As far as children are concerned, to medicate or not to medicate is the big question. When it comes to the health of their offspring, the worry for parents is sometimes overwhelming. With so many in-your-face ad campaigns promoting health insurance for children, parents who have signed up for such plans often think they should "maximise" the benefits by taking their child to hospital every time they so much as suspect an illness. Many doctors in this country are inclined to prescribe remedies for the mildest symptoms and if this happens often enough the excessive medication can have negative effects on a youngster's health.
While taking an incorrect dose or other improper use of over-the-counter medicine can be harmful for adults, it can be potentially fatal for very young children, warned Dr Terapong Boonyaleephun, a Bangkok-based paediatrician. He pointed out five common mistakes that parents make regarding the treatment of their kids' illnesses with drugs.
MEDICINE IS THE BEST ANSWER
Although first-time parents tend to get alarmed at the slightest sign of illness in their child, every single sneeze and cough doesn't have to be treated with drugs. Dr Terapong pointed out that some symptoms go away naturally without the need for medication.
One example he gave was using a cool, damp cloth to bring down a child's high temperature; he said this can sometimes be more effective than a pill.
"While medicine needs time to get absorbed and start its job, a cool washcloth works instantly. What's more, it can be used as frequently as you want, whereas fever-reducing medicine can only be re-administered at intervals no shorter than four hours."
Sometimes it is better to let nature run its course, he said, because medicine does not always cure an illness. Some illnesses need to be seen off by the body's immune system and taking medicine only serves to alleviate the symptoms.
Mild cases of sickness, like the common cold, can be treated with plenty of fluids, rest and lots of TLC, he said, while more severe conditions like dengue fever may need immediate attention.
"You shouldn't use medicine to fight every symptom. It doesn't solve the real problem. Some illnesses have many symptoms and if you are going to give your child one type of medicine for each symptom, the child's body certainly cannot take that amount of medication."
THE MORE, THE MERRIER
"Improper dosages of fever-reducing drugs is one of the biggest problems in giving medicine to children," said Dr Terapong. "If used more than directed, it can cause liver failure and even death."
Even over-the-counter remedies like painkillers and fever-relief pills can cause serious harm if used incorrectly, especially for young children. Do not assume that bigger kids can take double the dose recommended for little babies. Infants are usually given concentrated drops because they still cannot swallow very well, so giving an older child a larger amount of the same could be dangerous.
Always follow the instructions on the packet or bottle of medicine and never assume that you can speed up your child's recovery by increasing the dosage.
"Read the label carefully and don't assume that the more medicine your child gets, the faster the symptoms will go away. It doesn't work like that," warned the paediatrician. He also noted that some medicine, after prolonged use, can interfere with a child's growth and general health. As an example he singled out patent remedies for the common cold which in the past were often given to children to treat the effects of various allergies.
"When parents realised that medicine for colds could ward off allergy symptoms, some would go out buy a particular remedy even though it hadn't been prescribed for their child. But it was later discovered that children who were given cold medication over a long period of time did not grow as fast as other children," he said.
SAVING MONEY BY USING LEFTOVER MEDICINE
Sometimes adults reach for medicine left over from a previous bout of ill health, assuming that it is still good. Dr Terapong warned that once the packaging is opened, most types of medicine should be used within a month, or even more quickly if it has not been stored in a cool, dry place. He explained that children's medicine often has colour added and that this is not just for aesthetic reasons, but also to indicate whether the quality is still good.
"Notice the colour of your child's medicine. Most medicines for children come in vibrant colours and if the colour looks strange you should throw it away. Medicine should be kept away from direct sunlight and heat sources. Once you've opened the packaging, there's a risk of bacterial contamination and the medication should be kept in a cool, dry place. The longer you keep it, the higher the risk that it will lose its effectiveness."
DRUGSTORE PHARMACISTS CAN RECOMMEND THE RIGHT MEDICINE
A pharmacist's job is to recommend a remedy for alleviating a certain set of symptoms, Dr Terapong said, not to diagnose the cause of those symptoms.
"If you're going to buy medicine from a pharmacy, only buy ones that you have used before and are familiar with. You can describe your symptoms to the pharmacist, but in my experience the person often neglects to mention some crucial piece of information, and some things are hard to describe anyway. So it's always better to see a doctor."
Another dangerous mistake is mixing different types of medicine; some drugs should never be used together.
"Although the symptoms occur simultaneously, the medicine for each symptom, when given together, can be a match made in hell. Some pairings result in less effectiveness, while some could potentially be dangerous," the paediatrician warned.
WHEN IN DOUBT, GOOGLE IT
Dr Terapong does not recommend using this or any other search engine to find remedies for your child's illness.
"A doctor can tell the difference between different kinds of cough, for instance, or what a rash is caused by. But how would you accurately describe your child's symptoms if you were typing key words into a search engine?"
Although many physicians now give free advice via the internet, face-to-face time with a doctor is still the best option.
"Sometimes you just can't describe the symptoms properly. The symptoms that most parents describe during a visit to their doctor's office often don't provide any real leads. The doctor usually has to ask follow-up questions, things which parents sometimes think are irrelevant.
"You could miss vital points when looking up information on the internet. And the kind parents who share stories about their children's illnesses mean well, but don't forget that they are talking about their children, not yours."
SYMPTOMS THAT REQUIRE A DOCTOR'S ATTENTION
High fever (39C or more).
Diarrhoea that leaves your child noticeably tired and quiet or that causes him/her to abstain from urination for a long time.
Severe coughing that leaves the child short of breath.
Vomiting after having a meal, for three meals in a row.
Any illness that does not get better within the space of three days.
NATURAL REMEDIES FOR GENERAL SYMPTOMS
DIARRHOEA
Drink the water in which rice has been boiled instead of milk, as the former is nutritious, easier to digest and higher in fibre. Sip warm water regularly to stay hydrated.
FEVER
Place cold, damp washcloths on areas like forehead, back, armpits and neck. Keep the child in a well-ventilated room and avoid using air-conditioning. Encourage sweating by covering the child with a blanket or rubbing his/her body with a washcloth soaked in warm water.
RUNNY NOSE
Unblock the child's nostrils with a saline nasal solution or by nose-suctioning. Moist, warm air can also relieve a stuffed nose, so place a humidifier in the child's bedroom.
COUGHING
Make sure the child gets lots of rest. Honey mixed with hot water and a little lime juice can soothe the throat and repress the urge to cough. Watch out for allergies that may be causing the symptoms.