European Stars and Stripes (Newspaper) - April 24, 1990, Darmstadt, Hesse                                Medication for children parents often make faulty choices by Jane e. Brody new York times although most childhood ailments Are minor they Are often sufficiently bothersome to prompt parents to try some form of drug treatment to relieve symptoms or Foster a rapid recovery. A study of 500 parents by or. Marshall h. Becker and colleagues at the University of Michigan school of Public health revealed that half kept seven or More types of drugs on hand for their children often More than one drug in each category. Four out of five interviewed said they would medicate their children for fever without consulting a physician. A panel of six paediatricians who reviewed the drug choices concluded that the parents had a lot to learn about the effectiveness desirability and possible hazards of the medications they gave their children. Over All the panel gave the parents Low to moderate grades for their drug choices. The parents including those in the higher socioeconomic groups often medicated their children inappropriately choosing drugs that were either useless or counterproductive. The parents in the lowest socioeconomic group had the lowest ratings. But even in the highest socioeconomic group the ratings were poor. For example in treating children with upset stomachs or diarrhoea the parents often chose medications that caused More harm than Good. Some parents reported giving laxatives to their children every Day in Hopes of preventing constipation. Such a practice can permanently damage natural Bowel function and result in lifelong constipation. Other parents reported administering aspirin daily to prevent headaches not realizing that aspirin can cause stomach upset and bleeding. Among the lowest Marks parents received were for the use of vitamins which Becker called Quot the perfect example of an abused Over the counter  while noting that children who Are starving or subsisting on poor diets could Benefit from Vitamin supplements Becker said Quot the vast majority of children in this country done to need Vitamin  but Over the counter medications Are far from the Only problem. Prescription drugs too Are often inappropriately handled and administered by parents who Are poorly informed. Problems include giving children medication left Over from a previous illness giving them drugs that were prescribed for an adult changing the dose schedule to suit the family a needs or stopping the drug too soon. Also still a problem is careless storage of both prescription and Over the counter medications used by adults. Despite child proof lids each year thousands of Small children Are poisoned by their parents or grandparents drugs. Children s Small size is important because a Small mistake in dosage can be proportionately More harmful to a child than an error of the same size would be to an adult. But in calculating an appropriate dose for a child you cannot simply give half of an adult dose because the child weighs half of what you do. When it comes to medication or almost anything else for that Matte children Are not just miniature adults. They Are metabolically different thus drugs can affect them differently at different Ages. Their Organ systems Are still maturing and in infants and Small children the liver and kidneys cannot detoxify and eliminate drugs As readily. The immature gastrointestinal tracts of infants and Small children can also absorb drugs faster which would make a Small dose proportionately larger and increase its toxic effects As Well. Proportions of fat and water also change Over the years which can affect concentrations of drugs depending on age. Hundreds of liquid medications sold Over the counter contain alcohol which can counteract or enhance the effects of other drugs and in overdoses can Poison a Small child. Possible effects of medications on a child s growth and development must also be considered. Drugs that have no significant effects on adults May cause lasting damage to a growing child. For example the drug phenobarbital a Barbiturate that for decades has been routinely prescribed for children who suffered febrile seizures has been shown to Blunt intelligence. Other drugs can damage the growth centers in Bones and stunt a child a growth. Still others May interfere with personality development or socialization. Thus some drugs should never be Given to a child or Given Only under special circumstances when potential benefits clearly outweigh possible risks. Or the dosage May have to be carefully adjusted with a vigilant Eye toward unwanted Side effects. These precautions demand consultation with a physician who is aware of the special problems of prescribing for children. A consult a physician first. Whenever possible ask the child s physician before giving medication whether it is to reduce a fever relieve a pain quiet a cough Settle a queasy stomach or relieve an itchy rash. The symptom May mean More than you realize and the treatment you administer could easily be worse than the disease. A when bringing your child to the physician be sure to Tell the doctor what medications both Over the counter and prescription drugs you have Given the child. Home treatments May confuse the diagnosis by creating or masking symptoms. A do not save leftover medications. Unless the child s physician has instructed you otherwise discard All antibiotics and other medications that remain after a course of treatment has been completed. If you Are advised by the physician to save them be sure they Are clearly labelled As to contents Date and prescribing physician. A follow dosage guidelines. When told to give a medication every eight hours for example do so even if it Means arousing yourself or the child from sleep. This helps to assure that a therapeutic blood level of the drug is maintained round the clock. If told to give the drug for 10 Days or two weeks do not Stop after three Days because the child seems completely recovered. It is often necessary to use the prescription completely to eliminate an infectious organism or to prevent it from going underground Only to resurface later in a More dangerous form. A give the Correct dose. For liquid medications use a standardized measuring spoon or medication measuring tub How children Are different in general children need smaller doses of drugs than adults but adjusting dosage is not simply a matter of weight. Metabolism and Organ function differ with  enzyme systems Are not fully developed at birth so drugs Are broken Down slowly and May build up in the body kidneys especially in the first six months of life kidneys cannot excrete drugs As efficiently As those of an  tract in infants and Small children the stomach and intestines can absorb drugs faster which might make a Small dose too  composition certain drugs May be More diluted in an infant s body. The amount and distribution of fat also differs with age affecting the absorption of other medicines. T 55% i water 1 70% water adult infant source Quot the american medical association guide to prescription and Over the counter drugs Quot random House for infants not household Teaspoons which can vary greatly in size. Over the counter medications that May be Safe for children often do not list dosages appropriate for infants and toddlers. They suggest instead that you Call the physician. Do so rather than guess at the right amount of cough syrup to give your 18-month-old. A know what is prescribed and Why. Ask the doctor the name of the medication what effect it is supposed to have How Long it should take to show a Benefit and what Side effects you should be concerned about. Find out too How to administer the drug some should not be taken on an empty stomach or with milk for example. And write Down what the doctor tells you so you won t forget. A Monitor the child for Side effects. Each child is unique and a drug that May help one could harm another. Call the physician if the child develops new and unexpected symptoms while taking any medication whether it is a skin rash nausea or vomiting headache loss of balance undue lethargy emotional depression or hyperactivity. In addition never Tell a child that medication is Candy or tastes like Candy. Nor should you have to Reward a child for taking medication with More than a hug or verbal Praise. A child who can understand should be told simply that the treatment is necessary to relieve or prevent an illness for infants medication should just be Given with the same authority with which other unpleasant but necessary things Are done to babies. Page 16 a a a the stars and stripes tuesday april 24,1990 not a amps. Sharon Kilday