You may have heard of the recall of several types of children’s cold medicines not too long ago. You may have even been scared that such dangerous medicine was ever available. What you might not know, is that the medicines were not dangerous at all. The problem was parents overdosing their children without even knowing it.
Baby Medicine vs. Toddler Medicine vs. Adult Medicine
The key to all of the confusion is the way over the counter medications are produced. For an adult, Tylenol, for example, comes in several pill formats. Each pill contains a certain amount of acetaminophen, typically 325mg for Regular Strength Tylenol or 500 mg for Extra Strength Tylenol. As an adult, you swallow the pill with some water; no big deal.
For toddlers, asking them to swallow a pill with water is a little too much. Their small throats plus lessor control over both their swallowing and gag reflex makes standard pills a choking problem waiting to happen instead of helpful medicine on the way. Instead, toddler formulas of Tylenol, typically called Children’s Tylenol, are a liquid. The liquid contains 160 mg of acetaminophen in 5 ml of liquid, which equals 1 teaspoon. In other words, there is approximately 1/2 dose of adult Tylenol in each teaspoon of Children’s Tylenol. If you give your child two teaspoons of Children’s Tylenol, it is the same thing as giving them one Regular Strength Tylenol pill.
For babies, pills are of course out of the question. But, babies also can’t be expected to take a lot of liquid either. So, in Infants’ Tylenol Drops, there is 80 mg for every 0.8 ml. In other words, there is 100 mg of acetaminophen in every 1 ml of Infant Tylenol. Another way to put it is that in the same 5 mL that dosage that Children’s Tylenol uses to provide just 160 mg of medicine, there is 500 mg of acetaminophen, which is the equivalent of one whole adult extra strength dosage.
So, what’s the problem?
There isn’t one, as long as you measure correctly and accurately. But, if you think “close enough” as you measure out a teaspoon of medicine for your child, you might be causing a big problem.
This is exactly what was happening with those children’s cold medicines that got recalled. Parents who either lost the measuring cup from last time, or those who weren’t precise about their measurements were giving their children “just a little bit” over the proper dosage. However, as you can see above, just a little bit makes a huge difference in the more concentrated infant formulas. Even worse, since babies have small bodies, each extra bit counts for a high percentage of total body weight. So, when a baby that was supposed to get EXACTLY 2 mL got APPROXIMATELY 2 mL, they got the equivalent of 1 3/4 doses or maybe even 2 doses. Couple that with a parent impatient to wait the full amount of time in between dosages and you have a recipe for a big overdose of cold medicine, so rather than run the risk, the FDA pulled these types of medications.
Medical Measuring Syringes Used For Baby and Toddler Medications
The good news is that you aren’t really missing out on anything. Most pediatricians recommend against giving babies or toddlers medicines with multiple ingredients like most cold medicines. The bad news is that even with something like Children’s Tylenol or Children’s Motrin, you still want to be very precise with your measurements. Since babies and even some toddlers aren’t all that good at making sure everything in the little cup ends up in their mouth, you need something better.
If you get a prescription medication for your baby or toddler, the pharmacy will include a little oral delivery syringe with the medication to measure it with. These syringes are made of a clear-ish plastic and marked on the side with amounts indicating how much liquid is held in the syringe at each level.
The syringe works by placing the tip into the liquid and then drawing back the plunger. This sucks up the liquid medicine. Then, using the lines on the side of the syringe, you can push the plunger back down squirting the liquid back into the container until you have EXACTLY the right measurement. Place the tip inside baby’s mouth and slowly press down on the plunger. This ensures that all of the medicine ends up helping the baby, and none of it ends up on his face. It also ensures that she does not get any extra medication.
But, what if you don’t have a prescription and you need to give some Tylenol or Motrin (ibuprofen) to your baby or toddler? The syringe is still the best way to go. You can buy them as some pharmacies like Wal-greens or Rite Aid. However, you can get them for FREE at your local Target store. I found this out after wandering through the over the counter medicine area looking for children’s dosing syringes to buy and couldn’t find any. When I asked the pharmacist, he wandered over to an area behind the counter and came back with two syringes!
Tips For Giving Baby Medicine
By now, you know that the only way to give a baby medicine and do it right is with a medical syringe. Make sure you have some on hand, because you never know when a 2:00 AM trip to 7-11 to buy Children’s Motrin is coming.
Here are some other tips for giving babies and toddlers medicine.
- Aim the syringe so that it squirts into baby’s cheek and not directly into their throat, otherwise they might choke.
- For older children, press the syringe slowly and steadily and they will instinctively drink from it like a bottle.
- Replace your syringes every couple of months. Drop by a Target store and get new ones. Do it while you are filling a prescription (yours or anyone’s) to make it twice as nice, since they certainly have no trouble giving them out to paying customers. (I’ve never had a request refused, nor gotten even the slightest bit of attitude about it, but you never know.)
- Clean your syringes after every use and leave the parts unassembled on a plate to dry out.
- Throw away syringes after a bout of illness is complete. No sense keeping something around with germs on it to re-infect baby.
Make sure you use a baby syringe and follow your pediatrician’s guidelines about dosing. Generally, dosing based on weight is better than based on age, so make sure you ask about both Children’s Tylenol and Children’s Motrin at your next visit.