Over-the-counter cough and cold medications to alleviate cold symptoms in young children are being withdrawn from pharmacy shelves. This is because of unintentional misuse or of overdose of these medications, causing harm and, rarely, death, especially in children younger than 2.
These medications are frequently used in good faith, even though there is no scientific proof that these drugs are actually effective. This is a case where the risks outweigh the benefits.
Health care providers are now asked to advise not using these drugs for children younger than 6. Some of the most commonly used drugs in this category are PediaCare, Triaminic and Dimetapp.
I know this may sound discouraging when caring for a sick child, but there are very useful non-drug treatments for cold and cough symptoms:
- Encourage the child to drink plenty of fluids to prevent dehydration and to help thin out mucus. Contrary to popular opinion, milk has not been proven to increase mucus. The fat in milk does combine with saliva in the mouth, causing a slimy sensation, but that’s not harmful.
- Fever or pain can be controlled using either acetaminophen (Tylenol) or ibuprofen (Advil), giving accurate and consistent doses every six hours.
- Saline irrigations: For infants, use rubber bulb suction with saline nose drops to remove mucus. A saline nose spray can be used for older children.
- Use a cool-mist humidifier or vaporizer in the child’s room. To prevent contamination, the water should be replaced daily and the machine cleansed regularly according to the manufacturer’s recommendations. Keep indoor relative humidity at about 40 percent to 50 percent
- If a medication such as Tylenol or Advil is given, I do not advise the use of household silverware spoons to measure doses of medication. Common teaspoons can vary, holding anywhere from 2 to 10 milliliters (mLs) of liquid, which could cause either an under- or overdose of a medication. Proper measuring devices using units of milliliters usually come with the medicine or can be obtained from the pharmacist.
- Honey can relieve coughs by increasing saliva, which coats the throat and relieves irritation. Suggested doses are half a teaspoon for children between 1 and 5 years, 1 teaspoon for children 6 to 11 years, and 2 teaspoons for children 12 years and older. Do not give honey to a child younger than 1 year old.
See your health care provider immediately for any of the following cases:
- A child younger than 2 months of age with any fever
- A child younger than 2 years with a fever that lasts longer than two or three days
- A child who complains of an earache or a severe sore throat
- A child who has thick green nasal discharge for more than 2 weeks
- Mild symptoms that fail to improve after 10 to 14 days
- Any child who seems very ill to you
By the way, for children who have been appropriately prescribed antibiotics, I am frequently asked whether the drug needs to be refrigerated. The two most commonly prescribed antibiotics, Amoxicillin (which tastes like bubblegum or occasionally is fruit-flavored) and Zithromax (which has a cherry-vanilla-banana taste), can be kept at room temperature for as long as 10 days. Refrigeration may improve the taste, but it isn’t needed to maintain potency.