8 days old, and we have to give our DD a pill daily. Help us with figure this out, please. We... - Page 2

[sbgrace]

Will it dissolve in breastmilk? We used the cheek pocket technique to get meds in my son when he was an infant. It's described here. http://www.askdrsears.com/html/10/T110206.asp Our meds were liquid but horrible tasting.

He also talks about putting tiny pieces of tablets in the cheek. I can't imagine why they prescribed a pill for an infant.

[CallMeMommy]

Stupid question, but have you called around to other pharmacies? Lots of times pharmacies won't carry every form of the medication but other pharmacies will (like when my son needed to be on amoxicillin right before we were set to head out of town, so I requested the chewables but our pharmacy didn't carry them - their chain in the next town over did, though! )

[GoBecGo]

Talk to your endo about it. Is he a specific paediatric endocrinologist?

I have Hashi's, and take levothyroxine every day. These are the guidelines for MY meds (which may well be different for a baby, but you need to explore it all i think since i don't know what form you've been given).

It must be taken on an empty stomach (the pill is supposed to get to the small intestine without being "digested" in the stomach for optimum absorption - washing it down with water upon waking and at least 30mins before food is how they advise adults/younger people to do it, but this is obviously not possible with a baby).
It must absolutely not be taken with a vitamin pill, an iron pill or anything with calcium in it (including milk) because it binds with some other minerals and will not get into the blood properly if that happens.
It should not be chewed, powdered or broken unless to adjust dose (25mcgm is the smallest pill readily available for adults, this will not be the case for newborns) - i'm not sure why.

As a person with hypothyroidism who has been on this medication for years i would give it to my newborn as i would a cat - i.e. i would put it far back on the tongue and then squirt a little liquid (of whatever sort was deemed ok - breastmilk or water or whatever) in on top then blow on the face to cause a swallow. I would then soothe and nurse immediately. I know this sounds cruel, and it certainly isn't the kindest way, but if no liquid form was available, knowing what i do (first hand from adult hypothyroidism and in reading about paediatric hypothyroidism) i would regard it as a necessary evil - child diabetics hate their injections, but it's too important to muck about with.

Hopefully your endo will be able to answer all of these questions. I too am a big supporter of the PKU test for this reason. Huge to you, i know how daunted i felt when I was dx, i can't imagine having to deal with caring for a similarly affected newborn.

[gardenmommy]

Hugs Mama! I have no advice for you, but I just wanted to say again that your baby is so fortunate to have such loving and dedicated parents. Definitely take care of yourself, too! You are doing a terrific job of mothering your baby, but don't forget to look after your own needs, they are just as legitimate as your baby's.

[jeliphish]

Originally Posted by GoBecGo

Talk to your endo about it. Is he a specific paediatric endocrinologist?

I have Hashi's, and take levothyroxine every day. These are the guidelines for MY meds (which may well be different for a baby, but you need to explore it all i think since i don't know what form you've been given).

It must be taken on an empty stomach (the pill is supposed to get to the small intestine without being "digested" in the stomach for optimum absorption - washing it down with water upon waking and at least 30mins before food is how they advise adults/younger people to do it, but this is obviously not possible with a baby).
It must absolutely not be taken with a vitamin pill, an iron pill or anything with calcium in it (including milk) because it binds with some other minerals and will not get into the blood properly if that happens.
It should not be chewed, powdered or broken unless to adjust dose (25mcgm is the smallest pill readily available for adults, this will not be the case for newborns) - i'm not sure why.

As a person with hypothyroidism who has been on this medication for years i would give it to my newborn as i would a cat - i.e. i would put it far back on the tongue and then squirt a little liquid (of whatever sort was deemed ok - breastmilk or water or whatever) in on top then blow on the face to cause a swallow. I would then soothe and nurse immediately. I know this sounds cruel, and it certainly isn't the kindest way, but if no liquid form was available, knowing what i do (first hand from adult hypothyroidism and in reading about paediatric hypothyroidism) i would regard it as a necessary evil - child diabetics hate their injections, but it's too important to muck about with.

Hopefully your endo will be able to answer all of these questions. I too am a big supporter of the PKU test for this reason. Huge to you, i know how daunted i felt when I was dx, i can't imagine having to deal with caring for a similarly affected newborn.

I too wondered about giving it to her like you would a cat. That was my first thought actually because with crushing it you may potentially lose some of the pill as well as lose some of its effects.

[AfricanQueen99]

My cancerous thyroid was removed a couple of years ago and I've been on Levoxyl since then. GoBecGo mentioned good guidelines, but mine are different:
1. Take first thing in the morning with one glass of water
2. Do not eat or drink anything for one hour
3. Do not take ANY other medication within four hours (in either direction)

Honestly, I would call the Pharmacist and ask the protocol for an infant on your specific brand. That person should have access to a Q&A database (I've seen them access it) to determine how breastmilk might alter the medication. Then find out who can provide a liquid form for you.

[Contrariety]

Would something like this work? I've seen them before and it seems like it could work? Maybe?

[Bea]

I'd crush it between two dessert spoons and mix it with a teaspoon or so of water and give it that way. Either with a dropper or just straight off the spoon.

[tessie]

Did the pharmacist give the ok to crush it? it can be dangerous to crush some types of med as they are absorbed at the wrong rate. Hope all goes well with treatment and they can prescribe something easier for the baby to take.

[wednesday]

I think a medicine syringe with a plunger may work better for you than a dropper where you squeeze a bulb. Prevacid for babies comes as a tablet that you dissolve in a little bit of liquid. It disintegrates into little granules. When you pick it up at the pharmacy they give you a prevacid branded syringe that has a tip big enough for the granules to pass through. I'm thinking that's the sort of medicine syringe you need.

The Target and Walgreens pharmacies give out a very similar syringe whenever you pick up a liquid kids' medicine. If you don't have such a syringe already I suggest just going to one of those pharmacies and asking if they can give you one.

I do think tho that you absolutely need guidance from a pediatric endocrinologist on the ideal way to get this into your baby. I don't understand who prescribed this for your baby but they should not have just left you in the dark as to how to give it to her.

Good luck -- it sounds like you are trying very hard to take care of your precious girl.

[mwherbs]

info from a metabolic screening site about hypothyroid-

"Only the tablet form of levo-thyroxine should be prescribed. The U.S. Food and Drug Administration has not approved liquid suspensions. Suspensions prepared by pharmacists may lead to unreliable dosage. The tablets should be crushed daily, mixed with a few milliliters of water, formula or breast milk and fed to the infant. "

so this is why you have a tablet to give your baby- ask the pharmacist or maybe go to the hospital and ask one of the neo nurses they may have a trick or 2

[CorasMama]

We used a syringe, and I would squirt the meds in the very back of her cheek, and immediately blow in her face. Then sometimes, massage her throat to make sure it all went down.

[smeisnotapirate]

A pharmacist who actually DOES compounding (not your local Walgreens) is trained to create exact dosages from a solid to a liquid. Many will give you single-serving liquid forms (where I worked, we did it all the time because you're right- dosing can be tricky). I'd call around to your little pharmacies (mom&pop) to talk to the pharmacist. No pharmacist is going to risk compounding a liquid from a pill that shouldn't be compounded, and if you are able to talk to a few who can do research on it, it would save you a LOT of grief.

I agree - it's insane to give a newborn a pill, and it will only get harder.

[3*is*magic]

I see that you're in Boston, OP. Skenderian Apothecary in Cambridge (on Cambridge Street, I believe) is a compounding pharmacy. Perhaps they could help you.

You are in one of the best cities in the world to serve your baby's medical needs. Good luck!

[kgraham]

Giving a baby a pill

I had the same situation. I also went to the internet for help and found basically nothing out there. Here is what we figured out.

Don't dissolve the pill in anything because it will stick to the sides.
1. Crush it and dump it into an oral syringe. (Put your finger over the end so it doesn't spill out on the floor, then flip it over and put the stopper in just a little bit of the way. Flip it back and flick the sides so the medicine is against the stopper and not your finger. Take your finger off and then push the plunger in about half way)
2. Then suck in liquid (I used breast milk for the first 6 months or so, it didn't dissolve as well but she didn't spit it out) cover the end and shake it.
3. Give it to the baby
4. Do a "rinse" (suck in liquid a second time)Give it to the baby

5. Wash everything except your pill crusher. Never wash your pill crusher.
This way you stop losing some of the pill each time. Just store it in a clean place and only use it for this specific med.

This is the perfect way for synthroid. Our endocrinologist was no help with coming up with a method but approved this one.

I created a blog to try to put some of this stuff that I had to figure out myself out there. If you want the rest of the tips from someone who started doing this at 4 days and has made it to 10.5 months here is my blog:
http://www.momgauntlet.blogspot.com/

Wishing you less stress!

[Dov'sMom]

I don't know how big this pill is, or how much powder it makes, but I know when I had to give my DS antibiotics at a few weeks old and the doc said to give probiotics as well, what I would do is smear the powder over my nipple so he took it in when he nursed.

[KatWrangler]

Any update?

[itsang]

my son, who was born in november, was also dx'd with congenital hypothyroidism & has been taking a levothyroxine since he was about a week old. we just crush it between two spoons, then put it on our finger & into his mouth...he takes it very easily, as it tastes a little sweet, not bitter at all. we do sometimes have to hold his chin down a little with a finger to open his mouth, but often if we give it to him when he's in a happy mood or sleeping, he is just fine and doesn't fuss one bit. you're so right that it just doesn't work going the syringe/medicine dropper route...just gets stuck in the syringe. if you have any specific questions, feel free to pm me! good luck!

eta: it's easiest with two people...one to hold the baby's arms back & open her mouth; the other person to hold the medicine spoon & put the medicine in the baby's mouth.