Most kids use medications at times of illness or injury. Some children need to take daily medications to manage chronic illness or lessen the progression of a disease. Regardless of the reason for taking a drug, however, parents are often concerned about "over-medicating" their child. Appropriately, they want to be sure that medication is genuinely needed and properly used.
When parents are concerned about over-medicating, they typically mean one of three things: overdosing (too much), over-treatment (too many), or excessive intervention (not needed). In any of these scenarios, there are ways to help discern if medication is warranted and used properly.
Medications are best used at the proper (weight-based) dose and the appropriate interval.
It's important to understand that when medicating children, adequate dosing is based on a child's weight. Duration of treatment is based on medical evidence. Offering a "half-dose" of medication or stopping a prescribed medication early is not protecting a child from being overmedicated. In these situations, the medicine will not work and is now considered an unnecessary exposure. Also, this practice may increase a child's risk of relapsing infection, uncontrolled chronic illness, or incomplete management.
To prevent over-dosing your child, follow the weight-based dosage recommendations listed on over-the-counter products. Offer the correct amount using the medication syringe or cup included with the medication, no kitchen spoons. Also, if a drug is prescribed by your child's clinician, take the full dose as instructed for the entire duration of treatment. Need help to determine if or how much of a medication is necessary? Your doctor's office is available to help.
Understand the goal of the medication.
For certain conditions, optimal medical management may take more than one type of medication to complete therapy. For example, asthma and allergy medications are used to prevent inflammation and anti-depressants are meant to improve mood. It is not uncommon that children need to be on a combination of drugs for complete control of these issues. When multiple medications are recommended, it is not surprising that parents worry that their child is being over-treated.
We know that many medications work in synergy with each other, improving each drug's performance. Other medications may need additional time for titration or dosing adjustments to achieve the best effect. To help prevent over-treatment, expect your clinician to explain the goal of each medication that is prescribed and precisely how it works. By understanding the mechanism of how the medication works in your child's body and how it is contributing to the goal, you can offer the medication as recommended with certainty.
As a general rule, if you are not seeing the desired change after a week of starting a medication, it is best to check in with your child's clinician to make sure you are on the right track. Remember it's OK to ask more questions if you are unsure of the plan. We want to be sure that you feel confident and informed.
Exclusively use your child's medical “home.”
We know that the more doctors children see, the more likely they will be prescribed medications that are not needed. Antibiotics are over-prescribed when using urgent care centers and telemedicine services. Asthma and allergy control become increasingly complicated when multiple doctors are trying to manage one child. Medications for mental health issues can quickly multiply when different medical opinions are sought. In short, seeing multiple different clinicians for every infection or condition is a problem.
If you want to protect your children from unneeded medications and excessive intervention, consistently utilize your child's medical “home” and its providers. This includes your child’s pediatrician and other providers associated with that doctor. Your child's medical home understands evidenced-based child health and is specially trained in managing acute and chronic conditions most effectively — whether that leads to medication or not. In addition, having a personal relationship and knowledge of your family's history is helpful in determining the proper level of management.
If your pediatric office is not open seven days a week, be sure you know which physicians collaborate with your medical home during off-hours. This will increase the likelihood of consistent care and communication so that your child's medical record is complete and all medications can be accounted for. So if you are out of town and need help, try to select pediatric health centers when you are able. Together, we can safely and effectively achieve wellness without excessive or unnecessary medications for our kids.