That statistic comes from Up and Away and Out of Sight, a platform that raises awareness of the danger of overdoses that happen accidently. Prescription medications, over-the-counter medications, vitamins and supplements can all be harmful if they aren’t used as intended.

March 16-22 is National Poison Prevention Week, a chance to educate parents and caregivers about the importance of keeping children and teens safe from ingesting substances that can be dangerous. Poison prevention at Cook Children’s falls under the scope of injury prevention along with gun safety, drowning prevention, safe baby sleep and vehicle safety through the Center for Community Health.

Schools, clubs, libraries and organizations such as North Texas Poison Center work in partnership with the Center for Community Health. The center’s poison prevention program distributes medication lock boxes, cabinet locks and kits for disposing of unused medications.  

“Education and resources are shared at each level to help influence safer practices while the messaging stays consistent,” said Klaressa Broughton, program coordinator. “We use social media ads, trainings, parent group presentations, local community events and health fairs for the greatest reach and overall impact.”

Three Key Points

You can help prevent accidental overdoses with these layers of protection:

1. Safe dosing – Follow a medication schedule checklist to make sure your child gets the right amount at the right time. Set an alert on your phone to remind you when it’s time for another dose. Measure accurately using an oral syringe, dosing cup or dropper. Follow the instructions on the bottle.

2. Safe storage – Keep medications in a locked cabinet that children can’t access. According to the Cook Children’s 2024 parent/caregiver survey covering an eight-county service area of North Texas, about 570,400 children live in homes where medications aren’t always locked up.

3. Safe disposal – Remove any unused or expired medication from the home by taking it to a designated drop box. Don’t flush them down the toilet or pour them in the sink.

Medication safety can be an extra challenge, Broughton said, when families are traveling or when houseguests bring medications into your home. Good communication is needed if a child stays with multiple caregivers.

“A common mistake is double-dosing,” she said. “Similarly, it’s important to not take a medication that is not prescribed to you or for your age range. It may be very harmful.”

Ask Your Pediatrician

Karen Evans, M.D. points out that medications for children are usually calculated based on weight. When writing a new prescription, she explains the dosing instructions with the parents of her patients at Cook Children's Pediatrics Parkwood in Frisco while in the office.  

“That opens the door for the parent to ask questions,” she said, adding that pediatricians and pharmacists are happy to answer those questions.

From her experience as a mom with three kids, Dr. Evans offered a tip: If your child is sick, have a syringe or dosing spoon washed and handy in case your child wakes up with fever in the middle of the night. Review the dosing instructions ahead of time. Making a plan for dispensing medication can help prevent mistakes when you’re exhausted.

Never try to trick a child by saying medicine is candy, Dr. Evans advised.

She also emphasized the risk of teens sharing medication with other teens. Parents should talk with their teens about taking medications only from trusted adults. Even if a friend at school offers what appears to be a familiar brand of pain reliever, you can’t be sure what the substance is, Dr. Evans said.

Warning signs of potential overdose include change in the child’s behavior or awareness, vomiting, choking, trouble breathing, seizures or not responding. Call 911 and get medical help right away.

Contact the Texas Poison Center at 1-800-222-1222.  

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Future doctors make their mark at sites across Cook Children’s Health Care System, where they engage with patients, conduct research and practice their clinical skills.

From the outpatient clinics to the operating rooms and Emergency Department, medical students at Cook Children’s are shown the best practices of pediatric health care in hands-on experiences beyond the classroom.

There were almost 900 medical student rotations from four medical schools at Cook Children’s in the 2023-2024 school year. Students at one of those schools, the Anne Burnett Marion School of Medicine at Texas Christian University (TCU), are placed at Cook Children’s at least once during their four-year education

For primary training in the various medical specialties and surgery, the Burnett School of Medicine at TCU uses a unique and innovative model designed to provide long and potentially broad encounters with the same patients over an extended period.

Hannah Fouts Smitherman, M.D., Pediatric Clerkship Director at the Burnett School of Medicine at TCU, works in the Emergency Department (ED) at Cook Children’s Medical Center – Fort Worth. Because she has roles in both organizations, she has a unique vantage point for recruiting her hospital colleagues as preceptors, another name for teachers.

“The relationship with Cook Children’s is so pivotal, and our preceptors are amazing educators,” Dr. Smitherman said. “We really couldn’t do it without them.”

Before Nicole Jamieson, M.D., graduated in May 2024, she honed her research know-how by analyzing data related to a specific endocrine disorder, alongside Don Wilson, M.D.

Dr. Jamieson also spent time in Cardiology; Hematology/Oncology; Ear, Nose and Throat; and the Neonatal Intensive Care Unit (NICU). She observed how physicians, nurses, dietitians, child life specialists and other staff take a team approach.

“I learned so much about what it means to take care of the whole child and the whole family,” Dr. Jamieson said. “I was inspired across the board by how they make the child feel comfortable, the families feel comfortable. Everyone goes above and beyond to make sure everyone feels understood.”

Construction has wrapped up on the new Burnett School of Medicine medical education building named Arnold Hall just a few blocks from our medical center at the corner of South Henderson and West Rosedale streets. Welcoming the medical school to the Medical Innovation District, we want to spotlight the track record of collaboration between TCU and Cook Children’s. Here’s a closer look.

Research and Specialties

During the 2023-2024 academic year, students from the Burnett School of Medicine at TCU contributed across Cook Children’s:   

• 20 students in Special Projects & Thesis research
• 44 students immersed with hospitalists, NICU and Pediatric Intensive Care Unit
• 27 students in outpatient clinic rotations lasting 40 weeks
• 55 elective rotations in 34 pediatric specialties
• 4 students in psychiatry, neurology and trauma surgery  

One notable example of surgery instruction: two TCU medical students were present in the operating room during the complex and history-making separation of conjoined twins in January 2023.

“We start students seeing patients from Day One so they can start to assimilate the anatomy and physiology they’re learning in the classroom,” Dr. Smitherman said.

She mentors students in the Cook Children’s ED, where they learn to do resuscitations by shadowing the staff. Many parents appreciate the chance to share their point of view, she said. And some children in the ED enjoy showing off their injuries.

“I explain that they’re helping train a doctor, and they puff up with pride,” Dr. Smitherman said.  

Deep and strong ties form between the preceptors and the medical students they mentor.

“It’s a true apprenticeship that fosters the development of the whole physician. They’re not just teaching the skills – it’s the professionalism, it’s how the office works. They get to know the office staff and the families because they get to see repeat patients,” Dr. Smitherman said.

Sandra Peak, M.D. trains TCU medical students at Cook Children’s Pediatrics Lewisville-Castle Hills for 40 weeks. Students see continuity when patients come more than once for routine checkups and sick care. A student might meet a 2-month-old baby, for instance, and then see the same baby again at the 4-month, 6-month and 9-month visits. 

What’s one memory that sticks with her? Seeing an amazed look of understanding when a student in her clinic heard pneumonia in a child’s lungs for the first time.

“His face got concerned, and it was like watching the moment the student become a doctor. It was like a shooting star,” she recalled. “The students bring fresh eyes to things you’ve seen as a doctor over and over again. It’s hard not to be inspired by people who are that excited.” 

Empathetic Scholars®

The Burnett School of Medicine at TCU aims to instill compassion and an aptitude for communication in its students, an approach the school calls Empathetic Scholars®.

Dr. Jamieson said she saw empathy displayed in the Cook Children’s NICU. She remembers in particular one NICU patient who didn’t have family support.

“The nurses and physicians and every ancillary staff loved on this baby and treated him as if he was their own,” she said. “They made sure he was receiving optimal care. People advocated for him as if his family was there.”

Grace Newell, M.D. did research and rotations at Cook Children’s before graduating from the Burnett School of Medicine at TCU in 2023. Her two research projects – in conjunction with Christos Papadelis, Ph.D. and Scott Perry, M.D. – dealt with aspects of epilepsy. The research ignited her passion for child neurology. 

Spirit of Collaboration

James Marshall, M.D. serves as a professor and the academic chair of Pediatrics at the Burnett School of Medicine at TCU. Most of the approximately 300 faculty members in his department are Cook Children’s physicians – including Dr. Marshall, a Pediatric Critical Care Medicine subspecialist.

Dr. Marshall highlighted the scholarly output that results from the four-year research projects the TCU students conduct at Cook Children’s and other sites. Students develop a hypothesis, pursue the research with the one-on-one assistance of a mentor, and even have their work published or presented nationally. 

“Young people just have that mental plasticity and the time and opportunity to develop questions with physicians,” Dr. Marshall said. “That coming together of young minds and trained wise minds is just super fertile.”

Students aren’t the only ones who value the relationships that develop during medical education. Preceptors appreciate the chance to nurture the up-and-coming doctors. They tell Dr. Marshall that mentoring gives them joy and keeps them sharp. 

The only way to guarantee a steady supply of health care professionals is to train them, he pointed out. There’s still work to do, but Dr. Marshall predicts North Texas will be a leader in forming and retaining the medical professionals of tomorrow. 

“Cook Children’s and the Burnett School of Medicine at TCU have collaborated beautifully on an incredible elevator ride. Who knows where the top is together with the other health care systems in our region?”

By Michelle Bailey, M.D.

I’m writing this from home, dressed in three layers and with all unnecessary electrical items turned off. I’m anxious about when the power may go in and out, and if the water will continue dripping from the faucets. During extreme weather, with doctor’s offices closed, it may be worrisome to think about what you would do if your child is sick.

Right now with the power on, I am available, as are many other Cook Children’s Pediatric and Urgent Care clinics, to do telemedicine Zoom or phone visits. But if a medication is necessary, you’d still be responsible for going into a pharmacy to pick it up. Under some extreme circumstances, there are a few things you can find in your medicine cabinet to use in a pinch. Of course, follow any doctor recommended advice and call 911 if your child is having a medical emergency that needs immediate assistance.

The following is simply what can be done - if absolutely necessary - in extreme circumstances: 

• Heating formula or breastmilk bottles: While it’s nice to have a bottle warmer, if the power is out, it is not necessary. Your baby can and will drink milk even if it is cold. So go ahead and offer pumped breastmilk from the fridge, or mix formula powder with room temperature nursery water or even bottled water from the fridge. Room temperature breastmilk or formula should be consumed within 1-2 hours.

• Vomiting: The main goal is to keep your child hydrated. If you have powdered electrolyte solution on hand, such as Pedialyte powder packs, use this. Otherwise, offer frequent sips of water. Motion sickness medication and antihistamines, such as Dramamine and Benadryl, can also offer some relief to nausea and vomiting.

• Fever: If your child’s temperature is above 100.4F, use a weight-based dose of fever reducing medication. If you are out of medication, use natural ways to reduce temperature such as removing a layer of clothing, place cool wet rags to the forehead, armpits and back, and offer sips of cold water, popsicles or even yogurt. There is no “brain boiling” temperature, but you will want to keep your child comfortable by lowering their fever. Remember, fever is an actual thermometer measured temperature of above 100.4F, not just how warm your child feels.

• Wheezing, coughing, fast or difficulty breathing: If your child is in respiratory distress, call for an ambulance. If they are having a worsening cough or wheezing and you have a nebulizer and albuterol medication at home, start using it as directed on the prescription. It is always helpful for your child with asthma or wheezing to have a backup albuterol inhaler and spacer, in the event power goes out and you cannot use the nebulizer machine. If it has been awhile since you put together the nebulizer and tubing, here is a refresher video, click on the “using a nebulizer” tab: https://cookchildrens.org/pediatrics/McKinney/Pages/video-library.aspx. And in the most extreme of circumstances, if your child is wheezing or having trouble breathing and you are out of nebulizer medication, and/or or power is out, and you don’t have the albuterol inhaler, and you can’t drive to the emergency room, and 911 says they are 30 minutes away…. you get it, worst of worst scenarios, then offer your child some coffee or other highly caffeinated beverage. Caffeine is a weak bronchodilator, which can reduce respiratory muscle fatigue and can improve lung function for up to two hours. This is not to say coffee or soda is a replacement for your child’s prescribed inhaler, but it can make a difference when minutes matter during an impossibly unprecedented situation.

Again, call your child's pediatrician FIRST and speak to the doctor or nurse before trying any of the above. Please stay safe and stay warm!

Effectiveness/General Use

Do they really work or is it a mind over matter thing?

I think that there are probably some uses for oils that will be studied and proven to work. I think these will be pretty rare and only a small fraction of the claims that are currently made.

So, is it mind of matter (placebo)? Here are some of the most common uses I see for oils in kids:

Teething - It’s not even clear what symptoms teething causes …fussiness, fever, runny nose, etc have all come into question. But, if you give an oil and a symptom goes away, does that mean the oil fixed it? Not likely.

Fever - Fevers come and go during the day with illness, even without medication.

Cough/congestion - The regimens I see where children have oils placed frequently basically make it impossible to know if they do anything for these symptoms. Cough/congestion will be worse at certain times of day and better at others treatment or no.

How close are we to having actual research on the use of oils?

I still think we are quite some time away. Those that are currently doing research are often biased, are not doing high-quality studies and are using small sample sizes.

Marketing

Why are they sold through multi-level marketing (MLM)?

It’s a fast way to get a product out there and make a lot of money. Since I’ve been on social media, I’ve seen several of these types of MLM ideas crop up. The difference with these is I have some specific knowledge about the conditions they are being used for and specific concerns about how their use could harm a population of people that I care very much about. I know very little about bags and good smelling wax that can be melted with a light-bulb so I haven’t gotten involved until now.

In many ways, it protects the big company because they are not the ones out there making claims about the oils and what they can do. That falls to their independent distributors. If someone were to have a bad outcome because of their use of essential oils, who is responsible? If I prescribe a medicine that someone is allergic to, that responsibility falls squarely on my shoulders, not the makers of amoxicillin. If I prescribe the wrong medicine for a kids asthma and something bad happens, that responsibility falls to me.

Are they an increasingly popular trend or just something I was not aware of?

I’m not sure but it certainly does feel like they are gaining in popularity. Social media makes it seem that way at least.

Do you believe the claim that certain brands of oils are superior to others?

I’m sure there are differences but since we don’t even know what they do for the most part, it’s hard to answer this question.

Philosophy/Opinion

Regarding writing about essential oils: Are you mad, man?

Yes, in fact, I think I must be.

What’s the number one reason you see parents using oils instead of medicine?

In general, people are becoming less trusting of experts and organized institutions. Medicine and doctors are no different. The gap between what a doctor knows and what patients know shrinks every day. People can find out information about their conditions and know basically the treatment options that exist. People are looking to live more natural lives and most who use them feel that oils fit within that idea. When you combine these two issues, right or wrong, essential oils seem to step in the gap.

What is a good way to communicate with your doctor about your use of essential oils (for specific conditions and generally)?

I think it’s important to be honest with you doctor about your use of essential oils. As new information is uncovered it would be important for your doctor to be able to show you new research etc, especially if something shows a particular oil to be unsafe. They can only do this if they know about your use of them. Also, as doctors are prescribing medications, we need to know anything you might be on that could cause a drug interaction.

What is your take on the potential political barriers to the study of essential oils given that they are not backed by super profitable pharmaceutical companies?

Young Living is a very profitable company. They are big and profitable and will only continue to be more profitable. There is no reason that they could not start testing their own products or set up independent testing.

After your research as a pediatrician, would you use them on your children?

People will read all of this information or even do further research and come to different conclusions from me but here are two reasons I won’t:

1. I do not treat my kids with unnecessary medications. Since they are recommended for symptoms and given with the hopes of reliving those symptoms, I consider these oils to be medication.

2. I believe that, due to the lack of good studies, the use of them in children should be considered experimental at this point.

Summary

• The use of essential oils seems to be growing.
• The evidence for their use in children is slim.
• Talk with your doctor about the products you are using so that they can be aware of potential safety issues and medication interactions. 

Previous articles on this topic:

• New York Times Report: Are Essential Oils Safe For Kids?
• Essential oils and their use on children
• How safe are essential oils for children?

The products, marketed and sold by King Bio online and in local health food stores, have been recalled due to “microbial contamination.”

According to the company, “the use of drugs products with microbial contamination could potentially result in increased infections that may require medical intervention, and could result in infections that could be life threatening to certain individuals.”

No injuries or illnesses have been reported to date.

While this recall is alarming, the names of some of the medications also got my attention:

• DK Attention and Learning Enhance
• Chicken Pox Symptoms Relief
• Children’s Appetite and Weight
• Children’s Appetite Enhance
• Children’s Growth and Development
• DK Teething
• DK Colic
• Kids Stress and Anxiety

For the full list of medications involved see the FDA release.

While I love looking for non-traditional and less invasive treatment approaches for my patients, I think it's always important to evaluate new or different medications with a skeptical eye.

(For more on this approach, see: Honey for cough. Skipping antibiotics for ear infections. I’ve researched essenital oils, milk alternatives and many other topics trying to find the best information about alternative approaches for my patients and my kids.)

Weighing the risk of a medication against the benefit is an important part of what I do every day in pediatrics. When a medication is clearly indicated and will clearly give the child relief, we can tolerate a very small risk of an allergic reaction or other side effect. But, if the medication doesn’t have clear benefit, any risk is too much.

King Bio makes homeopathic medicines. You can read a full description of homeopathic medications and how they are made here. The summary is this: homeopathic medicine subscribes to the idea that you can give substances which would normally cause disease at very low level to prevent the same diseases that they cause. Homeopathic medications are super-diluted and by the time they reach the bottle that is shipped out, they will most likely not even contain a single substance that would matter. They are mostly water.

So, can they be effective? No. Unless you believe that a syringe of water is an effective treatment for anything, but a tiny bit of thirst, there is no logical reason to believe they would work.

Look at the conditions that King Bio proposes that they can treat. Teething and colic are notoriously hard to understand because it’s unclear if they cause any of the symptoms that have been attributed to them in the past. I’m really uncomfortable with supplements that propose to increase appetite or weight gain. Most developmentally normal kids will eat and grow if food is available. If there are true feeding problems, they need to be addressed. If something works for ADHD, it is affecting your child’s brain. There’s no other mechanism for it to work. Even if it did work, I’d be very scared to give it to my children based on the limited information available.

So… return your items to King Bio (or better yet, you can just throw them out) and if you were considering buying this product or something similar, think about it seriously and ask your doctor if you’d like more information.

Get to know Justin Smith, M.D., aka The Doc Smitty

Justin Smith, M.D., is a pediatrician in Trophy Club and the Medical Advisor for Digital Health for Cook Children's in Fort Worth, Texas. Dr. Smith is an experienced keynote speaker for a variety of topics including pediatric/parenting topics, healthcare social media and physician leadership. If you are interested in having Dr. Smith present to your conference or meeting, please contact him at thedocsmitty@cookchildrens.org.

 

He has an active community on both Facebook and Twitter as @TheDocSmitty and writes weekly for Cook Children's checkupnewsroom.com. He believes that strategic use of social media and technology by pediatricians to connect with families can deepen their relationship and provide a new level of convenience for both of their busy lifestyles. Dr. Smith’s innovative pediatric clinic, a pediatric clinic “designed by you,” open now. Click to learn more. To make an appointment, call 817-347-8100.

I read the paper during my lunch hour this week. It seems to be a decent study (sometimes studies aren’t that good. Remember that the next time you see an inflammatory headline and try to always read the study, or at least the fine print, for yourself!)

The researchers claim that children who are given antacids or antibiotics in the first six months of life are more prone to “allergic conditions” – like allergies, eczema, asthma, food/medicine allergies, and so on.

The study looked at over 790,000 kids in the Military Health System database from 2001 to 2013. It was a pretty big study.

What it concluded was that if a child got an antacid medication (like Ranitidine or Lansoprazole, amongst others) or an antibiotic (Amoxicillin, Augmentin, Bactrim), the kiddo had a higher chance for those problems listed above.

Antacids in the first 6 months doubled the chance of food allergy. Antibiotics doubled the chance of asthma.

The general thought is that antacid medications and antibiotics mess with our “gut biome.” Those are the living organisms in our gut that help us digest food and help our immune system to know friend from foe.

We want lots of different “good gut bugs” living in there to help us out. When you use antacids or antibiotics early in life, the theory is that this diversity is reduced.

As a mom, I asked myself, “Did those two months my son was on ranitidine cause him to have his awful cantaloupe allergy?” The guilty feelings were already sinking in.

Stop right there! Let’s not feel guilty about this. We are always learning and medicine is always changing. Let’s move forward. Yes this study seems solid, but what questions can we ask about their study methods?

Maybe we’d have more knowledge of a true connection if each individual medication was studied, instead of all of them lumped together?

Maybe kids who deal with reflux or infections as babies are just more prone to allergies and illness in general later on in life?

Are military families living in or with environmental conditions which may predispose the kiddos to allergic conditions?

I don’t know the answers to these questions. But boy, is this article making me think!

Like any “big discovery,” do we need more studies on this same topic to reduce any bias and truly know if there is a connection between these medications and allergies? Absolutely. We’ve done similar studies on animals in the past, but now it’s time to do more studies on humans.

For me, as a pediatrician, I’m going to walk through these risks with my patients a little more thoroughly.

Children with reflux suffer. I watched it happen in my own kid. Do some of them need the antacids to survive? Absolutely (some kids lose weight with reflux). Will I try to talk parents of children with more “mild” cases of reflux out of it? Probably.

Children with bacterial infections need antibiotics. Will I make sure to be certain to use the “least strong” antibiotic I can muster so as not to kill off too many of the important gut biome? Absolutely.

This article will no doubt cause some strong opinions. If, in the end, we are using less medication to treat our children’s mild infant illness, I think it will be better for everyone. I look forward to reading more research on this in the future!

“Despite being a staple in pediatric care for decades, cough medicines don’t work,” said Justin Smith, M.D., a Cook Children’s pediatrician. “Since being first approved for use in children in 1976, they have failed to prove their effectiveness for acute cough.”

This message is echoed in a new video released by the American Chemical Society. In it, the narrator explains how antitussive drugs are supposed to block the body’s cough reflex. But most studies have found no evidence that over-the-counter medications actually work. Often, they proved no different than a placebo.

Not only do they not work, they can have serious side effects. Thousands of children are sent to the emergency room every year due to accidental overdoses on cough medicine. More than half of those are children under the age of six.

“I don’t give my children cough medicine and I don’t prescribe it for my patients,” said Dr. Smith. “Instead, parents need to know that keeping a child hydrated can help with a cough. By drinking plenty of fluids, kids are able to thin out any extra mucus triggering their cough.”

Dr. Smith says humidifiers are also helpful for children. You can place one in their bedroom while they’re sleeping to ease their breathing.

“In medicine, you have to weigh the risk with the reward. For cough medicines, there are numerous risks and possibly zero benefit.”

About the Source
Justin Smith is a pediatrician and the Medical Advisor for Digital Health for Cook Children's in Fort Worth, Texas. He has an active community on both Facebook and Twitter as @TheDocSmitty and writes weekly for Cook Children's checkupnewsroom.com. His interest in communications started when he realized that his parents were relying more on the internet for medical information. He believes that strategic use of social media and technology by pediatricians to connect with families can deepen their relationship and provide a new level of convenience for both of their busy lifestyles. Dr. Smith’s innovative pediatric clinic, a pediatric clinic “designed by you,” is set to open in Trophy Club in 2017.

Imagine you are 5 years old. It’s a beautiful day and you are stuck in the house with a fever. Your wonderful mother gives you little orange tablets that taste like oranges. You think taking these little tablets that look a lot like M&M’s will make you feel better really soon. What a wonderful Mom! Then she leaves the bottle with the little orange flavored tablets on the table just a few feet away. What would you do?

I was the child that decided if a couple of little orange things would make me feel better than the bottle of little orange things would get me well quicker and I could get back to playing with my friends. What I didn’t know was that there were enough tablets in that bottle to cause a very large overdose. After I took the pills, my mom noticed that I wasn’t responding to my name. I was nearly unconscious. So I was given a trip to the emergency room at our local hospital. I was fortunate that someone noticed and that it wasn’t something worse. 

A recent study in Pediatrics found that 640,000 emergency department visits were made in the U.S. from 2004 to 2013 because children were able to to get medication without adult supervision.

When I became a mother myself, I was very diligent in keeping medications away from little hands by keeping the medications in a high or locked cabinet. We can protect our children from an accidental poisoning at home by looking at things from their eyes. Everything that looks like candy is interesting to them.

Every year Cook Children’s receives more than 600 children due to poisonings. Seventy-five percent are medication related. Children can be accidentally poisoned by finding medication belonging to a friend or family member at their house or in their purse or bag. Or by getting into a cabinet that contains household cleansers like bleach or window spray. Remind your friends or family members to keep medication and household cleaners out of the reach of your children. Often Grandmother’s medication looks like candy, just like my little orange pills, or the cleanser bottle looks like lemon/lime drink.

Sometimes it’s as simple as not measuring a liquid medication correctly. Ask your pharmacist for a medication measuring spoon or oral syringe so you give the correct amount of medicine to your child. The spoons in your kitchen will not always measure the same amount as a medication spoon.

Also, make sure to keep the poison control number (1-800-222-1222) near your phone in case you need it.

Rosanne Thurman is director of Pharmacy at Cook Children's. Cook Children's pediatric pharmacists are available at the medical center to make sure your child's medicines are safe and effective.That includes helping parents understand what their child's medicine is for, the best times to take the medicine, the right dose, side-effects and any possible drug interaction with other medications that their children may be taking, such as other prescriptions, over-the-counter medications like cough syrup or antihistamines and herbals. They can even tell parents what food and drinks might cause an interaction.

A recent study done in the adult oncology world and published in JAMA, found that doctors had a perception that patients were demanding extra treatment and testing. Review of the patient encounters showed that doctors perceived demands that did not actually occur. Many of the requests that did occur were medically appropriate.

In pediatrics, the most common issue where this comes to a head is the desire to give children antibiotics. It can also play out in other areas as well. Another common one that comes to mind is request for further testing for diagnosis.

Fortunately, in my experience, parents are becoming more informed about what situations require antibiotics and which illnesses will pass with a little time and TLC.

The problem is that many doctors have gotten into the unfortunate habit of wanting to provide what the parents are requesting without actually asking the parent what they expect. Doctors may perceive that parents want antibiotics or further testing when, in fact, they simply want reassurance that waiting is OK. This becomes a particular problem in urgent care or retail clinics where patient satisfaction plays a bigger role in getting patients to come back and see you.

So, how can you prevent this from happening to you?

Here are five casual statements that you might use the next time you visit the doctor to help them understand your expectations:

1. I’m pretty sure I’m just over concerned. I just wanted you to check things out so I can be sure.

2. I don’t really like to give my kids medicine but I wanted your opinion about what we should do next.

3. I’m totally OK with waiting, if that’s what you think is best.

4. What would you do if it were your child?

5. Are there other things we can try first or other options?

Your doctor should not feel threatened by these statements. If antibiotics are the only right choice, they should be able to explain the reasons why that is.

“Hey bud, how did you get that BAND-AID^®?”

“I just climbed up on this and got it (from the medicine cabinet).”

Those are 2 conversations that happen frequently and just yesterday, respectively, in my house.

A study released this month in Pediatrics (the journal of the American Academy of Pediatrics) looked at out-of-hospital medication errors in patients less than 6 years of age.

There were many questions that the study looked to answer:

How common are medication errors?

Almost 700,000 errors in these children over the 10 year period, that is equal to 1 error every 8 minutes.

Many of these were minor and required no medical care, but there were almost 2,000 children who required intensive care and 25 death due to medication errors.

What type of medications were associated with more errors?

Liquid medications were the most common, accounting for 81.9% of the errors. These kids are more likely to be taking liquid medications so this might be expected but it’s still a good reminder we need to be cautious.

Where do the ingestions occur?

The child’s own home was the location of the ingestions 96.9% of the time.

What errors were the most common?

The 5 most common errors were:

1. Medication accidentally given twice.
2. Confused the units of measure (1  milliliters (mL) vs 1 teaspoon (tsp).
3. Wrong medication taken/given.
4. Medication given too soon.
5. Accidentally was given or took someone else’s medicine.

So what can you do to protect your child?

1. Be aware. These errors are common and we need to be aware.
2. Be cautious with liquid medications. Kids can find and ingest them more easily and dosing errors are more common.
3. Protect your own home. Make sure that medications are locked away in a safe place.
4. Double, triple and quadruple check your dosing. You know the saying measure twice and cut once? For meds it should be measure 5x and give once.
5. Assign a primary medication giver for the house. If anyone else is giving meds, run it through them first.