How to give medicine to infants and young children with high incidence of respiratory diseases

Respiratory syncytial virus, mycoplasma, and influenza have become popular in autumn and winter recently. Nine out of ten parents in pediatric clinics will ask the doctor about feeding the medicine. In fact, the core principle is never "the medicine must be given in full", but to ensure that there is no choking or additional risks. The rest of the skills are centered around this core.

Last week, I met a 2-year-old boy at the outpatient clinic. He originally had a mild mycoplasma infection and was prescribed azithromycin dry suspension to take at home. As a result, the grandmother was afraid that the baby would vomit, so she pinched his nose and forced it down. The baby cried so hard that he couldn't breathe. He choked the medicine directly into the trachea, which turned into aspiration pneumonia. He stayed in the hospital for an extra week. The parents shed tears of regret.

The most confusing thing for many parents is whether to refill the medicine after vomiting it all. There is currently no unified conclusion in the industry: some doctors believe that if you vomit a lot within 15 minutes after taking the medicine, and almost all the medicine can be seen with the naked eye, you can refill it at the original dose; some doctors believe that infants and young children absorb the medicine quickly. The fever is faster than that of adults. Even if you vomit just after feeding, part of it may have been absorbed. It is safer to supplement half the amount to avoid excessive burden on the liver and kidneys, especially antipyretics such as ibuprofen and acetaminophen, or drugs with narrow safety windows such as azithromycin and theophylline. If you are not sure, ask the doctor first and don’t blindly supplement by yourself.

To be honest, choosing the right dosage form can save half the trouble. Many pediatric nurses around me have their own babies, and they give priority to choosing fruit-flavored drops and suspensions for their young babies. They try not to choose ordinary tablets ground into powder. Firstly, many enteric-coated tablets and controlled-release tablets for adults will destroy the sustained and controlled-release structure after grinding, causing the dosage to fluctuate. Secondly, ordinary tablets become bitter after grinding, which makes the baby more resistant. When feeding, don’t hold a spoon against the base of the tongue. Squeeze slowly along the gap between the cheeks and gums, a little at a time, and wait for the baby to swallow before feeding the next mouthful. This will not easily trigger the gag reflex and make it difficult to choke. After feeding, you can give the baby two sips of warm light apple water to smooth the taste, which can also reduce the probability of subsequent nausea and vomiting.

There is also a controversial issue: Can the medicine be mixed with milk powder or complementary food? There are two schools of thought on this topic: those who support it believe that as long as there are no clear incompatibility taboos between medicine and food, mixing a small amount of fruit puree and warm milk will make the baby more receptive and worry-free feeding; those who oppose it believe that mixing it with food may make the baby resist breastfeeding and supplementary food. On the other hand, if you mix a whole With bottle milk, if the baby can't finish it, it's impossible to calculate how much medicine he's taking, especially antibiotics that have strict dosage requirements. If you can, feed it directly. If you really can't feed it, you can mix one or two spoons of warm milk or fruit puree. Don't mix too much, just make sure the baby can finish it in two mouthfuls.

In fact, there is no need to fight with the baby for missing a mouthful of medicine, especially if the baby has a sore throat and uncomfortable body with a respiratory infection. Forced feeding will make the baby more resistant and may even cause choking. It doesn't matter if you feed a smaller amount at one time occasionally, as long as the next dose is spaced enough and you follow the doctor's instructions for a sufficient course of treatment. After all, the premise of giving medicine is always the safety of the baby first.