Cold and Cough Medicine for Infants and Children
Medical Author: Benjamin Wedro, MD, FACEP, FAAEM
Medical Editor: Melissa Conrad Stöppler, MD
Once upon a time, not so long ago, children were allowed to have runny noses and coughs. Colds were expected to last a few days and were considered an inconvenience.
But times have changed. The traditional family unit of one working parent and one at home is no longer the norm. Aside from not wanting your child to suffer, the practical considerations of adjusting day care and work - means adding more stress to a home with an ill child.
Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) are important drugs to use to control fever and pain in children. Too often they are bundled with combinations of antihistamines, decongestants, and cough suppressants, suggesting an all-in-one cure for the common cold and other upper respiratory tract infections (URIs). Store shelves are filled with these over-the-counter medications that beckon parents to make life a little easier for their child. Yet, even in adults, these medications are less than helpful, and the side effects can be potentially deadly.
Sometimes regulatory agencies move at a snail's pace when making their recommendations. The US Food and Drug Administration (FDA) issued a public health advisory about cold medication use in kids in August of 2007 warning of potential dangers of these medicines to children under the age of 2. But even this recommendation can be confusing, since most pediatric medication dosing is based on weight, not age. How much different is a child who is 2 years and 1 month old (25 months old), compared with an infant 2 months younger (23 months old)?
At the time of the recommendation the FDA was "committed" to studying the medications in kids aged 2-11. They are still studying the safety of cold medications in this pediatric population. Meanwhile, the American College of Chest Physicians has recommended not using them in children under 14 years of age. Decongestants contain pseudoephedrine, a chemical that acts like adrenaline, and may cause children to become "wired." Antihistamines may be useful but can cause excessive sleepiness in children (remember that they are the active ingredients in over-the-counter sleep medicines), and some children paradoxically get agitated with antihistamines. Perhaps the most important statement from the chest physicians is that cough medications do not work.
The bottom line is that children get colds and they are miserable. Parents want to make their child feel better, and that is not always easy. Drinking fluids, controlling fever, hugging your child, and tincture of time may be the best remedy.
