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Ack! Is Cough Medicine Safe? I'm So Confused!

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Dr. Alanna: Have you been to the pharmacy recently to buy cough and cold medicine for your child? Did you feel overwhelmed and confused? You are not alone.

A new study in the journal Pediatrics found that many parents are confused by product labels. The parts of the label that led to misperceptions were:

mom giving daughter cold medicine

The title of the medicine: even if a label read, "Consult your doctor for children under the age of 2," parents still thought the preparation was appropriate for infants because it was labeled as an "infant" medication.

Infant-related graphics on the box like teddy bears, pictures of babies, or dosing droppers and phrases like "pediatrician recommended" were misleading.

Let's set the record straight. For many years, the American Academy of Pediatrics has spoken against the use of over-the-counter cough and cold medicines for children. Studies have shown that they don't work and that they have potential complications. Why recommend something that doesn't relieve symptoms but could cause harm?

In fact, in the last forty years, cough and cold medicines have been implicated in more than 100 infant deaths. There have been even more ER visits as a result of adverse side effects from these medications. As a result, in 2007, the FDA recommended removing all of the infant cough and cold medications from the shelves, and the manufacturers voluntarily complied. But what about older children? As it stands right now, the FDA has allowed cough and cold medications for children to remain on the shelves -- however, the labels warn that they shouldn't be used in children under the age of 4. 

The FDA is examining the safety and effectiveness of these preparations in kids age 4 and older, but for now, they are still widely available. So, what should parents know?

1. Check with your pediatrician before giving over-the-counter cough and cold preparations to children. It's a good idea at each routine visit to go over which medications are okay for different symptoms, and what the dosages are (which will vary with age and weight) -- so when your child awakens coughing at 2 AM, you will know what to do.

2. Read labels carefully so you understand what the active ingredients in the medication are, the recommended dose, and the age range. Do not extrapolate for younger children. They are not mini-adults! If the dose is not explicit on the label, do not use it.

3. Be careful with combined medications. For example, if you are using a combined fever reducer and cough suppressant, you cannot give an additional cough medication as well.

4. Use appropriate measuring spoons or droppers. A kitchen spoon is not exact enough. And know the difference between a teaspoon and a tablespoon. Most medication doses are in teaspoons or milliliters (1 tsp=5 ml=5 cc).

5. Follow the dosing intervals carefully. Know which medications are every four hours, every six hours, or twice a day. If you are giving more than one medication at a time, record the times given, so you don't get confused.

6. Only repeat usage if your child feels better. If a medication didn't work to relieve symptoms, it's probably not effective.

What can you do for a child too young to take cough and cold medications? My own 4-year-old son asked me to "cut his nose off" with his last cold. I resisted his pleading and resorted to the old-fashioned remedies, which are still effective: Give plenty of fluids, elevate the head of the bed, put a humidifier in the room, give a fever reducer if needed, and wait for the symptoms to resolve on their own. If they don't or if you are concerned, consult your pediatrician.

next: "My First Priority is Being a Mom"
2 comments so far | Post a comment now
Angie June 1, 2009, 12:41 PM

I just want to say something on this topic…I have not used cough medicine in years and would not have my children as well- too much junk whether it is FDA approved or whatnot. Warmed water, lemon juice, and honey for children and for adults add some brandy. This really is the best remedy and if you don’t believer it just try it!

Heather June 2, 2009, 10:56 AM

Overwhelmed and Confused over cold medicine? OMG people. Use some common sense! My kids get sick rarely but when they do I would rather give them a dose or two of cold medicine than have them laying around miserable. It’s been the difference between feeling better and a trip to the ER with my 5 year old son who has Asthma. A warm bath, teaspoon of medicine, and plenty of rest and my kids are up and playing in no time.

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