Learn how over-the-counter children's cold remedies can do more harm than good.
It's 3 a.m. and your little girl, who is fighting a nasty cold, is crying and coughing, calling out for Mommy and Daddy.
She's miserable. You're miserable.
You want to make her feel better, but you're worried about giving her over-the-counter (OTC) cold and cough medications. After all, haven't there been warnings about not giving cold meds to young kids—and questions about whether or not they even help?
Warnings against over-the-counter cold medicines for kids
In 2008, there were several public advisories about OTC cold and cough meds from the U.S. Food and Drug Administration (FDA) and other health groups. The products may include one or more of the following active ingredients: decongestants, expectorants, antihistamines and antitussives (cough suppressants).
- January 2008: The FDA recommended that parents not give infants and children under the age of 2 years any type of OTC cough and cold medication.
- October 2008: The Consumer Healthcare Products Association (CHPA), which represents most makers of nonprescription OTC cough and cold medicines in children, announced that its members are voluntarily modifying the product labels for consumers of OTC cough and cold medicines to state "do not use" in children under 4 years of age.
- October 2008: An FDA advisory panel of health experts concluded that there is no evidence that OTC cough and cold medicines work for children under age 6 and called for more studies about how these products affect children.
Cold medicines for kids can hurt instead of helping
Dr. Megan Neuman, a Legacy Emanuel Children's Hospital pediatrician in Portland, Oregon, has some frank advice: "There's very little evidence that OTC cough and cold remedies help anyone, and they may potentially hurt." Based on her "First do no harm" oath, Dr. Neuman doesn't recommend any OTC cough and cold medicine for children who are smaller than adult size.
Dr. Neuman reminds parents that colds are inconvenient but not serious. "You can help your kids feel better with supportive care while the body is fighting off a normal virus."
According to Dr. Benjamin Danielson, a pediatrician and clinic chief of Seattle's Odessa Brown Children's Clinic, "Advice for each patient is individual, but there are some common underlying themes that apply to caring for kids with colds and coughs."
A cough helps a child work through his or her illness, so in most cases we don't want to stop a cough, explains Dr. Danielson. "Cough, runny nose and fever are the way our body battles a minor infection."
Dr. Danielson says that most cold and cough medicines are useless and can be overused, which can lead to dangerous health complications. "There are ways to make your child more comfortable," he says. "Think about what grandma told you—lots of fluids, steam up the bathroom, TLC, etc."
Sometimes the old ways are best
Dr. Cindy Ferrell, a pediatrician at Doernbecher Children's Hospital in Portland, is also an advocate of TLC and natural remedies for kids' coughs and colds.
"You get a cough for a reason, and medication just masks the symptoms," says Dr. Ferrell. "People need to realize that an average cold can last 7 to 10 days, but if parents have any concerns when their child is sick, they should call their health care provider."
As for OTC cough and cold medicine, Dr. Ferrell says absolutely do not use them for kids under 2. He doesn't recommend them for children between 2 and 6, and he doesn't think they help much at any age. "There's no clinical evidence to prove effectiveness or safety of OTC cough and cold medicine," he says. "But there is evidence that it can be seriously harmful if accidentally used inappropriately."
When her kids were younger, Cheryl Strayed, a Portland author, used to give Carver (4-1/2) and Bobbi (3) OTC medication to help them sleep when they were suffering from a cold or cough.
"Once the warnings about cold meds came out, I talked with my pediatrician and children's nurse and threw everything away," says Strayed.
Now Strayed relies on old-fashioned remedies, including tea, soup and an herbal vapor rub. "There are lots of ways that you can make your children feel better when they have a cold," says Strayed. "Kids want comfort, and if you crawl into bed and sleep with them, you'd be surprised how much better they sleep."
Safe and soothing children's cold treatments
The American Academy of Pediatrics (AAP) and most pediatricians agree that you can help your children feel better without using OTC cold and cough products. Here are some tips:
- Give them plenty of fluids—anything your child likes (except sugary drinks).
- Make sure they get lots of rest and sleep.
- Use saline (salt water) nose drops; for babies, use bulb suction.
- Give them moist air to breathe—a steamy bathroom or a humidifier or vaporizer in your child's room.
- Use straight honey or honey diluted in liquid to calm a cough (but no honey for children under 1 year old).
Published on Jan. 15, 2009; updated on May 23, 2014.