Ask Dr. Peltier
What’s safe to give my child for a cough or cold?
Parents face bewildering choices in the medicine aisle for their children’s colds and coughs. The best choice may be buying nothing.
Last year, the Food and Drug Administration (FDA) recommended against over-the-counter cold remedies for children age 2 and under. In response, manufacturers voluntarily withdrew products for younger children.
The FDA continues to study whether older children should take cold medicines. So far, studies haven’t shown they work for children. In addition, these medicines have side effects that – in cases of overdose – can be serious, even deadly. In 2004 and 2005, 1,500 children age 2 and younger were treated in emergency rooms for problems related to cough and cold medicines.
Viruses cause colds, and we have no treatments for viruses. No over-the-counter medicines shorten colds, and there is little evidence that they relieve symptoms:
Decongestants: Found in many children’s cold medicines, they treat stuffy noses. Decongestants have been shown to work in adults, but not children. Side effects include drowsiness, excitability or, with overdose, breathing problems, seizures and comas.
Antihistamines: These combat allergy symptoms like sneezing and runny noses. Use caution with young children; these cause drowsiness and nervous system changes.
Cough suppressants: Ranging from over-the-counter formulas (dextromethorphan) to prescription drugs (codeine), cough suppressants appear to act on the brain’s cough center. However, one study of children ages 18 months to 12 years found no difference between taking cough suppressants or a sugar pill. Overdose can stop a child’s breathing.
Honey: It worked no better than cough suppressants in one study and carries the risk of botulism, a paralyzing neurologic condition, in infants.
Zinc: Some studies showed zinc reduced a cold’s duration in adults; another showed no impact for children ages 6 to 16.
Menthol rubs: One study showed these did nothing to improve breathing in children with colds.
So, What Works?
Pain relievers such as acetaminophen or ibuprofen may relieve aches and pains from colds. Follow dosing directions carefully, and never give them with a multisymptom cold remedy containing the same drugs. Ask your pediatrician if you have questions.
Saline sprays sold at stores (or made at home with a quarter teaspoon of salt per cup of water) help irrigate clogged nasal passages. Use them with a suction bulb for children too young to blow their noses.
Increase your child’s intake of fluids.
Finally, while they won’t stop colds, annual vaccines can help prevent flu that can make children miserable with high fever, cough and muscle aches.
Christopher Peltier, MD, is a pediatrician with Pediatric Associates of Mount Carmel serving as editorial consultant for Young and Healthy. He also is assistant director of Community Pediatrics at Cincinnati Children’s.
