Sheena, a mum pharmacist explains about baby vaccinations and medication.

Vaccination time is one which causes stress and unease amongst parents and babies alike! As parents we want to do our best to alleviate our children’s discomfort or pain and often question what the best way to do this is. Giving medicines to babies prior to vaccination often comes up as a suggestion. I wanted to take the chance to explain when this is appropriate and when it is not.

Obviously, we all want to ease the pain of our little ones but over-medicating can be more harmful than the scratch of a vaccination needle. There are times when it’s a good idea – and times when cuddles will do just as much good! Hopefully I can explain the difference here!

• In the UK, like in Ireland, we vaccinate our babies against Men B. When this vaccine is given at 2 and 4 months of age your baby SHOULD be given paracetamol to prevent a high fever developing. The first dose (60mg = 2.5mls infant suspension) should be given at the time of vaccination and the second dose 4-6 hours after the first, and the final dose should be given 4-6 hours after the second. That is a total of three doses. The Men B vaccine is more likely that other vaccinations to cause a high fever and that is why this rule applies exclusively to it.
• Ibuprofen SHOULD NOT be given before vaccines as a preventative measure of fever.
• Men B is the only vaccine that has the requirement to treat with paracetamol in a preventative manner as described above – so medicine should not be given routinely at other vaccination appointments.

So, to sum it up, Paracetamol is recommended (please read the article about the safest way to administer medicine to babies) with the Men B vaccinations but other than that medicines should not be given to prevent fever or discomfort in babies prior to vaccination. The exception of this rule of course is if your baby does develop a fever over 39 degrees Celsius or is in pain or very irritable post vaccination. In this case either Paracetamol or Ibuprofen (please read the article about using Calpol and Nurofen together) can be used as per the product literature – always read the label to confirm the dose before giving medication as our babies grow up so quickly and dosage quantities vary with age and between products so a fresh eye on each administration can reduce errors and keep your baby safe and appropriately dosed.

If you have any questions I’m always happy to help. Contact me on my contact page on www.wonderbaba.ie or through private messaging on the WonderBaba Facebook page.

 

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Sheena, a mum pharmacist explains if Calpol and Nurofen can be given together.

Calpol is a commonly known brand of children’s Paracetamol, whilst Nurofen contains a different drug altogether, which is called Ibuprofen. I frequently get asked the question: “Can I give both of these medications to my baby at the same time?” The answer, like most things, is a little complicated, so hopefully I can make it a little bit clearer for you here!

Paracetamol (Calpol) works to reduce pain and fever in your child. It can be used for things like headache, teething pain, toothache, earache, sore throats, colds and flu, aches, pains and fever post vaccination.

Ibuprofen (Nurofen) is a pain killer and anti-inflammatory which also reduces pain and fever and is useful for the same types of illness or discomforts as Paracetamol but can also be useful for minor aches and sprains.

Unfortunately, most parents or caregivers come across these types of ailments at some stage or another when caring for a young child or baby and are faced with the question of which medication is best. Conflicting advice lays all over the internet about whether one medication should be chosen over another and if, in the case of a severe fever, both can be given at the same time. Recent guidelines published, both reassured parents and caused concern, due to the way in which they were translated by the media.

As a Pharmacist and mum myself, my ethos, which is in line with my code of conduct as a healthcare professional, is to give the lowest dose of medication necessary for the minimum required time. That is underpinned by our standard, that the correct medication is given to the correct patient, at the correct time and in the most appropriate form. No child needs to suffer unnecessary pain or distress and in the case of fever, or illness, it can actually be detrimental to under-dose your child.

So, what’s the best approach?

I recommend administering Paracetamol to your child if they have any of the conditions listed above and are feeling distressed. Always read the leaflet to ensure you are giving the recommended dosage based on your child’s age. If after an hour, your child’s symptoms have not been alleviated, then you can administer the appropriate dose of Ibuprofen.

I always start with Paracetamol as it is easier on the tummy. However, it is worth noting that Paracetamol works for 4-6 hours and can only be given a maximum of four times in 24 hours, whereas Ibuprofen works for 6-8 hours and can only be given for a maximum of three doses in 24 hours. You may choose to go with Ibuprofen rather than Paracetamol if you are administering medication when you are going to bed. It will last for longer and improve everyone’s chances of having a good night’s sleep!!! The main message is that you should not routinely administer both medicines at the same time – you should administer one and see what your baby’s response is, as they may not need the second medication. Obviously, after an hour, if you are unhappy with the response and feel they need additional medication, then it is perfectly safe to administer the second product, whilst sticking to the recommended dosage regimens!

I hope this helps to clarify the confusing topic of ‘over the counter’ medications for children. Please note that there are many products on the market with different names, which contain either Paracetamol or Ibuprofen. You have to be mindful that you do not administer two of the same medication, as this would lead to overdose.

If you have any questions I’m always happy to help over on my contact page on www.wonderbaba.ie or through private messaging on the WonderBaba Facebook page.

So you never miss helpful articles like this, please follow Medapti on Facebook, Twitter, Instagram or Sign Up to our Newsletter. Also, watch our video to learn how Medapti can help you dispense the medicine more easily and gently.

As the first-time mum, I wasn’t aware that the safest way to dispense the medicine was to aim it to the side of the mouth. I found out about it while looking for tips on how to safely give medicine to your baby, when my son refused to take it. I quickly learnt how scary it can be, if the baby suddenly moves and the medicine accidentally shoots straight down the throat and ends up in baby’s windpipe. Luckily, my son always got his breath back quickly but these short moments, when he was trying to catch his breath, were terrifying. The more I spoke to other mums about it, the more similar stories I have heard. This is why, I asked Sheena, a mum pharmacist, to explain why administering the medicine to the side is so important. Here is what she said, together with the best practices on how to dispense medicine to babies.

A mum pharmacist explains the importance of aiming to the side when administering medicine to your baby

Every parent is likely to come across a time where they have to give their baby medicines. It’s a scenario nobody wants of course but our babies and toddlers like to keep us on our toes!

There is every hope it could be for something as simple as giving a multivitamin syrup, but it can extend to administering medicines for pain relief, a high temperature, vaccination protocol and even infection control. Whatever the reason it can be a daunting task which leaves you wondering how best to approach it safely and also in a way that will cause minimum distress to your baby.

Let’s start by discussing how to give your baby medicine and then by exploring why side administration of oral liquid medicines is so important.

How to give liquid medicines to a baby

To administer oral liquid medication such as liquid paracetamol (e.g. Calpol) or ibuprofen (e.g. Nurofen) try the following technique:

• Read the bottle’s packaging fully and ensure the medication you are administering is the correct product, the correct strength for your baby, in the correct amount and at the recommended time intervals. Never give medication unless you are sure of what you are doing and if in any doubt contact your local pharmacist, or another healthcare practitioner. If you accidentally give too much medication to your child contact the National Poisons Information Centre or contact your doctor or emergency out of hours services as soon as you can.
• Wash your hands in hot and soapy water. Measure the recommended dose using a baby oral syringe or baby medicine dispenser. Get a double check of this if you have someone nearby – It’s always good to be careful – especially when we are all so tired with young children! I’m sure your other half will be delighted to be woken at 4am to cross check ?

How to use an oral syringe according to the NHS:

• Wash your hands.
• Make sure your child is sitting upright.
• Shake the medicine bottle unless stated otherwise on the label.
• Remove the top from the bottle and insert the bottle adapter if necessary.
• Insert the tip of the oral syringe into the bottle adapter.
• Turn the bottle upside down and pull the plunger until the medicine reaches the right dose.
• Gently remove the tip of the oral syringe from the bottle adapter.
• Put the top back on the bottle.
• Put the tip of the oral syringe inside your child’s mouth.
• Gently push the plunger to squirt small amounts of medicine into the side of your child’s mouth.
• Allow your child to swallow before continuing to push the plunger.
• Give your child a drink to wash down the medicine.
• When you have given the whole dose, wash the syringe in warm, soapy water unless directed otherwise on the label.

The importance of side administration

Now that we have discussed the correct protocol using best practice and the NHS guidelines, I just want to take the chance to highlight the importance of the side administration of medicine to your baby. This basically means that you are directing the medicine towards the back of the cheek in your baby’s mouth in small amounts. If you give large volumes of medicine or give it to the centre or front of the mouth it can cause problems for a few reasons.

First of all, the gag reflex could be triggered which would not be pleasant for your baby. This can also result in a loss of some of or all of the dose you are trying to administer. Secondly, if medicine is squeezed towards the front or middle of their mouth, then they are a lot more likely to spit it out or for it to dribble out of their mouths resulting in an inadequate or lost dose.

A baby has an extrusion reflex which is also known as the ‘tongue thrust reflex’ and this is a protective mechanism which helps to prevent them from choking. If you administer small amounts of the medicine to the side of the mouth near the cheek, you are bypassing this reflex which greatly increases the success rate! Any loss of medicine can result in a reduced dose but as you cannot measure what has been lost, due to spitting etc., it is not safe to give more medicine until the next regular dose is due. Giving an extra couple of mls could result in over-dosage.

Scarily choking is also a risk when giving your baby food or liquids. By using a side of the cheek administration technique, you are allowing your baby’s swallow reflux to cope with the small volumes of liquid you are giving them.  For the same reason, it is important to ensure your child is upright during feeding or medicine administration and never in a lying down position.

If you have any questions I’m always happy to help. Contact me on my contact page on www.wonderbaba.ie or through private messaging on the WonderBaba Facebook page.

So you never miss helpful articles like this, please follow Medapti on Facebook, Twitter, Instagram or Sign Up to our Newsletter. Also, watch our video to learn how Medapti can help you dispense the medicine more easily and gently.