does my baby weigh enough for epi jr?

Posted on: Sat, 09/16/2006 - 12:53am
muzzy's picture
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Joined: 09/14/2006 - 09:00

hello all,
my daughter of 15 months has been diagnosed with pa. the allergist gave a script for a vial of epi and syringe. I was wondering if the epi jr would be ok. she weighs 21 lbs. I dont like the thought of trying to fill a syringe in a crisis situation. any info would be grateful.

Posted on: Sat, 09/16/2006 - 12:55am
Carefulmom's picture
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Joined: 01/03/2002 - 09:00

We also had a vial of epi and a syringe at that weight. She did not get epi jr until she was bigger.

Posted on: Sat, 09/16/2006 - 1:32am
Corvallis Mom's picture
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Joined: 05/22/2001 - 09:00

We have carried an epipen Jr. since DD was 11 months old-- she weighed a bit under 18 lbs at that time.
There are risks to epinephrine overdose, however. Our allergist felt that the benefit of rapid administration (by other caregivers, mostly) outweighed them in light of DD's Hx. (I agreed with her.)

Posted on: Sat, 09/16/2006 - 1:57am
melissiabeth's picture
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Joined: 05/24/2006 - 09:00

My daughter was prescribed the epi pen jr at 19 months and at the time weighed 22lbs.

Posted on: Sat, 09/16/2006 - 3:34am
pitterpat's picture
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Joined: 02/04/2006 - 09:00

My 2 year old is only 20 pounds and has an epi jr.
Patty

Posted on: Sat, 09/16/2006 - 4:57am
barb1123's picture
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Joined: 04/08/2000 - 09:00

Uh, I hate to sound negative but what's the alternative? I mean if she's going into anaphylactic shock what are you going to do? Let her die? Of course not. If it were me I would have the epi jr. on hand at all times. We had one from when R was a baby (how little I can't remember but then he was 9lb. 4 oz at birth and grew fast so he was well over weight by the time he got one prescribed.
Barb

Posted on: Sat, 09/16/2006 - 5:19am
Corvallis Mom's picture
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Joined: 05/22/2001 - 09:00

The alternative is basically an AnaKit-- a syringe and a vial of stabilized Epi. The upside is that the dose is correct. The obvious downside is having to DRAW THAT CORRECT DOSE YOURSELF [i]during a major reaction.[/i] Some people can probably do this just fine (I wasn't worried about being able to, for example, and I suspect the children of medical or veterinary professionals would be fine as well....BUT.) You have to consider the other people who care for your child.
Well, we actually debated this... because the more under the wt rec. they are, the more probable a severe adverse effect becomes. And it isn't a trivial side effect, though it is rare. (It can lead to a brain bleed.)
We felt that having an immediate treatment with less hesitation was worth that risk. We felt that the four minutes or so that could be wasted was too much. But it made us very careful NOT to administer one of those epipens for hives alone, I'll tell you.
HTH.

Posted on: Sat, 09/16/2006 - 8:52am
SallyL's picture
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Joined: 02/20/2006 - 09:00

My DD was about that weight when we were prescribed an epipen. In Canada, the epi-pen Jr is for people UP TO 15kg (about 33lbs) and in the US it is 33-66lbs...and it's the exact dosage. I still don't understand why it would be so different, but obviously someone deemed it to be safe for kids under 33lbs.
I'm sure I would manage if I HAD to in the moment, but I'm glad we have the epi-pen! A load off my mind.

Posted on: Sat, 09/16/2006 - 9:36am
Carefulmom's picture
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Joined: 01/03/2002 - 09:00

For us it was not an AnaKit. It was a vial of epi and a syringe. It does not take four mintues to draw it up. I would say 30 seconds is more like it. However, there is much more room for error if you are drawing it up yourself. I certainly would not want anything like that at school, but of course by then your child will weigh enough for epi or epi junior. Dey recommends the Jr for 33 pounds and up. The actual dose of epi if you are drawing it up is 1 mg per kg. 1 kg is 2.2 pounds. The jr has 15 mg of epi which would be exactly the right dose for 15 kg which is the same as 33 pounds. If your child is 18 pounds that is about 8 kilos, so an epi jr is twice as much epi as the correct dose. The decision is really based on whether in the moment you think you can draw the right dose. I figured with dd`s life depending on it, I would. Giving twice as much as the correct dose could kill her. Fortunately by the time she had her first anaphylactic reaction she was bigger and had the epi jr.

Posted on: Sat, 09/16/2006 - 10:49am
Corvallis Mom's picture
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Joined: 05/22/2001 - 09:00

Sorry Carefulmom-- didn't mean to imply I thought it would take me 3-5 min either... I think your estimate is correct.
However, I [i]really[/i] think this one depends on who is caring for the child. I was surprised, but even DH had a bit of a psychological block about using a syringe-- it's this whole "But I can't do that-- I'm not a doctor.... what if I do it wrong?"
For my Mom and MIL, I stand by my 4 min estimate. [img]http://uumor.pair.com/nutalle2/peanutallergy/wink.gif[/img]

Posted on: Sat, 09/16/2006 - 12:22pm
Carefulmom's picture
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Joined: 01/03/2002 - 09:00

Yes, when they don`t really weigh enough for an epi junior, it is a big catch 22. Do nothing, child can die. Get epi and a syringe and draw it up yourself, make a mistake, and child can die. Use epi junior when the child weighs so little that it is twice the correct dose, child can die. There is really no good option at that weight.

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