available in the United States. Some children, especially those who are allergic to ragweed, may be allergic to Echinacea. The alcohol-based tincture form of Echinacea can be irritating to mucus membranes. Further, recent studies find no benefit from the use of Echinacea.

Some people use large doses of Vitamin C to prevent or to treat a cold. Large doses of Vitamin C can cause stomach upset, diarrhea, and heartburn.

Honey is popularly used to relieve sore throat, or to mix with lemon to relieve colds. Honey should not be given to any child under one-year-old because of the risk of infant botulism.

Multivitamins can be toxic to children. Iron-containing vitamins are a threat to children and should not given to children without the advice of a physician.

Headaches, sore throats, and other pain should be treated with ibuprofen or acetaminophen, but never aspirin. Aspirin should not be give to anyone under 19-years-old since it is a salicylate that can react with a virus that can cause the dangerous Reyes Syndrome. The adult formulation of Pepto Bismol, Kaopectate, and willow bark are also salicylate-containing compounds and must be avoided by infants, children, and teenagers. Use ibuprophen or acetaminophen in forms designed for pediatric use, rather than smaller doses of adult formulations.

Vomiting, nausea, and diarrhea are all potentially dangerous conditions that may lead to dehydration. Pediatric electrolyte replacement drinks are appropriate. Diluting adult electrolyte replacement drinks will give the patient a drink that is too acidic for a child.

There are many effective strategies to relieve the discomfort of teething but Anbesol to be used by adults and liquor may burn the gums and should be avoided. Cold gel pacifiers are a better choice.

Intestinal gas and heartburn are treatable with a large variety of safe products. Use those made for the age of the child. Too much antacid can cause constipation, diarrhea, or stomach cramps. Over dosage of acid blockers can inhibit digestion. Track the diet of children with stomach or digestive discomfort for a few days to check if there is a sensitivity to some food.

Among the most effective methods to prevent the spread of illness is careful and frequent hand washing. Plain soap and water are all that is necessary.

If a child is cranky because of fatigue, do not give medication to quiet the child. Most complaints are temporary and self-limiting and do not require medication. Sufficient sleep and a nutritious diet often allows the body to heal itself.


(For complete contact information for resources contact Be the Best Nanny Montly Guide. 1. American Botanical Council 2. AMA Family Medical Guide 3rd ed. 3. National Council on Patient Information and Education 4. City Futures, Inc. 5. Integrative Medicine Communications

6. Courtroom Television Network LLC 7. 8. Family Health and Medical Guide 9. Griffith, H.W. Complete Guide to Vitamins, Minerals, and Supplements. 10. Institute for Safe Medication Practices

11. 12. 13. Merchant, Anne. M., The Nanny Textbook. 14. The PDR Family Guide to Prescription Drugs.

15. 16. Physicians Desk Reference.

17. Prevention Magazine's Nutrition Advisor.

About The Author
Stephanie Felzenberg has been the Executive Editor of the nanny trade publication, Be the Best Nanny Monthly Guide, for more than five-years. She has more than ten-years experience as a professional nanny. After earning a Bachelor Degree in Psychology, she worked as a counselor with children, with mentally handicapped adults, and neglected and abused teen-aged girls. She volunteered as the International Nanny Association newsletter editor for more than four-years and has edited a nanny text book to be published later this year. To learn more about the newsletter visit or email Stephanie at:

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