Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: MONDAY, April 16, 1990 TAG: 9004140230
SECTION: EXTRA PAGE: E-1 EDITION: METRO
SOURCE: JANE E. BRODY
DATELINE: LENGTH: Medium
A study of 500 parents by Dr. 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 pediatricians 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 diarrhea, 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 "the perfect example of an abused over-the-counter drug."
While noting that children who are starving or subsisting on poor diets could benefit from vitamin supplements, Becker said, "The vast majority of children in this country don't need vitamin supplementation."
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's 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 matter), children are not just miniature adults.
They are metabolically different and 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's 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.
by CNB