Recent heartbreaking news reported about a baby who died due to a medication overdose by his babysitter/nanny has me reeling. And although this is a tragic, outlier type event, it can awaken us to everyday ways to improve our children’s safety with over-the-counter medicines.
The tragic story: a fussy baby was mistakenly given allergy medicine to calm him down and get him to sleep after a day of crankiness. Allegedly, the babysitter unfortunately gave an adult dose of an allergy medication. Sometimes medicine side effects can impair or stop breathing. Especially at elevated doses. The lesson from this horrific story is threefold:
- Medicines, even those sold over-the-counter have real effects and demand our serious attention. We need to make sure medication dose is the right one. The story of this tragedy is a nightmare to even think on, but it can remind us to make sure we are always a part of every dose our children are given of ANYTHING. Every parent should know it’s not “over-the-top” to have any caregiver review medication administration with you every time for safety.
- Kid medicines for kids not for the adults who care for them. Medicines should be used only when necessary and not for adult convenience. Fussiness in babies is exhausting for parents and caregivers. Read about fussiness and the period of PURPLE crying here especially in early infancy that’s considered normal. We need familial and community support for parents exhausted and overwhelmed by fussy babies. And we need back-up plans for respite for caregivers to babies, but we also need to remember that medicines given to a child for the benefit of a parent just isn’t the reason they were designed or licensed. As a pediatrician I just can’t recommend using allergy medicine to knock your kid out. Just doesn’t make sense. Proper and appropriate medication dosing is paramount but using medicines only when necessary is where you have to begin.
- Allergy medicines, even over-the-counter medicines are not recommended for use in babies under age 2 years.
Medication Rules For Parents Everywhere
- If your child is in need of medication, require your child’s caregiver (grandparent, nanny, babysitter, friend, etc.) to call you to review dosing before administering the medicine. ALWAYS do this with young children, especially if they are not daily medicines. Why not?
- Keep the dosing devices that came with medication rubber banded to the medicine. This avoids someone reaching for a spoon to dose medication or reaching for an adult dose in error.
- Keep a print out of an up-to-date dosing graph on your fridge & in your medicine cabinet. You can ask for a print out at your pediatrician’s office!
- I stand by what I’ve said before, no allergy/anti-histamine medication for travel or to help your child sleep! Using a medicine for parental convenience is not an indication to medicate your child. I just can’t advise that you put medicine in your child’s mouth for ease of travel or convenience. Especially since we never know which child (and why) will have side effects. Side effects to medications represent a huge number of visits to pediatricians and emergency rooms, especially for kids under age 5, as it’s often their first-time exposure to a medication.
This post was written in partnership with KnowYourOTCs.org. In exchange for our ongoing partnership helping families understand how to use OTC (over-the-counter) meds safely they have made a contribution to Digital Health at Seattle Children’s for our work in innovation. I adore the OTC Safety tagline, “Treat yourself and your family with care all year long.” Follow @KnowYourOTCs #KnowYourOTCs for more info on health and wellness.
Joseph Piacentine MD says
I had just the opposite. A 15 month old infant ate a peanut butter cookie. The mother, at the grocery store when this happened, asked for the Benadryl. The pharmacist told mom not to use it and the child suffered an anaphylactic reaction and almost died. There ARE times to use OTC meds.
Wendy Sue Swanson, MD, MBE says
Well OF COURSE there is an exception to report — especially in a life threatening situation — where we need to intervene w OTC medications. As a physician you know this. As do I. But this post is for the public and to improve knowledge about situations that are typical.
Risk and benefit always has to be weighed. And in the example you share it wasn’t evaluated properly
D. Chapman, MD says
It should be noted that Benadryl (diphenhydramine) only treats the pruritus and rash components of an anaphylactic reaction. Epinephrine is needed to treat the life threatening swelling part of the reaction. I only mention this so a parent does not think that they can treat or prevent a life threatening anaphylactic reaction with Benadryl alone.
Shannon Staples says
I also want to caution the use of a title of an article saying “No allergy medicine for Kids under 2”. Just as the above comment states, diphenhydramine (Benadryl) has its place in treating several common pediatric illness as you know. I think it is more appropriate to caution that all parents should ask their child’s health care provider about the appropriate use of allergy meds. Of course I agree with not using it for sedation in a toddler. Thanks for keeping our awareness up about these crucial issues.
Wendy Sue Swanson, MD, MBE says
Thanks, Dr Staples! A complicated challenge to write for the public and include alternative examples/use cases, etc. Appreciate your advice.
Miss you!
succimer says
That’s a real tragedy. Medication for kids may different from that for adults, in this way we shouldn’t weigh the same, but need to take the professional advice. This story may also give us a warning that it’s time to put emphasis on child drugs, there should be a child version for drugs that can be applied to their tiny body.
Jennifer Patano, ARNP says
I think one of the larger underlying issues is in your point #2, in families who have difficulty tolerating crying infants and toddlers, and/or children who don’t sleep through the night, and that there is lack of awareness regarding normalcy to crying and awakenings. In addition there seems to be inadequate support through the community or extended family to those families who are struggling.