Safety First Parents Need to Know How to Handle Children’s Medications

Medications can be lifesavers — but, handled incorrectly, they can be extremely dangerous, especially to children.

Parents and caregivers need to be aware of several medication-safety guidelines that are critically important to follow, chief of which involve the proper dosage of all medicines, following directions carefully, and safe handling and storage.

Dosage and Directions

The inaccurate measuring of liquid doses is one of the top medication errors occurring in children. Never use a household teaspoon. Instead, ask your pharmacist for an accurate dosage cup, spoon, dropper, or oral syringe. When over-the-counter (OTC) medications are packaged with a measuring device, use only that tool to accurately deliver the dose of that specific medication.

Accurate dosing and measurement of a child’s medication, especially liquids, is essential because his or her body is typically more sensitive to overdoses than an adult’s. For this reason, it is important to know your child’s current weight. Unlike adults, who use standard doses, doctors and pharmacists determine a child’s dosage based on weight and/or age.

Reading the directions is critical for both prescription and OTC medications. These directions provide helpful guidance on how to take the medication. Ask your pharmacist about possible side effects, how long to take the medication, and what to do if your child misses a dose. In addition to dosage instructions, be particularly mindful of directions such as ‘take with food or milk’ or ‘take on an empty stomach,’ which can affect how the medicine works.

If your child begins to exhibit side effects from the medication or their illness suddenly gets worse, know how to contact your doctor after hours. If your child misses a dose, doubling the dosage is not the answer. Check with your pharmacist on what to do.

Sometimes missing a dose has nothing to do with being forgetful and everything to do with the taste of the liquid or the inability to swallow a pill. If taste is preventing your child from taking the prescribed medication, check with your pharmacist, who may be able to make it more pleasing with special flavorings.

If a child will not swallow a pill, ask your pharmacist if it can be crushed. Some extended-release medications cannot be crushed, chewed, or altered in any form. So it’s a good idea to check with your pharmacist first. If it’s OK to crush, mix it into a small amount of soft food such as applesauce, pudding, or mashed potatoes. The food must be consumed in its entirety, so smaller amounts are better compared to larger portions, which may not be completely eaten.

In the worst-case scenario, if a child simply won’t take the pill, no matter how it’s presented, there may be a liquid application available. If your doctor can’t find a liquid form listed, double-check with your pharmacist, who may be able to prepare a liquid formulation by special recipe. There are also newer methods of delivery for some medications that you should ask your pharmacist about, such as chewable pills and others that disintegrate under the tongue.

Storage Solutions

Children love to imitate their parents, so it’s a good idea to avoid taking your own medications in front of them. Many kids love candy, so it’s a good idea to never refer to any medicine as ‘candy.’ In fact, many flavored medications contain high amounts of sugar and taste like candy. Chewable multivitamins, for example, look like candy and taste good to many children, but can be harmful if taken in excess because they contain iron.

To guard against any temptation, keep all medicines out of the reach of children, preferably in a locked cabinet or box. Some medications require refrigeration and should also be placed out of reach on the top shelf of the refrigerator. Also, make sure all medications are supplied in a childproof container.

Parents should also be especially cautious when purchasing OTC medications for their children. Due to safety concerns recently published by the U.S. Food and Drug Administration, cough and cold medications should not be given to children under 4 years of age. Also, do not give aspirin to youngsters under 16 years of age who may be suffering from a virus such as the flu or chicken pox. Doing so could result in Reye’s syndrome, a potentially life-threatening disease. Always read the labels, as some OTC medicines contain aspirin, which may also be referred to as salicylate or acetylsalicylate.

Additional tips include keeping a list with you at all times of your child’s prescription and OTC medications, vitamins, herbal remedies, or dietary supplements, as well as any allergies to specific medications. Share the list with your child’s pediatrician, pharmacist, and school nurse. Also, consider using one pharmacy to dispense all of your medications as the best method to identify any potential drug interactions. v

Kathleen B. Kopcza, Pharm.D., BCPS, is a clinical pharmacy specialist, pediatrics, in the Department of Pharmacy Services at Baystate Health. Mark Heelon, Pharm.D., is a medication safety specialist in the Department of Pharmacy Services at Baystate Health.