Family and friends of 6-month-old Harper Rose Briar will hold a fundraiser in Rutland Monday to offset funeral and legal bills.
The Pittsford infant’s death in January was ruled a homicide. Stacey Vaillancourt, the baby’s daycare provider, faces felony manslaughter charges for allegedly administering unprescribed allergy medicine. She pleaded not guilty.
While experts say this tragedy may be a first in Vermont, infant deaths from drugs like Benadryl are not uncommon.
Diphenhydramine is an antihistamine commonly available in over-the-counter cold and allergy medicines. Adults reach for it to relieve runny nose, hay fever and the common cold. Drowsiness is a common side effect.
Doctors say it can be used effectively in small children, even infants, to treat severe allergic reactions or itching from serious skin conditions — but only under close physician supervision.
Dr. Kirsten Bechtel, an associate professor of pediatrics and emergency medicine at Yale School of Medicine, said problems arise when parents and caregivers reach for over-the-counter cold medicines to put babies to sleep.
“We know that this is a common practice,” she said. “You know, one study that was done by the Today Show and Parenting magazine, found that one in five [of more than 26,000 mothers who responded to an online poll] admitted giving their kids some medications like Benadryl to get them through like a big event, or a long car ride, or promote sleep.”
And according to Bechtel, that can be deadly. She co-chairs Connecticut’s Child Fatality Review Panel and said four infants and toddlers died in that state after receiving antihistamines like Benadryl in 2017.
In the last three years, two infants died in Ohio under similar circumstances. And in 2006, 10 infants died in Arizona.
Vermont Department of Health officials couldn’t recall any other infants in Vermont who have died in this manner, besides Briar in January, but they were not able to confirm that.
Bechtel said states don’t have uniform ways of reviewing child fatalities, so she said it’s hard to know how many babies have died nationwide.
Connecticut released a public health alert to pediatricians, pharmacists and the state’s poison control center following the 2017 deaths in the state. Bechtel said there have been no reported infant deaths from over-the-counter cold medicines since then.
A warning on the bright pink box of Children’s Benadryl clearly states "Do not use to make a child sleepy" and the directions also say do not use in children under age 2. But the print is small, and studies have shown these warnings are not being followed by parents. One study found that poor math skills among caregivers led more than 50% to misunderstand dosing instructions.
Dr. Joseph Hagan, a longtime pediatrician in Burlington, is not surprised by that statistic.
"We spend too much time making labels glitzy to sell the product and not enough time and space on the label telling the dose." — Dr. Joseph Hagan, Vermont pediatrician.
“We spend too much time making labels glitzy to sell the product and not enough time and space on the label telling the dose,” Hagan said.
The pediatrician said parents frequently call him late at night struggling to figure out how much medicine to give their child. They’re stressed and often sleep-deprived, so labels need to be easier to understand, added Hagan.
“I’d like kids in high school to learn milliliters rather than teaspoons because it’s a more accurate dosing," Hagan said, "and we’re now moving with children to use all dosing in mLs, not in teaspoonfuls.”
Some argue that cold and allergy medicines like Benadryl should be moved behind the counter so customers would have to interact with a pharmacist to make a purchase. But Hagan felt that could limit access to the medication’s legitimate benefits.
He said he believes a more effective approach would be to better educate parents and especially caregivers that “you don’t go grabbing medicine out of your medicine chest or bag and give it to somebody else’s child without permission.”
Vermont’s child care licensing regulations contain nearly two pages of rules for administering medications, foremost of which is to get a parent’s permission before any drugs are given.
According to the Department for Children and Families, which oversees child care licensing, Vaillancourt — the woman caring for Briar — was a registered child care provider with the state.
DCF Deputy Commissioner Reeva Murphy said a child fatality review team has been investigating what happened to Briar. Murphy said at this time her department has not made any decisions yet as to what, if any, policy changes are needed.
