OTC Medicines: When Parents Play Doctor

April 2, 2008

There has been discouraging news over the last year for parents who use over-the-counter medications formulated for children.

Wow. And wow. As a parent, these types of incidents are just incredibly hard for me to understand. I hope that these unfortunate events promote a public discussion with regard to what constitutes an appropriate role for faith with regard to medicine and healthcare, and particularly for children.

On the other side of the spectrum, there has been discouraging news over the last year for parents who use over-the-counter medications formulated for children. I found it interesting that that UK has just banned the sale of infant cough and cold remedies, on the heals of the public health advisory issued last year by the FDA. However, unlike the UK, the US is depending on voluntary withdrawal of medications on the market.

One of the problems we face is that the deaths which have been documented in children as the result of decongestants and antihistamines in the US have been predominantly in children under the age of 2, and I can go just about anywhere and purchase a pediatric cold medication that provides caretakers with a dosage for children under the age of 2.

You’re already acutely aware that working parents are between the proverbial rock and hard place. My own daughter went to her first corporate meeting when she was 9 days old, and was in daycare by 5 ½ weeks (I wasn’t eligible for family/medical leave, so my employer at the time called the shots). Within weeks of starting daycare, she had her first cold and within weeks of that, her first ear infection. I recall feeling like I was leaving her each day in a functional petri dish. And even when I knew better, the temptation to try to relieve her symptoms was enormous — after all, most of us don’t have the luxury of a schedule that accommodates illness, and this is especially true when illness occurs with any kind of frequency. Not to mention that it’s hard to watch your child suffer.

There’s also the “little adult” approach that some parents take to consider. Children just don’t metabolize medications the same way that adults do, and this is a difficult concept for many parents. A father who knows through experience that dextromethorphan, for example, reduces his own cough symptoms may not recognize that the same medication will not be effective for a child in a smaller dose. In a dose large enough to be therapeutic for a young child, many of these medications are dangerous.

And my questions are, as we are coming off of the cold and flu season, how do you think we’re doing so far with respect to encouraging parents not to use these products? What is your own office doing to educate parents on the dangers of treating viral symptoms with OTC medications? Has the potential for parents to misuse these products (or using them despite the warnings posted to the public) really been addressed, and if not, should the FDA take stronger action to get them off the shelves?