When your child is sick, as new parents, it’s only natural to desire swift relief for their discomfort. Many parents often find themselves promptly requesting antibiotics from their pediatrician. However, it’s crucial to understand that antibiotics, medications designed to eliminate bacteria, may not always be the optimal solution. The suitability of antibiotic usage depends on various factors, including your infant’s symptoms and illness. So, let’s explore what new parents need to know about antibiotics for their infants, ensuring informed decisions are made regarding their healthcare.
Iona Munjal, M.D., head of the Pediatric Antimicrobial Stewardship Program in Bronx, New York, says that antibiotics only work against bacteria, so they can’t help with viral illnesses like the flu and colds. The American Academy of Pediatrics (AAP) says that giving medicines when they are not needed can do more harm than good.
We consulted professionals to learn more about the benefits and drawbacks of giving a newborn medication.
When Should Antibiotics Be Given to Babies?
Experts say that, in general, babies only need medicines when they have a bacterial infection. Here are some of the most common children illnesses for which a doctor sometimes gives antibiotics.
Dr. Munjal says that a fever shows that the body’s immune system is working to fight off germs. This is encouraging, but a more serious bacterial illness may be present if the fever persists for more than a day or two (100.4°F for infants younger than 3 months and 102°F for infants aged 3 to 12 months). However, this isn’t always the case as a virus could also cause high fevers. Take your kid to the doctor if you suspect a bacterial infection needs treatment.
It’s hard to tell whether pneumonia is caused by a virus (like an upper respiratory illness) or by bacteria. Most of the time, fever, coughing, shortness of breath, and/or sickness are the first signs of pneumonia.
Pediatricians often give medicines like amoxicillin, ampicillin, and penicillin to children with pneumonia, even if they aren’t sure it’s a bacterial infection because babies are more likely to have complications from pneumonia, such as trouble breathing.
Pertussis (whooping cough)
Antibiotics work best when given within the first week or two of getting pertussis when the first signs are a slight cough or fever but before whooping cough. But it’s important to know that medicines can stop the infection from spreading, but they won’t stop or treat the cough that comes with it, says the AAP.
Azithromycin is usually the first choice for treating pertussis, but Clarithromycin and Erythromycin are also good choices. The best way to keep your baby from getting whooping cough is to make sure he or she has all of the recommended shots and encourage anyone who takes care of your baby to get protected.
If your child is older and has an ear infection, the doctor may wait 7 to 14 days to see if it goes away on its own. About half of all ear infections go away on their own without medicines, and viruses actually cause many ear infections, so an antibiotic wouldn’t help anyway.
The only exception to this wait-and-see method is babies: Allison Bartlett, M.D., a pediatric infectious disease specialist at La Rabida Children’s Hospital in Chicago, says, “A baby can’t tell you how much pain he’s in or if he’s getting worse. This is why most pediatricians prescribe an antibiotic like amoxicillin.”
Your baby may have an ear infection if they tug or pull on their ears, cry a lot, have trouble sleeping, and have a high fever.
Urinary tract infections (UTIs)
When feces or other germs get into the bladder or kidneys, they can cause urinary tract infections. Babies with UTIs typically only have a fever, but other symptoms can include irritability, vomiting, and diarrhea.
Dr. Bartlett says that a urine culture can prove the diagnosis and find out what kind of bacteria is causing the infection. “This helps the doctor decide which antibiotic will work best against those bacteria.”
Other bacterial infections
Babies rarely get strep throat, which causes a sore throat, fever, and trouble swallowing, or sinus infections, which cause a lot of stuffy nose and fever or cough and need medicines. However, both can happen.
Is It Safe to Give Babies Antibiotics?
Antibiotics are usually very safe for children to take. But, like all medicines, they can cause side effects or other problems.
Reactions to Allergies
Only a small number of kids are allergic to medicines. For example, about 10% of U.S. children are allergic to the drug penicillin. Red, swelling, itching, hives, or welts are common side effects of penicillin and other drug allergies.
“A rash is much less severe than hives, and it’s more likely to be caused by a virus than by a reaction to a drug,” says Dr. Munjal. Still, if your baby gets a rash while taking antibiotics, you should let your doctor know. “It’s usually not necessary to treat the rash with an allergy medicine like Benadryl,” says Dr. Munjal.
What went wrong:
The AAP says that about 1 in 10 children who take antibiotics have side effects. Most of the time, people have diarrhea, feeling sick, and stomach pain. “Antibiotics not only kill bad bacteria but also good bacteria in the gut. Dr. Munjal says that this can cause stomach pain or diarrhea.
You could talk to your child’s doctor about giving probiotics, which are “good” bacteria that help repair the bacteria in the stomach.
As more medicines are used over time, bacteria change and become less sensitive to them. This is known as antibiotic resistance, and it’s a major factor in why doctors attempt to limit medication prescriptions to emergencies only.
When Do Antibiotics Begin to Take Effect?
Most kids feel better after 48 to 72 hours of treatment, but the AAP says it’s important to keep giving the medicine for as long as it says, even if your child seems better. Too soon, a break in treatment could result in a return of the infection.
“The doctor may then have to give a stronger antibiotic because the bacteria have become resistant to the first one,” says Dr. Bartlett. This makes the germs harder to kill.
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