Drugging Children: Unrecognized Form of Child Abuse?

"If a child is very irritable and colicky, a parent may try to use cough and cold syrup to keep the child quiet, especially if the parent is overwhelmed and immature and thinks the child is doing this on purpose," said Dr. Lea DeFrancisci Lis, an associate clinical professor at New York University School of Medicine. Teenage mothers are at particular risk for making the mistake, she added.

Even when an overdose is not deadly, continual abuse of drugs in children "is likely to have cascading effects on the developing biology of children and even potentially long-term effects," said Alan Kazdin, a professor of psychology and child psychiatry at Yale University.

Mistake, Misuse, Maltreatment: When Is it Criminal?

Traditionally, child abuse is a blanket term for four types of maltreatment: sexual abuse, physical abuse, neglect and emotional abuse.

Yin argues, however, that malicious use of medication or drugs on children should be considered another form of child abuse, and many pediatricians agree.

"The practice guidelines should be changed to include malicious use of pharmaceuticals ... and questions to parents [on it should be included in] child abuse screenings," said DeFrancisci Lis.

But when is a parent's action malicious, and when is it just misinformed?

Clearly, when illicit drugs or adult prescription medications are used on infants and children, it constitutes child abuse, experts agree. But parents using over-the-counter medicine inappropriately may just be misinformed.

"Determining cause -- malicious vs. accidental -- is not easy," said Mark Riddle, professor of child and adolescent psychiatry at Johns Hopkins Children's Center.

"A little Tylenol can be helpful, too much Tylenol can be lethal. [Pediatricians should] look for a pattern of behavior, prior neglect or maltreatment" to help determine whether an overdose in a child is an honest mistake or a sign of abuse, he said.

Raising awareness on misusing drugs among parents, pediatricians, and other health care professionals working with children is the first step in cutting back on this kind of malicious or unintentional abuse, Dasgupta said.

"And parents should know that they can always ask a pharmacist which over-the-counter drugs are safe to give to their kids," he said. "They'll give you free advice."

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