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Benadryl and Babies

Article below is from CBS News' Early Show: I'm told they aired the story
today. I've heard stories about parents and other caregivers using Benadryl,
but
never realized the margin of safety is so small.

What do folks on the list think about the point made by Dr. Sears that
sedatives are especially dangerous to young babies because they compromise the
ability to avoid choking on spit up? If so, seems like sedatives have no
place in
baby care, not just day care?

Anyone have experience counselling parents about why they shouldn't use the
"old school" practice?

Deadly Dose Of Daycare
BARTOW, Fla., Sept. 2, 2003

Paula Burcham ran the kind of day care working mothers dream about.

Her house was immaculate, the children's meals were home cooked. Kids would
line up to get a hug from "Mama Paula."

But the families who trusted Burcham didn't know she was giving
over-the-counter medicines to their children without their permission. Some
now suspect she was using the drugs to sedate cranky little ones.

On Aug. 15, Burcham was sentenced to eight years in prison for giving a
3=-month-old girl a lethal dose of Benadryl. And since Grace Olivia Fields'
death
in December 2001, her parents have found they are not alone in their loss.

In the last three years, at least 10 other cases of day care workers
allegedly sedating children with cold medicines and cough syrups have been
investigated nationwide. Four babies died in those cases. At least four
people were
charged, with one acquittal, and some cases are still pending.

Grace's mother, Tracy Fields, and other parents are now pushing for new laws
that would make it a felony for day care workers to give a child medicine
without written permission from a parent or a doctor's order. One state has
already passed such a law.

"I don't want any other parents to go through this," Fields said. "It didn't
take a whole lot for this beautiful little baby to die from an
over-the-counter medicine."

There is also a growing movement among medical examiners for greater
awareness of the practice, as some pathologists fear babies who died after
being
drugged were written off as sudden infant death syndrome cases.

Burcham had poured about a tablespoon of children's Benadryl into a
four-ounce bottle of breast milk before feeding it to Grace. The dose was
three times
more than what would be needed to sedate an adult.

Burcham admitted giving the baby the drug, but denied it was to control
behavior. Her critics aren't swayed.

"She found a way to make those kids sleep half the day," Fields said, adding
her 2=-year-old daughter told her she was given "bubble gum" flavored
medicine
before nap time at Burcham's.

Drug makers are adamant that their medicines aren't intended for infants and
put warnings on containers that doctors should be consulted for use in any
child younger than age 6.

Dr. William Sears, a pediatrician and author of books on infant sleep, said
it is an "old school" practice to use cold and allergy medications to sedate
babies, but even using a small amount of drugs is dangerous.

"Categorically, sedative medications have no place in day care," he said.

Young babies need to awake easily to protect themselves from dangers like
choking when they spit up. The sedative interferes with that natural waking
mechanism, Sears said.

Sharon Dabrow, associate professor of pediatrics at the University of South
Florida, said some pediatricians do advise parents to use appropriate doses
of
Benadryl to sedate children who are at least 12 months old. Dabrow doesn't
recommend it.

"Our society is so wrapped up around medications being a fix for anything,"
she said. "To be using it (Benadryl) on a 3-month-old is just horrible."

In Mobile, Ala., Robert and Mary Hernandez's 2-month-old son, Douglas, died
last year at day care after being given a combination of drugs found in
allergy
and cold medicines.

A toxicology test turned up the drugs. A grand jury is expected to hear the
case later this year.

The Hernandezes have sought a state lawmaker's help to introduce legislation
that would make it a felony for a day care provider to give a child
medication
without their parents' permission or the consent of a doctor.

Parents whose children died in Ohio and North Carolina have waged similar
campaigns.

Last month, North Carolina made it a felony to give children medicine without
permission. That law was named for 5-month-old Kaitlyn Shevlin, who died in
2001 after being given the generic form of Benadryl. Her caretaker, Josephine
Burke, served four months in prison on misdemeanor charges of child abuse and
neglect.

Ohio communities have begun adopting ordinances prohibiting the unauthorized
use of medicines in day cares following the 2000 death of Allison Kuczmarski.
Baby sitter Karen Zemba pleaded guilty to reckless homicide for giving the
baby Benadryl, but was sentenced to just 250 hours of community service.

The cases of five otherwise healthy infants who died from overdoses of
diphenhydramine, one of the ingredients in Benadryl, were detailed in an
article
published earlier this year in the Journal of Forensic Science.

The research began after high levels of the drug were found in a baby who
died in Virginia in 2001. Everyone who had access to the child has denied
giving
him the medicine; the case remains under investigation.

For info email us at hidden@email-address

Shaking Kills: Instead Parents Please Educate and Remember
If today is an average day in the United States, 4 children under the age of
5 will
die or suffer permanent disabilities when they are shaken by a caregiver.

Parents can prevent shaking injuries.

The "SKIPPER" Initiative
was formed by concerned parents to increase SBS awareness in the Hudson
Valley
and educate parents and caregivers about prevention.
We are working with
government agencies, local hospitals, day care providers, and community
organizations
to help parents and caregivers prevent shaking injuries.

Benadryl and Babies

On Fri, 26 Sep 2003 hidden@email-address wrote:

>Article below is from CBS News' Early Show: I'm told they aired the story
>today. I've heard stories about parents and other caregivers using Benadryl,
>but
>never realized the margin of safety is so small.

Small???

>On Aug. 15, Burcham was sentenced to eight years in prison for giving a
>3=-month-old girl a lethal dose of Benadryl. And since Grace Olivia Fields'

>Burcham had poured about a tablespoon of children's Benadryl into a
>four-ounce bottle of breast milk before feeding it to Grace. The dose was

OK, they don't give the weight of the infant. But she was 3 mos old.
Leaving aside the issue of whether or not it is ever ok for a layperson to
give diphenhydramine to an infant under a year of age (I have had
conflicting answers to that question), she certainly had to weigh less
than 20 lbs. The caregiver gave this infant about 40 mg of diphenhydramine
- FORTY MILLIGRAMS!!! The dose most commonly cited for a 20 lb one year
old is 10 (ten) mg. That's 25% of the dose given to this 3 month old. This
is not a situation where there was a small margin of error. At least, it
doesn't seem that way to me.

hillary israeli vmd http://www.hillary.net hidden@email-address
"uber vaccae in quattuor partes divisum est."
not-so-newly minted veterinarian-at-large :)

Benadryl and Babies

Benedryl is not a sedative, it is an antihistamine with anticholinergic and
sometimes sedative effects. The biggest dangers are actually the
anticholinergic effects. The dose for a child is 5mg/kg/day divided qid
which, for a 3 month old weighing about 7 kg, would be about 8
mg/dose. This woman apparently gave 1 TBS or 15 ml of 12.5 mg/5ml
liquid or more than 4 times the recommended dose.

I do use Benedryl with little ones. I had a toddler in today with a really
severe drug reaction and, in addition to the prednisone, I had the family
give Benedryl (in an appropriate dose). Any medication is dangerous if
misused. Benedryl seems to me to one of the safer ones.

That said, I really am not sure that we need to be giving much in the way
of drugs to most babies. Parents want quick fixes but it is safer to use
saline drops, humidifier, etc., than antihistamines and decongestants
under 6 months of age.

Vicki

---------- Original Message -----------
From: hidden@email-address
To: hidden@email-address
Sent: Fri, 26 Sep 2003 22:33:16 EDT
Subject: Benadryl and Babies

> Article below is from CBS News' Early Show: I'm told they aired the
story
> today. I've heard stories about parents and other caregivers using
> Benadryl, but never realized the margin of safety is so small.
>
> What do folks on the list think about the point made by Dr. Sears
> that sedatives are especially dangerous to young babies because
they
> compromise the ability to avoid choking on spit up? If so, seems
> like sedatives have no place in baby care, not just day care?
>
> Anyone have experience counselling parents about why they shouldn't
> use the "old school" practice?
>
>
>
> Burcham had poured about a tablespoon of children's Benadryl into a
> four-ounce bottle of breast milk before feeding it to Grace. The
> dose was three times more than what would be needed to sedate an
adult.