1. Stick to the Recommended Dose
Of course, the best way to manage Gray Syndrome is to avoid giving infants the medication that causes it, since this is the age group most susceptible to the toxic build-up of the drug. Unfortunately, there are circumstances under which total avoidance isn't possible and newborns must be given IV doses of the antibiotic chloramphenicol. For example, an infant who has meningococcal meningitis, cholera or MSRA may need chloramphenicol to save her life. In that case, staying at or below the maximum recommended dose is necessary to manage or avoid Gray Syndrome. According to the Merck manual, this dose for infants under the age of 1 month is no more than 12.5 mg daily.
2. Monitor Blood Levels
While your baby is taking chloramphenicol, ask her doctor to monitor the level of the antibiotic in her blood. Because young infants lack the enzymes necessary to metabolize and excrete the drug effectively, it's important to keep an eye on how much of it is building up in her system. Management of Gray Syndrome relies on knowing blood levels both before (trough) and after (peak) a dose of the medicine. Ask the doctor about what the numbers mean and what levels are safe, so you can keep track of your baby's progress.
3. Avoid Breastfeeding While Taking Chloramphenicol
Even if you are only using a topical preparation for conjunctivitis or drops for an ear infection, if the medicine contains chloramphenicol, avoid breastfeeding your baby while taking the antibiotic and for a few days after the course is complete. The drug can be passed from mother to child via breast milk, causing the devastating symptoms of Gray Syndrome.
