Kids and cold medications: What should you do?

Kids and cold medications: What should you do?


Kids and cold medications: What should you do?


by Barbara Schuetze / Contributor

Posted on January 22, 2010 at 5:19 PM

Updated Wednesday, Oct 30 at 8:41 AM

It's 3 a.m. and your little girl, who is fighting a nasty cold, is crying and coughing, calling out for Mommy and Daddy.

She's miserable. You're miserable.

You want to make her feel better, but you're worried about giving her over-the-counter (OTC) cold and cough medications. After all, haven't there been warnings about not giving cold meds to young kids--and questions about whether or not they even help?

In 2008, there were several public advisories about OTC cold and cough meds from the Food and Drug Administration (FDA) and other health groups (see sidebar). The products concerned may include one or more of the following active ingredients: decongestants, expectorants, antihistamines and antitussives (cough suppressants).

Megan Neuman, MD, a Legacy Emanuel Children's Hospital pediatrician in Portland, Ore., has some straightforward advice: "There's very little evidence that OTC cough and cold remedies help anyone, and they may potentially hurt." Based on her 'First do no harm' oath, Dr. Neuman doesn't recommend any OTC cough and cold medicine for children who are smaller than adult size.

Dr. Neuman reminds parents that colds are inconvenient but not serious. "You can help your kids feel better with supportive care while the body is fighting off a normal virus."

According to Benjamin Danielson, MD, a pediatrician and clinic chief of Seattle's Odessa Brown Children's Clinic, "Advice for each patient is individual, but there are some common underlying themes that apply to caring for kids with colds and coughs."

A cough helps a child manage an illness, so in most cases we don't want to suppress a cough, explains Dr. Danielson. "A cough, runny nose and fever is the way our body battles a minor infection."

Dr. Danielson says that most cold and cough medicines are useless and can be overused, which can lead to dangerous health complications. "There are ways to make your child more comfortable," he says. "Think about what grandma told you--lots of fluids, steam up the bathroom, TLC, etc."

Cindy Ferrell, MD, MSEd, a professor of Pediatrics at Oregon Health & Science University and pediatrician at Doernbecher Children's Hospital in Portland, is also an advocate of TLC and natural remedies for kids' coughs and colds.

"You get a cough for a reason, and medication just masks the symptoms," says Dr. Ferrell. "People need to realize that an average cold can last 7-10 days, but if parents have any concerns when their child is sick, they should call their healthcare provider."

As for OTC cough and cold medicine, Dr. Ferrell says absolutely not for kids under 2, he doesn't recommend them for children between 2 and 6, and he doesn't think they help much at any age. "There's no clinical evidence to prove effectiveness or safety of OTC cough and cold medicine," he says. "But there is evidence that it can be seriously harmful if accidentally used inappropriately."

When her kids were younger, Cheryl Strayed, a Portland author, used to give Carver
(4 1/2) and Bobbi (3) OTC medication to help them sleep when they were suffering from a cold or cough.

"Once the warnings about cold meds came out, I talked with my pediatrician and children's nurse and threw everything away," says Strayed.

Now Strayed relies on old-fashioned remedies, including tea, soup and an herbal vapo rub. "There are lots of ways that you can make your children feel better when they have a cold," says Strayed. "Kids want comfort, and if you crawl into bed and sleep with them, you'd be surprised how much better they sleep."

The American Academy of Pediatrics (AAP) and most pediatricians agree that you can help your child feel better without using OTC cold and cough products. Here are some tips from the AAP and from doctors interviewed for this article:

  • Plenty of fluids: Anything your child likes (except sugary drinks) is fine.
  • Lots of rest and sleep.
  • Saline (salt water) nose drops; for babies, use bulb suction.
  • Moist air: Try a humidifier or vaporizer in your child's room. Or steam up your bathroom with hot water.
  • Honey: For children 1 or older, straight honey or honey diluted in liquid helps calm a cough. (Do not give honey to children under 1.)

About the Author

Barbara Schuetze is a Portland, Ore., freelance writer who specializes in health and wellness topics. She has written for most of the major health systems in Oregon and Southwest Washington, and her work has appeared in magazines, newspapers and on the Web. She has been writing professionally since 1983.