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.

I hope you have found the information in this article useful, if you have any queries don’t hesitate to contact me. My name is Sheena and I am an Irish Pharmacist at www.wonderbaba.ie