The following is a rant, and not medical advice. Also, I’m not a physician.
So a very nasty early cold has been sweeping the Geek household over the last couple of weeks. Himself was sick early last week, this week the baby is succumbing. Which means I’m getting acquainted with the gigantic pain in the ass that is the new infant’s acetaminophen concentration.
The old concentrated drops were 100mg/mL. So you were giving the littlest babies (under a physician’s instructions) a 40mg dose in 0.4mL, which is less than a tenth of a teaspoon. By the time they were two, they’d be getting a 160mg dose in 1.6mL, which is still less than half a teaspoon. It was concentrated, but easier to get in contrary littles without spilling.
The new infant acetaminophen is reduced to the 32mg/mL concentration of children’s liquid acetaminophen. To get the same dose into an infant you need to give them 3x the amount. And when I tried to dose Raphael, it was a disaster. A big, sticky, pinky, clothes-staining disaster. He ended up wearing it and looking like Heath Ledger’s Joker. And I couldn’t just give him more because I wasn’t sure how much he’d actually gotten the first time.
As far as I can determine, the reasoning behind the dosage change is that exhausted parents were getting confused and accidentally overdosing their kids. Any accidental overdosing by parents is a big problem, and in general having two different concentrations of liquid acetaminophen is stupid. It just invites confusion.
What I don’t understand why they lowered the concentration of infant drops instead of raising the concentration of children’s liquid.
Babies need liquid drops. Bigger kids have a variety of tablets and melts to take. So I think it’s reasonable to make the liquid suspension in a concentration where you can get a dose down a baby without wearing it. Intractable toddlers with a preference for the liquid can still take the appropriate dose of liquid suspension – there’s no magical difference between 160mg/5mL infant acetaminophen and 160mg/5mL children’s acetaminophen! There’s no magical difference between any dosage delivery system as long as you give the same dose.
There are good things to be said for the new bottles. The custom slip tip syringe that into the bottle for filling is a brilliant thing – the only thing that could be improved would be including a cap so you can easily carry the syringe after using it. It’s very easy to use and a vast improvement over the previous dropper style, where you had to worry about medicine clinging to the exterior of the dropper.
But the improvement of the measure doesn’t change the fact that dosing a baby with increased volumes is a nightmare. Ugh.