Medications Packing Guide
The following is a guide drawn from a document provided by Dr Susan McNair.
Susan M. McNair BA MD CCFP MCISc (FM) FCFP
Department of Family Medicine, Faculty of Medicine
University of Western Ontario London, ON
Dr. McNair adopted a daughter from China in December, 2000 and shortly after prepared a guide intended to help adopting families with the planning of medical supplies for the child and traveling adults. Dr. McNair intends that this guide serve as a starting point for discussion with your family physician and is not intended to substitute for advice provided by your own family physician.
Prune Juice, Glycerin infant suppositories (Over the Counter)
Your baby is apt to become constipated with the change in formula, food, routine, etc. If your baby does not have a bowel movement for 2-3 days, try prunes or prune juice. Failing that, consider a glycerin suppository.
Gastrolyte Rehydration Powder (Over the Counter)
If your baby should develop vomiting or diarrhea and becomes dehydrated, this product (mixed with bottled water as per directions) will provide the appropriate fluid replacement.
Gravol (Dimenhydrinate) Liquid, Pediatric Gravol Suppositories (Over the Counter)
These may help if your baby has an upset stomach and requires an anti-nauseant. If the child will not take Gravol Liquid consider using the suppositories.
Skin and Hair
Canestan topical (Clotrimazole) Cream (Over the Counter)
This will help with yeast/fungus skin infections which are common on damp body areas, often over the diaper area. It usually appears as reddened areas of skin, often with little white dots or "satellite lesions".
Hydrocortisone Cream .5% (Over the Counter)
This will help with eczema (reddened/dry patches of skin). It can also be useful if the skin is irritated from insect bites, soaps or new clothing. Apply it a couple of times a day for a few days but avoid prolonged use as it can contribute to skin thinning in the affected area. Do not use on areas that are oozing or have pus evident.
Antibiotic Cream (Over the Counter and Prescription)
There are many brands (Polysporin, Bactroban, Fucidin, etc.). Use on any areas of the skin that show localized signs of early skin infection (redness, soreness, pus, etc.) If the reddened area is large or is spreading or there is a fever, seek medical help.
Nix (Permethrin) Dermal Cream (Over the Counter)
This is a topical scabicide (it kills scabies). Scabies is quite common among institutionalized Chinese infants. It is characterized by very small dots or "tracks" often around the waist and diaper area as well as the underarms, hands and feet. It is intensely itchy, especially at night. This cream is applied to all areas of the skin below the neck and on the scalp, temples, and forehead. It is then washed off 12 hours later. To prevent reinfestations, all clothing and bed linens used within 2 days prior to treatment should be machine washed in hot water and dried in the dryer for at least 20 minutes.
Vaseline, etc. (Over the Counter)
Do not forget to take along a good preparation for your baby's bottom at the time of diaper changes. I favour Vaseline – others favour Zinc Oxide.
Children's Acetaminophen Drops or Syrup (Over the Counter)
This is most often sold as Tylenol but cheaper and equally effective brands are available. This is useful if your infant is fussy or running a fever over 38.5 c. Use a dose calculation of 10 to 15 milligrams per kilogram per dose. Some physicians recommend Motrin or children's Advil as an alternative.
Cough and Cold Preparations (Over the Counter)
Talk to your family physician about choices of preparations and about the proper dose for a child of your baby's age. It is not unusual for an infant moving out of the orphanage setting to get the "sniffles". However, if your child begins to have difficulty breathing and has a high temperature, you should seek medical attention.
Saline Nose Drops, Nasal Aspirator (Over the Counter)
If your baby is nasally congested it may be helpful to place one drop into each nostril with a dropper before the baby tries to sleep or feed. You may also find it helpful to then suction the nostrils once with a nasal aspirator.
Take along a supply of an antibiotic. Some suggestions include Amoxil (Amoxicillin) or Zithromax (Azithromycin) or Septra (Trimethoprim-sulfamethoxazole). These can be useful for ear infections and chest infections. Some antibiotics come premixed while some come as a powder and require mixing with sterile water (ask the pharmacist to give you a little bottle of the required amount of sterile water). Ask your doctor to write dosage requirements based on weight. You should talk to your doctor before you leave about conditions under which she/he would feel comfortable that you begin an antibiotic (eg. fever, irritable and pulling at her ear, etc.) Of course, if your child has a high fever, is lethargic, etc. seek medical attention. Don't forget to ensure that the pharmacist has included a calibrated syringe to allow you easy measurement of the required amount of antibiotic.
Digital Rectal Thermometer (Over the Counter)
Place your infant on her tummy across your knees, place a little Vaseline on the end of the thermometer and insert the thermometer a couple of centimeters into your infant's rectum. If your child's temperature is over 38.5 C, and particularly if the infant is irritable or lethargic, or refuses to eat and drink, etc, seek medical advice.
First, remember to pack all of your prescription medications into your carry-on bag. If you have a number of prescription medications with you (and particularly if these include narcotics) I suggest having your family physician provide you with a signed note listing these medications and stating that you require them for medical purposes.
Ensure that you have arranged medical health insurance while out of Canada.
Purchase a couple of sterile syringes in case you require an injection while in China. They are inexpensive, available at the pharmacy and worth the effort.
Many of the preparations packed for your daughter may also be useful for yourself (eg. Gastrolyte oral rehydration powder, antibiotic ointment, anti-yeast/fungal cream, etc). In addition, you may wish to consider the following:
Adult Acetaminophen (Over the Counter)
Most often sold as Tylenol. Useful for headaches, muscle aches and fever.
Adult Gravol (Dimenhydrinate) (Over the Counter)
If you develop gastrointestinal symptoms including nausea and vomiting, this could be very useful. If your symptoms persist despite the Gravol, seek medical advice.
Talk to your physician about taking an antibiotic to combat a respiratory tract infection - common on these trips. Discuss with your physician the symptoms which would necessitate starting the antibiotic (eg. symptoms of a presumed bacterial bronchitis, pneumonia or sinusitis). A suggestion includes Zithromax (Azithromycin), which tends to be well tolerated, and is safe for individuals with a penicillin allergy.
In addition I strongly suggest taking along a five-day supply of Ciprofloxacin in case you develop infectious diarrhea. Talk to your doctor more about this.
Imodium (Loperamide Hydrochloride) (Prescription)
This is an anti-diarrhea medication used in addition to oral Rehydration for the symptomatic control of acute diarrhea. It comes in tablet form and could be a real asset if you find yourself so infected!