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Tuesday, December 16, 2008

Cough and Cold Medicines for Children

By CharlotteSmartyPants Guest Blogger, Dr. Sameena Evers, a pediatrician in Charlotte, NC

'Tis the season for pumpkin pie, family gatherings, and of course the dreaded cough and cold symptoms we all despise. So what's with all the recent advisories to stop using over-the-counter (OTC) medicines to help treat cold symptoms in our children? What is safe to use? Do we really need something else to worry about? I'll try to help answer these questions in this article.

The FDA first made a statement about OTC cough and cold medicines about a year ago warning that many of these products were unsafe to use in children under the age of 2. More recently, many pharmaceutical companies have voluntarily labeled their products unsafe for use under the age of 4. These changes have come about far too late, in my opinion, for several reasons. First, the use of cough and cold medicines in young children has never been validated by good scientific evidence. We do know, based on sound medical experiments, that many antihistamines and decongestants on the market are effective in reducing the annoying symptoms of the common cold IN ADULTS. These medicines help to alleviate symptoms in teenagers and may work a bit in kids age 6-12 but there is no evidence showing them to be helpful in kids younger than that. Of course, the pharmaceutical industry doesn't go around touting this data as they have been busy stocking the shelves of every drugstore and supermarket in the country with a huge variety of remedies to "help" your child's cold symptoms.

The second problem I have with common OTC cold medicines for kids is that the labeling is so confusing! Even with my medical degree, I find myself stuck in the first aid aisle forever trying to decipher what is actually in these boxes. Many products have 3 or 4 active ingredients in one formulation. This leads to the biggest problem with these medicines which is that it's fairly easy to get confused with the actual drug being given to your child and overdose. Although the medicine doesn't do much good or harm in the recommended dose, you certainly can give too much of it and cause serious damage. Several deaths in this country due to improper use of OTC cold medicines in children led to the FDA's decision to publish the recent public health advisories. By the way, before there is mass panic over the fact that you have used some of these medicines in your own child, let me also say that no serious harm has ever been related to the use of these products in the recommended doses. So basically, you have a product that has never been proven to be effective or harmful when used as directed in children.

In summary, don't rush out to the drugstore to buy medicine for your little one when they get the sniffles. Make sure they are drinking plenty of fluids as staying well-hydrated can help your child get rid of the cold a bit faster. Rest up - get the kids to bed early if possible. A cool mist humidifier may help at night. For fever, acetaminophen or ibuprofen can be used. A saline spray followed by nasal aspiration with a bulb can help infants and toddlers to temporarily relieve nasal congestion. Also, a teaspoon of honey has been shown to be effective in kids older than a year at relieving cough. For the most part, time and TLC are the only necessary treatments for the common cold. Of course, if your child has a fever that lasts more than three days, trouble breathing, or seems dehydrated, see your doctor.

One final reminder, it's time for you and your children to get the flu vaccine if you haven't already!!

Thank you to Dr. Sameena Evers! Do you have advice from your local Triad pediatrician that you can share in regards to treating coughs and colds this time of year?

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