RE : Custody Case  Beth Schlesinger (mother) and twin sons Benjamin and Samuel Schlesinger

To Whom It May Concern,

I am UK-trained Medical Professional (currently working in Australia) and am writing to you to clarify the use of paracetamol suppositories in children in the UK and the implications this has in the above custody case.

I was shocked and surprised to read that the inability of Mrs Schlesinger and her parents to administer paracetamol suppositories to her young twins for post circumcision analgesia was interpreted by the Judge as evidence that Mrs Schlesinger was unable to perform basic parenting skills.

There are clearly differences in the use of suppositories between Austria and the UK.  In the UK the majority of parents in the UK would be reluctant to use suppositories as culturally they are considered distasteful and they may harm the child physically.

In the UK paracetamol suppositories are available to buy but are rarely used by parents. They are mainly used in hospitals when children are unable to tolerate oral medication and in this environment will be administered by trained staff.

Parents will be occasionally be advised by medical professionals to use suppositories at home, for example if the child cannot tolerate oral paracetamol due to vomiting. In this situation parents will be instructed by a pharmacist or doctor how to use them.

The majority of parents in the UK will never have the need to use paracetamol suppositories and they are not considered a core parenting skill.

Universal practice in the UK for post circumcision analgesia is paracetamol syrup.

We would like to refer you to the product literature for paracetamol suppositories available in the UK as published by the Medicines and Healthcare Products Regulatory Agency (MHRA) www.mhra.gov.uk.

The guidance is clear that they are to be used for children who find it difficult to take paracetamol tablets or syrup. The guidance also clearly states that “if your child’s doctor or pharmacist has told you how to use this medicine do exactly as they have told you, otherwise follow the instructions. If you do not understand the instructions or are not sure ask a doctor or pharmacist.”

It is my medical opinion that a parent raised in the UK would most probably be unfamiliar with the use of paracetamol suppositories and that Beth Schlesinger behaved sensibly and safely by seeking help from someone familiar with their use.

I hope this statement clarifies this issue.

Please do not hesitate to contact me if you have any further questions.

Yours faithfully,