Over-the-counter Medicines for Your Child’s Cough and Cold

Over-the-Counter Medicines for Your Child’s Cough and Cold

When your child develops a cold, it can be hard to know which over-the-counter medications, if any, you can give to him/her. When you walk down the aisle of your local pharmacy, you are faced with many over-the-counter products marketed for children. Many of the products contain similar ingredients and you may question the difference between them, and wonder if they will be both safe and effective. Many of the products differ with respect to what ages and weights they can be used. Some product instructions provide specific dosing for children, and some instruct you to speak with a doctor in order to determine the dose that is best for your child.

Many of these questions are dependent on the age of your child. In March 2009, the Food and Drug Administration (FDA) recommended that parents and caregivers no longer give over-the-counter cough and cold medicines to children under the age of 4 years. The reason for this is that they have actually not been proven to be effective, nor safe, when used to treat symptoms of a cold. Aside from not providing relief, these medications were also able to cause significant serious side effects, including some fatalities. Over-the-counter cough and cold medicines have not been shown to be effective and safe for children older than 4 years as well, although the FDA has not yet recommended against their use for these ages.

If your child does develop a cold, it will be self-limited, meaning that it will go away on its own without the use of medications. The duration of the typical cold is about 7 days. No medications that will cure the viruses that cause colds. Although over-the-counter cough and cold medicines should not be given to children, there are other therapies that you can use to help with your child’s cold symptoms.   These include honey, saline solution, humidifiers, and hydration. Honey, specifically buckwheat honey, can help reduce the irritation associated with sore throat, and can lessen a cough. Honey has been shown to be effective and safe for children 1 year of age and older. Honey is given in a dose of ½-1 teaspoonful before bedtime for children aged 1-5 years, 1 teaspoon for children aged 6-11 years, and 2 teaspoonsful for children 12 and older, to help reduce mucus secretion and reduce cough. Although many over-the-counter cough products are available to treat a cough from colds, they are best not given to children, as they have not been shown to be effective nor safe. These products commonly contain dextromethorphan. This drug has been shown to cause significant side effects in children, and some teenagers have been known to abuse it by drinking large quantities.

Saline solution, such as nose drops, can be used to temporarily remove nasal secretions, congestion, and crusting. It is commonly administered using a medical syringe or dropper and is very safe. Humidifiers help loosen nasal secretions by adding moisture to the air, much like a steamy shower. Cool mist humidifiers are recommended for children, and not hot water humidifiers, to avoid potential burns. If your child has a fever associated with his/her cold, ibuprofen or acetaminophen can be used. Ibuprofen is recommended for children 6 months of age and older, and acetaminophen can be given to children of all ages. These products should be given to improve your child’s overall comfort, rather than targeting a specific temperature decrease. Dosing of ibuprofen and acetaminophen are best based on your child’s weight, rather than his/her age. A pharmacist can assist you with determining an appropriate dose for your child.

Taking steps to prevent the spread of colds can be important in limiting the number of colds your child develops in a year. This includes ensuring that your child is getting the right amount of sleep for his/her age. The Centers of Disease Control and Prevention recommends that newborns get 16-18 hours of sleep per day, preschool-aged children 11-12 hours, school-aged children at least 10 hours, and teens 9-10 hours per day. Practicing good hand-washing hygiene, which includes washing hands often with soap and water for 20 seconds, can additionally help prevent colds.

Haley Deering

March 2016

References:

  1. Daniel L. Krinsky, Rosemary R. Berardi. Handbook of Non-prescription Drugs. American Pharmacists Asscociation; 2012.
  2. Goldman RD. Honey for treatment of cough in children. Can Fam Physician. 2014;60(12):1107-8, 1110.
  3. Pappas DE, et al. The common cold in children: Treatment and prevention. http:www.uptodate.com/home. Accessed March 3, 2016
  4. Sullivan JE, Farrar HC. Fever and antipyretic use in children. Pediatrics. 2011;127(3):580-7.
  5. https://www.gov.uk/drug-safety-update/over-the-counter-cough-and-cold-medicines-for-children. Accessed March 3, 2016
  6. http://www.cdc.gov/dotw/common-cold/index.html. Accessed March 3, 2016
  7. https://www.healthychildren.org/English/health-issues/conditions/ear-nose-throat/Pages/Caring-for-a-Child-with-a-Viral-Infection.aspx. Accessed March 3, 2016