So I am still terrible at posting more often. There is plenty of stuff that I want to post about but the time to do it is hard to find. For example I have 4 tests next week alone.So what I am going to talk about today is the use of cough medicine in kids. When is it okay to give your kids cough medicine? at 3 months? 6 months? 1 Year? 2 Years? When your pediatrician gives you a specific dose for you child?
Surprisingly none of the above are correct. The FDA has come out with new guidelines that say you should never give a child under the age of 4 any over the counter (OTC) cough medication. Your pediatrician may give you a dose for your child but the evidence still shows that the medication is still not going to be helpful or possibly even safe.
Current research has show that OTC medications for cough don't work for kids under 4, not only that but the chances that they will have a bad reaction are much higher. We have many moms come into the pharmacy and want to give their kids cough medicine, some have asked for recommendations for their very young kids. I personally have had a mother ask me how much NyQuil she could give her 4 month old! What is worse is when a mother asks for a dose for her baby, we explain to her that her child can't safely take the medication and then she wants us to sell it to her anyway.
It is a moderately recent change in guidelines, a couple of years ago it was okay to give OTC cough medication to anyone 2 and over. So it can be hard to remember that you can't give your 3 year old cough medication anymore. Pediatricians know about this change but there is one big difference between Doctors and Pharmacists. Pharmacists' hands are tied by the FDA, Doctors aren't. So when the FDA says that OTC cough medications are unsafe for children under 4 pharmacists are no longer allowed to give dosing to for kids under 4. Whereas Doctors don't have to follow FDA guidelines, that is why they are allowed to prescribe experimental medications and why they can prescribe medications for a disease other that what they have been proven to treat. So your pediatrician may give you a dose for your child but it is most likely because it is easier to give you dosing on a medication that he knows isn't going to work than it is to explain to you that it isn't going to work.
If you want to know what you can do to help your kids when they have a cough here are some suggestions. A humidifier , lots of fluids, rest and less activity, and letting it run its course naturally. If it last more than a few days, if the child has a fever, or even if your just worried take your kid to the doctor and see if he/she wants to prescribe an antibiotic.
Another thing, if you do have to give your kids medications then designate a medicine giver. Most problems that come from cold medications happen because Mom give the kid some medicine and goes to do her hair and then Dad comes down stairs and give kid another dose not knowing that Mom already gave kid some medication.
Really what it boils down to is finding a Doctor and a Pharmacist that you trust and then taking their advice when they give it.
This is me again. (3/5) A few days after I posted the original blog. As I was reading through it again I realized that my main goal of this blog wasn't apparent in my original posting. My whole goal of this blog in general other than occasionally catalogging what is going on in my life is to make sure people understand how important it is that you find a doctor and pharmacist that you can trust, and are competent. Simple things such as OTCs can be fatal in certain people, for example cough syrup in kids, Benadryl in the elderly, Aspirin in childern, Ibuprofen in unborn children, and the list goes on. What is scary is that there are many health care professionals that are unaware of these things. Just yesterday a professor in my Therapeutics class warned us all that we should think about Malpractice Insurance for when we graduate because the day that a pharmacist can be sued for an OTC recommendation isn't far away. The reason it isn't far away is becuase people put too much trust into health care professionals that don't always deserve that trust, I bet most people have had a bad expercience with a doctor, pharmacist, nurse, dentist, or some other health care professional so my goal is to stress the importance of finding the doctor that you know has your best interest in mind and is doing all he/she can to stay current on what is best for you.
One last thing. I do intend to give my future kids cough syrup, but only after I have taken them to the pediatrician, and only after I have found that the pediatrician is worthy of my trust.
Are you talking about OTC alone, or prescription as well? My Dr. is quick to write a prescription for cough medicine, even for Klaire. What do you think?
ReplyDeleteI am glad you know all of this stuff... that way when our little one comes... I have you to tell me what I can and can't do. Love you and keep up the good work in school!
ReplyDeleteMarli, So it all comes back to trusting your doctor. There are many different reasons we find that doctors prescribe cough medications. Some do it because they don't know any better. Some do because they don't want to explain why it is bad. Others do it because there is a slim number of kids that do get some relief from the medication. Remember that drugs effect us all differently so some kids may be just fine with cough medications. So what I think is that if you trust your doctor then take his/her advice and give Klaire the medication.
ReplyDeleteWhat would happen if you did give
ReplyDeleteyour child cough medicine?
The worst case scenario of what would happen is that the child would get really sleepy and stop breathing. That is WORST CASE scenario. The ingredient in cough medications that stops the coughing is Dextromethoraphan. Dextromethoraphan is in the same class of drugs as Oxycontin, Percocet, and Lortab. The only difference between those and cough medications is that the cough medication can't get into your brain. Instead it goes to the other areas of the body to cause you to slow your breathing just enough to prevent coughing. After you have taken it your liver and kidneys get it out of your body. Young kids don't have a fully developed liver or kidneys to be able to get rid of the drug so the side effects are far far worse with only small doses because once the medicine gets in it is very hard for their body to get it out. Every child's organs develop at a different rate, some kids may be fine at age 2 others not until 4. That is why we like you to talk with your doctor first so they can help you make the decision when is okay.
ReplyDeleteSorry I just wanted to add that technically this is always a concern. Even for adults, the concern is that because kids aren't fully developed the risk is much higher and much harder to predict. So when it comes to kids instead of having a bad reaction in 1 out of 1000 people it is more like 1 out of 50.
ReplyDeleteI sure wish you had been around when my children were little. I know that often I had questions and concerns and didn't know what to do (and probably did a lot of dumb things!). That risk help line sounds great!
ReplyDeleteI for one dreaded the day they took cough medicine off the market for kids! I still have one bottle with the dosing chart from when Hailey was a baby. I treasure it and dole it out only when the kids are really sick. We had it as babies, my oldest had it- we're all just fine. I know that it doesn't "cure" the cold, only treats the symptoms, but I think it's inhumane to let them suffer with the symptoms when the proper dose of a cold medicine can relieve them and let them sleep. When baby comes, you'll understand. It's torture to sit and watch your baby unable to breathe. The reason it was taken off the market was because of the idiot parents who ABUSED it and overdosed their kids. Stupid people, ruining it for everyone.
ReplyDeleteGreat blog Ben, and on a sidenote I appreciate your intelligence as it pertains to my own medical problems! :)