Preschool parents learn about managing colds

The BC Strong Start program is a free program that provides early learning activities for preschool children. As the parents are required to accompany their children, this was an excellent forum for us to educate parents about Health Canada’s advisory against over-the-counter cough and cold products for children and how best to manage the symptoms. The Strong Start program at Parkside Elementary School is run by a dedicated facilitator who occupied the little ones as we spoke to their parents. An informal talk rather than do a formal Powerpoint presentation , it worked better for this group.  Of the eight participants, three were aware of Health Canada’s advisory – which was better than most groups we have talked to so far. One got this message from a pharmacist which underscores the important role of community pharmacists in promoting drug safety.

The parents were very knowledgeable and asked a lot of questions which generated good conversation:

• The doctor said that cough and cold medication is safe if properly used. Is this true? Answer: No. While true that these medications are often associated with misuse and overdose, they are no longer considered safe. There is no evidence that they work and they could cause serious harm.
• Why have these medications suddenly become unsafe? Most of these products are early generation drugs that were mainly tested in adults. There is clear evidence that children do not metabolize medication in the same way as adults and this is why many countries have decided to bar their use in children.
• Are safer products for children going to be developed? Answer: Only manufacturers can answer those questions
• Are antihistamines for allergies safe? The advisory applies to the use of antihistamines being used for coughs and colds – not allergies.
• What is safe for fever? Answer: acetaminophen (Tylenol) is the safest to use for fever and pain as it has been around for the longest. It is really important to use plain Tylenol – not for colds. Ibuprofen (Advil, Motrin) is good if there is also inflammation in addition to fever and pain but is harder on the stomach and should not be used in children under 6 months. ASA (Aspirin) should not be used in children under 20 years old as it could cause Reye’s syndrome. 
• One parent said that her friend always gave her child slightly more than the recommended dose because she thought that it would not be strong enough to be effective. All parents agreed that this was very unsafe indeed. Always go by the recommended dose, using the right measuring device. Good medication information is found in the BC Health Guide
• Good non-medicinal methods suggested included: elevating with pillows, honey (available in honey sticks), vapour/steam, Vicks for children. One parent said that the humidifier did not work for her child.

Language not a barrier at Chinese family drop-in group

We had the privilege of talking to a Chinese family drop-in group held at a Richmond community centre about the over the counter cough and cold medication advisory. The facilitator had said that she never knows how many will show up but  14 families came!  The facilitator had two volunteers to help occupy the children in a corner of the room. Some of the parents brought the grand parents to look after the children while they listened to the program. Yes, it was noisy but necessary because the children are calmer if they see their parents across the room.

Of the 14 parents, 1 had seen the advisory leaflet at another drop-in program while the rest were unaware of the message. We went over the Powerpoint presentation, relying on the translator to translate every few sentences. We wondered how effective the delivery was but  it turned out that the parents understood the message very well. We could tell this from their insightful comments and questions:

• The translator was unsure of the Chinese word for humidifier (it was amusing to see the parents help her out).
• One parent said that they applied alcohol on their child’s body to cool down a fever. Evaporation of alcohol would have a cooling effect but this was the first time we were hearing of this. We need to look into this.
• What do you do with the saline solution (salt water) – give the child to drink? No, it’s administered as nose drops to help with a stuffy nose. We needed to be more explicit.
• What’s the recipe for the salt water? It is commercially available but can be prepared at home. We’ll find a recipe and share it with parents

One of the points that all the parents appreciated learning was the need to a) use proper measuring devices for medication rather than kitchen spoons and b) take the child’s weight into account when determining dosage

The facilitator had prepared a number of resources and handouts to support our message – emphasizing the importance of correct hand-washing in cold prevention.  We talked about the value of the BC health Guide as a source of health information for these parents. These community groups and the dedicated facilitators who run them have a really important role in disseminating health information and promoting health particularly in diverse communities. And who said that language is a barrier?