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Children & Medication Outside the Home

The use of medication for young children is on the rise. This increase is due to several reasons: the increase in asthma treatments, a greater reliance on medication for behavior control, and the increased incidence of some diseases. Most medications given to children are for colds, infections and pain or fever, but many children are diagnosed with chronic conditions such as Attention Deficit/Hyperactivity Disorder (ADHD), diabetes, depression or asthma where therapeutic drugs have become a way of life.

Educators and parents must work together to develop appropriate strategies for the use of medication in the child care or school setting. A child’s medical condition and the drugs being used to treat it require good communication between parents, teachers, nurses, providers, counselors, and children.

Keeping Records

By keeping good records of your child’s medical history - everything from immunizations to allergies - you will be prepared should she become seriously or chronically ill. Update your home health file regularly as you will need it again and again when enrolling your child in child care or summer programs. Take careful note of any medications that may have caused an adverse reaction.

Provide your child care provider or school nurse with the names and phone numbers of your child’s health care professionals. For chronic conditions such as allergies, asthma, or diabetes, write down when the illness was first diagnosed, how it is being treated, and what drugs are being used for treatment. To help prevent a mix-up, be sure to write down any special instructions directly on the bottle, such as before or after meals, or with or without a drink.

Administering Medications in the Child Care or School Setting

Parents and school nurses or child care providers must develop a good system of communication with one another to know where medications are consistently kept, who has access to them and who administers them. Most questions about administering medications are best answered by the doctor or pharmacist but here are a few general guidelines you can keep in mind:

• Most liquids should be refrigerated as many can lose strength if stored at room temperature. 
• Most antibiotics for young children can be taken with food but be aware of tetracycline which should not be taken with milk products and not used for children under age nine.  
• Most asthma inhalers come with 200 puffs per vial. An inhaler that floats is a good sign that it’s empty, but keeping track of the number of puffs used is most accurate. 
• To measure medicine accurately use a marked medication cup, dropper or spoon. An ordinary teaspoon is not accurate. 
• Medication should be in the original, child-proof container. Parents can ask the pharmacy to divide the medications into two containers to avoid taking medication home from school each day. 
• Be sure children take medications for as long as and exactly as prescribed. This is especially true with antibiotics.

Medication Permission Forms

For each medication a child is using, schools and child care centers must ask the parent to fill out and sign a form before the child is dropped off for care. Design your form with the following in mind:

• name, address and phone number of the child’s doctor 
• the name of the medication 
• what the medication is for 
• when to use the medication (when symptoms are displayed or at set times of day or for emergency) 
• how to use the medication (pill, liquid, inhaler, full strength or diluted) 
• special considerations (take with or without food/liquid or milk products) 
• dosage or amount of medication 
• how soon the medication should take effect 
• how the medication should be stored 
• possible side effects 
• life expectancy of medication (expiration date or knowing when a container is empty, such as an asthma inhaler).

For medications taken on a long-term basis, schools and child care centers should know when to inform parents when medicines are low. A routine prescription refill can take as long as a week.

Wash It Down With Water

Recent research has shown that substances found in grapefruit juice can dramatically increase the potency of some medications. Other citrus juices can actually lessen the strength of certain drugs including some antibiotics. It’s a good idea to stick with water or a less acidic juice, such as apple, when giving medication. Stay away from milk too as it can cause adverse reactions with certain antibiotics. To be safe, ask your pediatrician or pharmacist about food and drug interactions before starting new prescriptions.

Side Effects

Parents and educators must be alert to any unusual symptoms as well as the impact of side effects on a child’s learning and behavior. Side effects can range from minimal to life-threatening. So-called ‘minor’ side effects could be diarrhea, drowsiness or a rash. These are unpleasant but not intolerable.

Other side effects may warrant medical attention or at least a call to the doctor or health care provider. Symptoms to be aware of would include irregular heartbeat, protracted vomiting or diarrhea, fainting, extensive rash, seizures or convulsions, difficulty breathing, severe headaches, or yellowing of the skin or eyes. Be aware of the impact of medications and develop a critical awareness of what to look for.

For Your Reference

Parent & Educators’ Drug Reference: A Guide to Common Medical conditions and Medications for Children By Alan P. Agins, Ph.D., Pharmacologist Published by PRN Press, Cranston, RI, 1999 or use www.kidmeds.com. This easy-to-use medication guide provides practical information on how various drugs work, their side effects, and how medications impact children’s education. Explanations are given for common medical conditions and treatments for children. Throughout the book are helpful tips, recommendations, and suggestions for both parents and teachers.

The ABCs of Safe and Healthy Child Care: A Handbook for Child Care Providers Published by the Department of Health and Human Services, 1996. Call 800-553-NTIS or use www.cdc.gov/ncidod/hip/ABC/abc.htm

Child Health Talk
Newsletter for parents published by the National Black Child Development Institute. Call 800-556-2234 or use www.nbcdi.org

Healthy Child Care America
Newsletter by the American Academy of Pediatrics for health care professionals, child care providers and families. Call 888-227-5409 or use www.aap.org

Sesame Street Goes To The Doctor
Created by Children’s Television Workshop and sponsored by Pfizer. This package for child care providers and parents includes a video, magazines, a poster, a guide to good health practices and is available at your local child care resource and referral agency.