I appreciate Dr Simon's reply regarding our study. We agree that medication prescribing in young children is too often based on anecdote and experience rather than evidence. However, in our experience, the lack of evidence on medications for children is partly because of the obstacles in conducting pediatric research. It is important to take proper precautions when conducting studies on children, but at times insitutional review boards, funding agencies, or physicians would rather use untested medications on children rather than encouraging quality research in controlled settings. At present, one of the most common problems new parents face, childhood sleep disorders, has few well-conducted randomized controlled studies. Although Congress passed the Pediatric Research Equity Act of 2003, which was endorsed by both the Centers for Medicare & Medicaid Services commissioner and the Health and Human Services secretary, it is still very difficult to conduct effectiveness translational research in children. It is time that parents and pediatricians start relying on evidence-based medicine supported and encouraged by institutions set up to protect and treat children.
Merenstein D, Diener-West M, Halbower AC, Krist A, Rubin HR. Diphenhydramine in Infants—Reply. Arch Pediatr Adolesc Med. 2007;161(1):105. doi:10.1001/archpedi.161.1.105-b