MOTHER AND CHILD MEDICATION

SANU RCLINICAL EDUCATORHCAH

Medication Safety Tips for the Breastfeeding Mom

Many medications are safe to take while breastfeeding, you should always consult your health-care professional before taking any medication, drug or herbal remedy.

Something which is safe for use during pregnancy may not necessarily be safe for a nursing baby.

BREAST FEED WHILE ON MEDICATION

Should only take medication if you really need it.

In general, most medications that are applied to the skin, inhaled (for example, asthma treatments), or applied to the eyes or nose are safe for breastfeeding women.

Most vaccines are safe, as well as medications that are commonly prescribed to infants.

CONT..

Some medications which can be used while breastfeeding may require close monitoring.

For example, you and your baby’s blood levels may need to be evaluated regularly.

Closely monitor your infant for any potential adverse effects.

Medications can pose a higher risk and are usually not used in conjunction with breastfeeding:

Anti-cancer drugs Immune suppressants Ergot alkaloids Radioactive medications Anticonvulsants

Nearly all medications transfer into breast milk to some extent.

Although a mother’s use of topical preparations such as creams, nasal sprays or inhalers generally carries less risk to a breastfed infant than medications administered orally

It is important to remember that medication or products applied directly to the nipples before or after breastfeeding may be harmful for your baby.

The safety of certain medications also depends on the age of the infant.

Nearly all reported adverse effects in nursing infants have occurred in infants less than six months old.

New born and premature infants are most at risk.

• When taking any medication, watch closely for reactions in your baby, including• Loss of appetite• Diarrhoea• Sleepiness• Excessive crying, • Vomiting• Skin rashes. • Call your baby's paediatrician immediately if any of

these symptoms appear.

MEDICATIONS WHICH AFFECT ABILITY TO PRODUCE MILK

Breast feeding mothers should always watch for changes in their milk production, even for subtle differences. Some medications can decrease milk production: Antihistamines Sedating medications Some decongestants Some weight loss medications Diuretics Very high doses of vitamin B6 Hormonal contraceptives containing estrogen Nicotine Ergot alkaloids

AVOID….??????????

• Caffeine• Alcohol • Cigarette smoking • Street drugs • Over-the-counter products • Natural or herbal remedies

Administration of Medication in the Child Care Setting

When medicine is given in the child care setting

All staff members designated to administer medication must receive training by a health care professional annually.

Staff designated to administer medications are familiar with the actions of medications, their administration, dosages, measurement, documentation and specific policies and procedures of the program

Medicines are given for acute(sudden or short term) conditions like antibiotic therapy or

for chronic (ongoing) conditions like asthma.

Medications must be prescribed by a physician

OTC medication given by permission of the parent with prior approval of the physician.

• Written Authorization • Staff must have a written

authorization signed by the parent/guardian for medication prescribed by the child’s health care provider.

• Must have a written authorization signed by the parent/guardian for OTC (over the counter) medication and prior approval (standing order) by a health care provider designating the intended use of the medication

• Receiving Medications• Both prescription and OTC medication

shall be accepted only in its original container

• Prescription medications shall be labelled with the full pharmacy label and clearly readable.

• OTC medication shall be clearly labelled with the child’s name.

• The container must be in a condition that the name of the medication and the directions can be read

• Protect the safety of the child.• A designated, trained staff

person shall administer and document giving the medication.• Prescription medication shall

require a signed authorization by the health care provider and the parent and shall be kept on file and updated regularly. • OTC medications may be

dispensed in accordance with the manufactures' instructions with written permission by the parent.

How to give medicine in the child care setting:Receiving Medications Check the label of the original

container before accepting the medication from the parent/guardian.

Always use the right technique: Note the expiration date. (Do not

accept and/or discard expired medications) Make sure the medication is in a child-proof container.

Make sure the administration of medication consent is completed properly, is current and on file. 

The “5 Rights”

1.Right child (Child’s first and last name). 2.Right medicine (generic or brand name)3.Right dose (teaspoons: tsp, cubic centimetres:

cc)4.Right route (mouth, nose, eye, ear drops)5.Right time (before meals, after meals) and

frequency (per day) or intervals (every 4 hours)

Administer medication and document immediatelyObserve child and monitor periodically for side

effects and allergic reactions.Observe for the most dangerous type of allergic

reaction, Anaphylaxis.An emergency care plan is posted in each

classroom and someone trained in first aid and CPR should be on duty. 

AnaphylaxisThis is a severe allergic

reaction which is life-threatening.

Anaphylaxis occurs after the administration of a drug, eating a particular food, or sting of an insect to which the person is allergic.

If you observe or think a child is having an anaphylactic reaction:

Instruct someone to call ems STAY WITH THE CHILD

Anaphylaxis cont’d

Signs and symptoms of anaphylaxis may include: Hives/itching Dizziness/weaknessNausea/ vomitingAbdominal crampsSwelling of the face, hands, feet, and mucous membranes WheezingShortness of breathDifficulty breathingSense of impending doom/fear Loss of consciousness

Allergic Reactions

• These reactions are related to the action of the medicines• When an allergic reaction to

a drug occurs, the body’s immune system reacts to a drug by producing histamines. • Histamines produce

symptoms of an allergic reaction and the severity of the symptoms can change quickly

Allergic Reactions cont’d

Signs of allergic reactions

• Mouth- itching, swelling of the lips, tongue or mouth• Throat: itching/sense of tightness in the throat, hoarseness

and hacking cough • Skin: hives, itchy rash, redness and swelling of the face and

extremities ◦ Abdomen: nausea, abdominal cramps, vomiting, diarrhoea • Lungs: shortness of breath, repetitive coughing, wheezing • Heart: Thready pulse, fainting, loss of consciousness

All above symptoms can potentially progress to a life threatening situation

Common Dosing Instruments

The following are tips for using common dosing instruments:

Syringes: Syringes are convenient for infants who can’t drink from a cup.

Draw up the correct dose at eye level and squirt the medicine in the back of the child’s mouth where it is less likely to spill out.

Syringes can be measured out and caped for later use.

However these caps can be a choking hazard if not removed before administering the medication

Common Dosing Instruments cont’d

The cap should be discarded or placed where the child can not get it.

There are two kinds of syringes:Oral syringes for administering

medications by mouthHypodermic syringes (for

injections), which can be used for oral medication when the needle are removed.

Parents should remove the needle from the hypodermic syringe.

Always remove the cap before administering by mouth

Common Dosing Instruments cont’d

Droppers: Safe and easy to use for infants and children. Always measure at eye level and administer quickly because dropper tend to drip,

Cylindrical dosing spoons: The spoon looks like a test tube with a spoon at the end. Small children can hold the handle and the spoon fits easily into their mouth.

Common Dosing Instruments cont’d.Dosage cups: These are used for children who can drink from a cup without spilling. Be sure to check the measurements on the side of the cups for the correct number. Measure liquid doses at eye level.Medication pacifiers: These are used for infants. The medication is measured and poured into the medication holder and the infants sucks the medication through the pacifier. 

Common Dosing Measurements

Whether they measure teaspoons, ounces or millilitres, dosing devices must be used.

Regular tableware must never be used because it is not an accurate measure.

One type of teaspoon may be twice the size of another.If a product comes with a particular device, it should be

used.Do not use a device from another product.Read the measuring instruments carefully, the numbers on

the side are small and sometimes difficult to read.

Procedures for giving topical medications:

Skin Creams/Ointments Wash hands, identify child, read

medication consent.Check expiration date. Remember “5 Rights”. Explain the procedure to the parent,

provide privacy. Put on disposable glovesRemove any dressings if necessary. Place in a plastic bag.

Procedures for giving topical medications cntd….

Remove previously applied medication with a gauze pad using a circular motion

from the centre to the outside of the affected area.

Discard each pad. Change contaminated gloves.Apply medication using a clean glove or

applicator. Apply dressing as instructed.Remove gloves, discard equipment in

plastic bag and wash hands.Document on medication log that

medicine was given

Procedures for giving Metered Dose Inhalers:

Wash hands, identify child, read medication consent.

Check expiration date. Remember “5 Rights”.

Explain the procedure to the parent, provide privacy.

Shake inhaler for about two (2) seconds,Hold mouthpiece 1-2 inches from lips

(or as instructed), open mouth wide(if using a spacer, place mouthpiece in mouth).

Procedures for giving Metered Dose Inhalers contd…

Breathe out normally, open mouth and begin to inhale slowly, as the canister is squeezed.

Have child hold his breath for about 10 seconds to allow medicine to settle into air passages.

Wait 1 or 2 minutes before the second puff.

Document and observe child for effects of the medication