Baby Miriam got her first fever when she was a few months old. Late at night, I went to the store to get some Tylenol. It was the first time I had ever bought medicine for a baby, and I found the offerings on the shelf very confusing. There were all kinds of bottle sizes and flavors and formulations, but I ended up buying something called "Children's Tylenol" because Miriam was, after all, a child.
When I got home, I opened the package and checked to see how much medicine to give Miriam. To my disappointment, the package simply directed me to "ask a doctor." What the? It was the middle of the night. Miriam was irritable and feverish and I was beyond tired. I wanted to give her medicine to help her, not dig up the pediatrician's after-hours number and spend 30 minutes on hold waiting for a nurse. But that's what I did. It took a long time, but I finally got the instructions I needed.
But then, THEN, when I tried to administer the dose of medicine, Miriam coughed and vomited it up because it was so much fluid for an infant. It took a long time over another 30 minutes to administer the medicine in small enough portions that she wouldn't gag on it.
It was only later that I realized that what I should have bought at the store that night was Infants' Tylenol, which is a completely separate product. Infants' Tylenol is highly concentrated, which means that the dose for a baby Miriam's age would have been something like 0.8mL rather than something like 5mL for the Children's Tylenol. That would have been a lot easier to administer.
Anyway, no harm done, and it was all part of the learning curve for a new mom. Over the years, however, I have remained irritated that most medications for children do not come with dosing information for babies under two years old. It's always that maddening "ask a doctor." If these drug manufacturers would stop to think about it, they might realize that a sleep-deprived parent dealing with a fussy, sick child at 3am is not inclined to call the doctor (IF they have one; IF they can even dig up the emergency number, etc.). Oh no. They are inclined to just guess at the dose, based on the amounts given for other ages. Yep.
Those of you who listen to This American Life may know where I'm going with this - TAL's latest episode was all about Tylenol and how easy it is to accidentally overdose, especially for children and especially because of those horrible "ask a doctor" labels. I was sad to hear stories like this, which could so easily happen to any new parent who, like me in 2005, had no idea of there being different Tylenol formulations for different ages of children.
Still, I thought I was up to speed on the confusing drug labels on children's/infants' medicine. I've been a parent long enough now that I know all the secret dosing amounts they don't dare print on the package itself.
However, I learned something new from the podcast - in 2011, Tylenol eliminated the Infants' formulation of its medicine. You can now only buy Children's Tylenol. I had no idea this had happened, but it explains why I was so confused this summer when I was stocking up on American medicine to take back home (liquid pain reliever medicines here taste horrendous and it's just easier to buy a few bottles in the US and keep them on hand, to the point that my kids actually ask before taking medicine, "this is the American kind, right?").
I thought I was buying the same old Infants' Tylenol (in the convenient concentrated formula that makes it easier to administer to a baby, in this case Sasha 3.0) and Children's Tylenol. But after listening to the podcast, I took another look. Here's what I have:
The one on the right is Costco brand, but you can see that one is called Children's, and one is called Infants'. However, they are the same formulation - 160mg of drug per 5mL, for both. This means I could have saved myself the trouble and just bought the Children's Tylenol - it was probably cheaper than the specially labeled Infants'. Even the dosing information is the same:
Except that the Infants' version (same liquid as the Children's, just in a pack labeled "Infants'") dosing only goes up to age 3...and completely eliminates dosing information for age 2 and under. So frustrating.
Just to make sure, I checked the ibuprofen I bought in the US. Same differentiation in the package designation (Children's vs. Infants'):
But look again! Ibuprofen has maintained two separate formulations, with the Infants' version being far more concentrated at 50mg per 1.25mL as opposed to the Children's 100mg at 5mL. At least the dosing information is a little more complete, with instructions on the Infants' box going all the way down to 6 months:
I'm glad I listened to that podcast, because it alerted me to the fact that the dosage for Infants' Tylenol will now be much higher than I was used to with my older kids. If I had stumbled upon this unawares in the middle of the night a few months hence, I would have been very confused, indeed.
To sum up: there is now only ONE Tylenol for children/infants, and good luck getting all that extra liquid down the throat of your tiny infant, especially if s/he is gag-prone like Miriam was. But ibuprofen still has two different formulations - keep them straight!
Oh, and for two long years, you will need to ask a doctor for dosing information for Tylenol. Ridiculous! Just put it on the package already, seriously. In my opinion, that would have been a better safety reform than eliminating the Infants' formula altogether.
When I got home, I opened the package and checked to see how much medicine to give Miriam. To my disappointment, the package simply directed me to "ask a doctor." What the? It was the middle of the night. Miriam was irritable and feverish and I was beyond tired. I wanted to give her medicine to help her, not dig up the pediatrician's after-hours number and spend 30 minutes on hold waiting for a nurse. But that's what I did. It took a long time, but I finally got the instructions I needed.
But then, THEN, when I tried to administer the dose of medicine, Miriam coughed and vomited it up because it was so much fluid for an infant. It took a long time over another 30 minutes to administer the medicine in small enough portions that she wouldn't gag on it.
It was only later that I realized that what I should have bought at the store that night was Infants' Tylenol, which is a completely separate product. Infants' Tylenol is highly concentrated, which means that the dose for a baby Miriam's age would have been something like 0.8mL rather than something like 5mL for the Children's Tylenol. That would have been a lot easier to administer.
Anyway, no harm done, and it was all part of the learning curve for a new mom. Over the years, however, I have remained irritated that most medications for children do not come with dosing information for babies under two years old. It's always that maddening "ask a doctor." If these drug manufacturers would stop to think about it, they might realize that a sleep-deprived parent dealing with a fussy, sick child at 3am is not inclined to call the doctor (IF they have one; IF they can even dig up the emergency number, etc.). Oh no. They are inclined to just guess at the dose, based on the amounts given for other ages. Yep.
Those of you who listen to This American Life may know where I'm going with this - TAL's latest episode was all about Tylenol and how easy it is to accidentally overdose, especially for children and especially because of those horrible "ask a doctor" labels. I was sad to hear stories like this, which could so easily happen to any new parent who, like me in 2005, had no idea of there being different Tylenol formulations for different ages of children.
Still, I thought I was up to speed on the confusing drug labels on children's/infants' medicine. I've been a parent long enough now that I know all the secret dosing amounts they don't dare print on the package itself.
However, I learned something new from the podcast - in 2011, Tylenol eliminated the Infants' formulation of its medicine. You can now only buy Children's Tylenol. I had no idea this had happened, but it explains why I was so confused this summer when I was stocking up on American medicine to take back home (liquid pain reliever medicines here taste horrendous and it's just easier to buy a few bottles in the US and keep them on hand, to the point that my kids actually ask before taking medicine, "this is the American kind, right?").
I thought I was buying the same old Infants' Tylenol (in the convenient concentrated formula that makes it easier to administer to a baby, in this case Sasha 3.0) and Children's Tylenol. But after listening to the podcast, I took another look. Here's what I have:
Just to make sure, I checked the ibuprofen I bought in the US. Same differentiation in the package designation (Children's vs. Infants'):
I'm glad I listened to that podcast, because it alerted me to the fact that the dosage for Infants' Tylenol will now be much higher than I was used to with my older kids. If I had stumbled upon this unawares in the middle of the night a few months hence, I would have been very confused, indeed.
To sum up: there is now only ONE Tylenol for children/infants, and good luck getting all that extra liquid down the throat of your tiny infant, especially if s/he is gag-prone like Miriam was. But ibuprofen still has two different formulations - keep them straight!
Oh, and for two long years, you will need to ask a doctor for dosing information for Tylenol. Ridiculous! Just put it on the package already, seriously. In my opinion, that would have been a better safety reform than eliminating the Infants' formula altogether.