Underdosing February 2, 2009

It’s a cruel rite of passage that most new parents experience during their first year on the job. Having escaped the trial with my first, I was put to the test with my second child.

At around midnight, I heard my 10-month-old daughter crying in a way that told me she was not just turning over or wanting an extra cuddle. Something sounded wrong and sure enough, she was burning up. I promptly went to the medicine cabinet, took out the infant Tylenol and gave her the dose listed on the bottle.  By 4:00am her temperature was rising again. So back to the medicine cabinet I went. As I rocked her, I noticed her eyes staring up at the ceiling – looking at something that I was sure was not there. I will never forget that stare. Just then, those little eyes rolled back, her lips turned blue and her body shook. And then she stopped breathing.

I’m not sure how long it lasted but by the time the paramedics arrived she was breathing fine. When I saw my doctor the next day, she explained that my daughter had had a febrile convulsion caused by how quickly her temperature had risen.  After discussing what I had done to try to bring my daughter’s fever down, we discovered that I had probably underdosed her.

Rather than dosing my daughter according to her weight, I had used the chart on the medicine bottle that lists doses according to age.

I later learned that this is not an uncommon mistake made by many parents.

Why do so many parents not give their children enough fever-reducing medicine? Studies  suggest a couple of reasons, including the one that got me – package labelling that gives the dose by age and not by weight.

When I reached for the Tylenol that night, I should have referred to the small paper insert inside the box that lists doses by individual weight. I would bet however, that in most households, once the medicine bottle goes into the medicine cabinet both the box and that insert go into the trash.

Pharmaceutical companies should be required to print the dose by weight on the outside of the bottle and the outside of the box. A parent who is trying to sooth a feverish baby in the middle of the night can’t be expected to have the frame of mind to dig out that little piece of paper (assuming he or she kept it) that lists dose by weight.

Parents also need to be warned at pre-natal classes, during their time in hospital after delivery, and by their doctors not to dose their baby according to her or his age.

Like so many other health care dilemmas, what is at stake is absolutely priceless. What is remarkable about this particular problem, however, is that it can be easily solved.

Mihad Fahmy

Mihad Fahmy is a London Ontario mother of three. She practices human rights and labour law and is always on the lookout for the perfect novel to escape into at the end of a busy day.

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