What to Expect the First Year (119 page)
Read What to Expect the First Year Online
Authors: Heidi Murkoff
⢠Unless the doctor specifically instructs you otherwise, give a medication only for the indications listed on the label or information insert.
⢠Do not give your baby more than one medication at a time, unless you've checked with the doctor or pharmacist to be sure the combination is safe.
⢠Check the expiration date. Drugs that have expired aren't only less potent, but may also have undergone chemical changes that in some cases can make them harmful (this applies to prescription meds you may have hanging around from a baby's previous illness, too). Always check the expiration or discard-by date before you buy a drug or pick up a prescription. Recheck expiration dates periodicallyâotherwise you may end up making a pharmacy run in the wee hours.
⢠Store medication according to instructions on the label or package insert. If a medication must be kept cold, store it in the refrigerator at home and in an insulated bag with an ice pack when you'll need to give it while away from home.
⢠Administer medications only according to the directions your child's doctor (or the pharmacist) has given you,
or according to label directions on over-the-counter products. If directions on the labelâor on the printed pharmacy materials that come with the drugâconflict with the doctor's instructions (or aren't specified for your baby's age), call the doctor or pharmacist to resolve the conflict before giving the medication. Follow suggested dosing information about timing, shaking, and giving with or without food.
⢠Reread the label before each dose, both to be sure you have the right medication and to remind yourself about dosing, timing, and other pertinent information. If you're giving it at night, check the label first to make sure you haven't grabbed the wrong bottle.
⢠Measure medications meticulously. Once you've nailed down the correct dose, make sure you dispense that dose precisely. Dispense the medication in a calibrated medicine spoon, dropper, syringe, cup, or medicine pacifier (if your baby will suck on itânot all will). Never increase or decrease a dosage unless the doctor has directed you to.
⢠If your baby spits out or vomits up part of a dose of pain relievers or vitamins, it's usually smart to play it safe and not give extraâunderdosing is less risky than overdosing. If you're giving antibiotics, however, check with the doctor about what to do if your baby spits out or vomits up part of one or more doses.
⢠To prevent choking, don't squeeze your baby's cheeks, hold his or her nose, or force his or her head back when giving medicine. If your baby is old enough to sit, dispense it with him or her in an upright position. If your baby doesn't sit yet, aim the dropper toward the inside of baby's cheek while you prop baby up slightly. This will prevent choking. Don't point the dropper toward the back of the mouth, since that could trigger gagging.
⢠Don't put medicine in a bottle or sippy cup of breast milk, formula, or juice unless your doctor recommends it. Your child may not drink the whole bottle or cup and won't get the entire medication dose. Once baby is taking solids, ask the doctor if it's okay to mix the medicine with food (say, pureed fruit)âthough only if you're sure baby will eat all the medicine-spiked food.
⢠Keep a record of the time each dose is given, so you'll always know when you gave the last one (it's easy to forget). This will minimize the chance of missing a dose or accidentally doubling up. But don't stress if you're a little late with a scheduled medication. Just get back on schedule with the next dose.
⢠Always complete a course of antibiotics, as prescribed, even if your baby seems completely recovered, unless the doctor has specifically told you not to.
⢠Don't continue giving a medication longer than prescribed.
⢠If your baby seems to be having an adverse reaction to a medication, stop it temporarily and check with the doctor right away before resuming use.
⢠If another caregiver, at home or at daycare, is responsible for giving your child medication during the day, be sure that he or she is familiar with the drug-dispensing protocol.
⢠Never pretend medicine is a treat. Sure, that trick might get the dose down without a fuss, but that kind of association could lead to overdosing if your baby somehow finds and manages to open the medication (or any medication) later and is tempted to sample more of the “treat.”
There are many kinds of pain relievers and fever reducers on the market, but only two that should be considered for young children: acetaminophen (such as Tylenol, Tempra, and Panadol) for babies 2 months and older, and ibuprofen (such as Motrin and Advil) for babies 6 months and older. Never give your baby under 2 months medication, even over-the-counter pain and fever reducers, without consulting with the doctor first.
Both acetaminophen and ibuprofen are generally recommended interchangeably by pediatricians to relieve pain or fever, though they work differently in the body and have different side effects. Acetaminophen is a pain and fever reliever onlyâit doesn't reduce inflammation that might be triggering pain. It's considered safe when used as recommended (dosing is every 4 to 6 hours)âa good thing, since you'll likely pull it off the shelf multiple times in your baby's first yearâbut shouldn't be given regularly for more than a week at a time, since long-term use can cause liver damage. A large overdose of acetaminophen (about 15 times the recommended dose) can cause fatal liver damage, yet another reason why all medicines should be stored out of your baby's reach. Your baby won't swallow liquid meds? Ask the doctor about giving acetaminophen in suppository form (Feverall) after age 6 months.
In addition to relieving fever and pain, ibuprofen has an anti-inflammatory effect, making it more effective when there's inflammation at the root of the pain, as there is with teething. It's also slightly more powerful and longer lasting (dosing is every 6 to 8 hours). Ibuprofen is generally safe, with the biggest drawback being the potential for stomach upset. To avoid, don't give it on an empty stomach, and don't use it to treat stomach pain.
Never give your baby a pain reliever formulated for older children or adults (even in a reduced dose). Make sure you use the infant formulations.
Some of the medications you may be used to reaching for can be unsafe for babies. These include:
Cough and cold remedies.
Studies have shown that children's over-the-counter cough and cold remedies don't stop the sniffles or silence the hacking in little ones, and they may even cause young kids to develop serious side effects, such as a rapid heart rate and convulsions. That's why the FDA advises that these drugs not be given to children under age 2, and why cough and cold remedy labels recommend against using these meds to treat children 4 years old and younger.
Aspirin (and anything containing salicylates).
Doctors have been warning parents for years against giving their kids aspirin, but it's a message that bears repeating: Don't give aspirin (even children's aspirin), or a medication containing aspirin, to children younger than 18 years, unless it has been specifically prescribed by the doctor. Aspirin has been linked to the onset of Reye's syndrome, a potentially fatal disease in children. Although research comes down hardest on aspirin, the National Reye's Syndrome Foundation advises against giving children any medication that contains any form of salicylate, so read ingredient lists on drug labels carefully.
They've been used for centuries to relieve the symptoms of hundreds of ailments. They're available without a prescription. They're natural. But are herbal remedies really effective and safe, especially when it comes to your little one?
No one knows for sure. What is known is that some herbs have a medicinal effect (some very powerful prescription drugs are actually derived from herbs), and that any substance that has a medicinal effect should be categorized as a drug. That means the same precautions need to be taken with herbs as with other drugs.
But there are additional concerns with herbal remedies: Herbs are not regulated by the federal government for either effectiveness or safety. So when you pick up an herbal remedy, you may not get what you think you're getting, and you may get ingredients or contaminants that you didn't expect and that you certainly don't want. So just as you wouldn't give your baby a medicine without the doctor's approval, you shouldn't give an herbal remedy without a medical okay either (and no, the guy in the supplement department of the health food market doesn't count). That includes homeopathic treatments for colic, gas, teething, and so on. Check with the doctor before dosing your baby with any of them.
If you're lucky, your baby is one of those who actually looks forward to (or at least doesn't strongly object to) medicine taking, who savors (or tolerates) the taste of those sweet, syrupy liquids, and who opens up wide at the sight of a medicine dropper. If you're not so lucky, your little one possesses a sixth sense that says, “Clamp mouth shut” when medicine is anywhere in the vicinity. To break the seal on your baby's tight lips, consider:
Timing.
Unless you're instructed to give the medication with or after meals, plan on serving it up just before feeding or snacking. First, because your baby's more likely to accept it when hungry, and second, because if medication is vomited up, less food will be lost.
Delivery.
If your baby turns up that button nose at the medicine dropper, use a plastic syringe that squirts out liquid meds, or a medicine spoon (never use a regular spoon). Or try a bottle nipple or medicine pacifier so baby can suck the medicine out (if baby will suck long enough to get all the medication out). Follow this with breast milk or formula (or water for an older baby) from the same nipple so any medication remaining in the nipple can be rinsed out in the baby's mouth. If you meet resistance, try switching up the delivery systemâa little variety may distract enough to get a dose in. If any liquid leaks out of your baby's mouth, use your finger to push it back inâchances are, your baby will latch right on to your finger and suck the rest off.
Location.
Taste buds are concentrated on the front and center of the tongue, so bypass those finicky taste zones by placing the medicine between the rear gum and the inside of the cheek, where it will easily glide down the throat with minimal contact with taste buds.
Temperature.
Ask the pharmacist whether chilling the medication will affect potency. If it won't, offer the medicine to your baby coldâthe taste will be less pronounced. If the medicine can't be chilled, offer your baby a cold bottle first (or a mesh feeding bag with crushed ice or frozen fruit in it for an older baby) so his or her tongue gets slightly chilled.
A trick.
Gently blow on your baby's face when giving the medicine. It will trigger the swallowing reflex in young babies. Or give your little one a pacifier to suck on immediately after dropping or squirting the medicine into that sweet mouth. The sucking action will help the medicine get where it needs to go.
Flavor.
Ask your pharmacy whether a better-tasting flavoring can be added to a yucky-tasting liquid. FDA-approved medication flavorings, such as FLAVORx, come in every flavor from bubble gum to tangerine and are designed to combat the bad taste and smell of liquid medicines.
Once a baby is old enough to be given an over-the-counter medication (such as acetaminophen or ibuprofen), the appropriate dose is based on weight, not age. Which is why you'll need to get the proper dosing from the doctor or pharmacist before you medicate your little one.
Happily, babies in their first year of life are generally healthy. Even when they do get sick, the bugs they catch don't usually bug them for very long. What's more, these common illnesses are typically easy to treat. Here's what you need to know:
The common cold is even more common among the very young. That's because babies and small children haven't yet had the chance to build up immunities against the many different cold viruses in circulation. So be prepared to have at least a few run-ins with a runny nose during the first couple of years, probably more if your child attends daycare or has older siblings.
Symptoms.
Happily, most cold symptoms are mild. They include:
⢠Runny nose (discharge is watery at first, then thickens and becomes opaque and sometimes yellowish or even greenish)
⢠Nasal congestion or stuffiness
⢠Sneezing
⢠Sometimes, mild fever
⢠Sometimes, sore or scratchy throat (not easy to spot in a baby)
⢠Dry cough (which may get worse at night and toward the end of a cold)
⢠Fatigue, crankiness
⢠Loss of appetite
Cause.
Contrary to popular belief, colds aren't caused by being cold, going bare-headed in the winter, getting feet wet, exposure to drafts, and so on (though being chilled can lower a baby's immunity). Colds (also known as upper-respiratory infections, or URIs) are caused by viruses. These viruses are spread via hand-to-hand contact (a child with a cold wipes her snotty nose with her hand and then holds hands with another child, and the infection is passed on), via droplet transmission from sneezes or coughs, and via contact with an object that's been contaminatedâsuch as a toy that's mouthed first by a sick child and then by a healthy child. There are more than 200 viruses known to cause colds, which explains why colds are so “common.”
The incubation period for a cold is usually 1 to 4 days. A cold is typically most contagious a day or two before symptoms even appear, but can also be passed along when the cold is already under way. Once the really runny nose dries up, a cold is less contagious.