Does your little one have a red, slightly raised birthmark on their body? Sometimes, as a mother, you may feel very scared and worried when you see these growing a little too quickly. In medical terms, we call this 'Infantile Hemangioma '. Don't worry, these are not cancerous . But sometimes, depending on where they are (for example, near the eye) or because they grow too quickly, they need to be treated. One of the main medications that doctors often recommend for this is a syrup called Propranolol . So, today we will talk about this medication, how to give it, and what to be careful about.
What kind of medicine is Propranolol?
Simply put, Propranolol is a medication that is used to treat the condition we mentioned earlier, Infantile Hemangioma, which is a rapidly growing birthmark in babies. It belongs to a class of drugs called beta-blockers.
Imagine that red spot is a collection of small blood vessels . What this medicine does is reduce the blood flow to the area where the red spot is. What happens is that the redness, size, and hardness of the spot gradually decrease. This medicine is usually sold in Sri Lanka under the brand name HEMANGEOL.
Things you need to tell your doctor before starting medication
Before starting this medication for your baby, it is very important to give your doctor a complete description of your baby's health . Especially if your baby has any of the conditions listed below, you should definitely tell them about it.
| Health status | Why is that important? |
|---|---|
| Asthma or other breathing difficulties | Propranolol can sometimes constrict the airways and increase breathing difficulties. |
| Diabetes or low blood sugar | This medicine can lower blood sugar levels and may also prevent symptoms of low blood sugar (such as sweating and shaking). |
| Heart disease or slow heartbeat | Propranolol can slow down your heart rate even more, so it can be dangerous if you already have a heart problem. |
| Low blood pressure | This medicine can further lower blood pressure. |
| Loss of appetite or problems drinking/eating milk | It is essential that the baby eats well, as giving the medicine on an empty stomach can cause dangerously low blood sugar levels. |
| Rare conditions such as PHACE syndrome or Pheochromocytoma | These are specific medical conditions, and the doctor should be especially careful about the use of Propranolol. |
| Allergies to propranolol or other medicines or foods | If your baby has had any previous allergies, it is important to inform the doctor about it. |
How exactly should the medicine be given?
The way this medicine is given is very important. Even a small mistake can affect the baby. So remember these steps carefully.
1. Measure the correct dose: Use only the oral syringe or dropper that comes with the medicine to measure the exact dose prescribed by your doctor. Do not use things like teaspoons or plastic syrup measuring cups that you find in the kitchen. They are not accurate.
2. Give with food: This is the most important thing. Always give the medicine to your baby during or after breastfeeding.
3. Give it on time: Try to give the medicine at the same time every day. Usually, it is said to be given twice a day (about 9 hours apart).
4. Don't stop until the doctor tells you to: Even if you think the baby is doing well and the rash has subsided, don't stop giving the medicine until the doctor tells you to.
5. If your baby vomits : If your baby vomits, throws up, or you are not sure if they have taken all the medicine, do not give another dose of medicine. Wait until the next dose is due.
Remember, never give this medicine to your baby on an empty stomach. Always give it with or after a meal. This can help prevent your baby's blood sugar levels from dropping dangerously low (hypoglycemia).
What do you do if you forget to give a dose of medicine?
We forget things sometimes. If you forget to give a dose of medicine, don't worry.
- Give me the forgotten time as soon as you remember.
- However, if it is almost time for your next dose (e.g., less than two hours away), skip the missed dose. Just take the next dose at the scheduled time.
- Never give a double dose to make up for a missed dose.
Things to be especially careful about when giving medication
- Regular medical checkups : Be sure to take your baby to the doctor's appointments. The doctor will regularly check the baby's weight, heart rate , and blood pressure .
- Attention to food: It is very important that the baby drinks and eats well during this period of medication. If the baby has an illness such as a fever or cold and is not eating or vomiting, stop giving the medicine until the baby is eating normally again. Talk to your doctor about this.
- Symptoms of low blood sugar: Propranolol can prevent the symptoms of low blood sugar (hypoglycemia). So, be aware if your baby looks pale, is sweating, is crying abnormally, or has a change in breathing rate.
What are the possible side effects?
Like any medication, Propranolol can cause some side effects. While most of these are minor, there are some things we should be very careful about.
| If you notice these symptoms, call your doctor or go to a hospital immediately. | |
|---|---|
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue. |
| Difficulty breathing | Shortness of breath, wheezing. |
| Slow heartbeat or low blood pressure | The baby's skin turns blue/purple, becomes pale, has cold hands and feet, and is unusually weak. |
| Low blood sugar (Hypoglycemia) | Pale skin, blue/purple discoloration, sweating, restlessness, rapid heartbeat, refusal to drink milk, low body temperature. |
| Symptoms of heart failure | Difficulty breathing, swelling of the ankles, feet, or hands, sudden weight gain, unusual tiredness. |
| Stroke-like symptoms | Staring at one place, trembling or jerking of the face, hands, or legs, and momentary pauses in breathing. |
| If these persist or are bothersome, tell your doctor. | |
| Sleep changes | A change in the baby's sleeping pattern. |
| Vomiting or diarrhea | Although these are usually not serious, if they persist, inform your doctor. |
What if I give too much medicine and how do I store it?
Overdosage
If you have the slightest suspicion that you have given your baby more medicine than you think, don't waste any time. Immediately call the National Poisons Information Centre at the Colombo National Hospital . Or take your baby to the Emergency Treatment Unit (ETU) of the nearest hospital.
How should I store the medicine?
- Keep it out of reach of babies and pets.
- Store at room temperature (between 20-25 degrees Celsius). Do not store in the fridge.
- Discard any remaining medicine 2 months after opening the bottle. Also, do not use expired medicine.
- If you are going to throw leftover medicine in the trash, mix it with something like coffee grounds, soil, or cat litter, put it in a tightly sealed bag, and throw it in the trash.
Take-Home Message
- Always give Propranolol syrup to your baby during or immediately after breastfeeding. Never give it on an empty stomach.
- If your baby is sick and has a loss of appetite or is vomiting, stop giving the medicine until your baby is eating well again.
- Always be aware of the signs of low blood sugar (blue skin, sweating, extreme restlessness) and other dangerous side effects.
- Never give two doses of medicine at the same time just because you forgot to take a dose.
- Use only the special syringe or dropper that comes with the medication to measure it.
- If you have any questions, concerns, or doubts about this medication, talk to your doctor immediately.
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