Dr. Stuart Macleod, a senior clinician at the Child and Family Research Institute at BC Children's Hospital, says great strides have been made in ensuring drugs are well-made, but all of the rules are related to adults.
"Drugs do behave differently in children. For one thing, children are not a uniform population. They range from newborn babies to teenagers and not surprisingly the way the drugs act will change as the child develops."
Dr. Macleod says doctors will often prescribe drugs just on the basis of their belief that they think it might work.
Educated guesses on dosage
"I guess the right term is that we extrapolate to calculate the dose for children, and sometimes just to make an educated guess the drug will work in children."
A few years ago, Health Canada convened an expert panel to examine this issue. Dr. Macleod led the panel and presented the results to the federal government.
Since then, Parliament has passed a new bill to make Health Canada's drug approvals more transparent -- but Dr. Macleod thinks they need to go further.
"It's a step forward, but the law is primarily concerned with safety. It doesn't really address the questions of getting the right dose for a small child or doing the research. You need to find out more about how the drug acts and what the concerns might be about its safety."
Other countries ahead in ensuring safe drugs for kids
Dr. Macleod says Canada is 20 years behind the United States and Europe when it comes to ensuring safe drugs for kids. He says the delay can be attributed to Canada's relatively small population and not having comparable pharmaceutical industries.
"I think there has been an assumption that eventually the important knowledge will filter into the country from other sources," said Macleod. "There's no question Health Canada doesn't know Canada is a bit of an outlier in this situation. However, at the moment they don't have the legislative tools that will allow them to move ahead quickly."