To Your Health
Are Children's Cold Remedies Safe and Effective?

by Paulette Avery, R.N., M.S.N., I.B.C.L.C.

What do you do when your child gets a cold? If, like millions of parents, you head to the local supermarket or drugstore for an over-the-counter (OTC) remedy, you will be confronted by dozens of possibilities. You'll also contribute to the billions of dollars spent on these products each year. But what are the best options for treating colds and coughs in children, and will what you choose be effective and, more important, safe for your child?

The answers to those questions may become clearer now that a team of drug regulators led by Dr. Charles J. Ganley, Director of the Office of Nonprescription Drug Products at the US Food and Drug Administration, has begun a review to determine the safety, benefits, and risks of children's cold and cough remedies. Already, one recent study found that two of the most common ingredients in children's cough medicines, dextromethorphan and diphenhydramine, are no more effective than a placebo. Although those two ingredients have been around for about 50 years, apparently they were never adequately tested for their safety and effectiveness.

According to a March 2007 article on Medscape by Howard Markel, M.D., Ph.D., many pediatricians are thrilled that the FDA is finally reviewing these medications. For years doctors have expressed concern about the potential problems resulting from parents giving OTC medications containing antihistamines, decongestants, cough suppressants, and expectorants to their children, especially to children as young as two years old. When parents give these medicines to children under two, the consequences can be dire. Dr. Markel reports that a recent study conducted by the U.S. Centers for Disease Control and Prevention found that between 2004 and 2005, "At least 1519 children under two years of age experienced serious health problems after being dosed with common cough medicines and remedies."

Wanting to give your child relief is understandable, says Dr. Markel. Unfortunately, since the average child gets six to ten colds a year, the risk of problems from accidental overdoses, incorrect doses, or bad reactions to the drugs is high.

If you do give OTC cough or cold remedies to your children, be sure to read and follow the dosing instructions on the product. If your child is under two, avoid giving any medications unless you talk to your doctor or an advice nurse first and are told it is safe to do so. Always avoid giving aspirin or aspirin-containing medicines to children under 20 years of age due to the association between aspirin and the development of Reye's syndrome, a potentially deadly condition. Avoid giving multi-ingredient products to your children. Instead, use a product aimed at easing a specific symptom such as nasal congestion.

The best advice may be to avoid the medicines altogether. Stick to the basics by encouraging extra rest, lots of fluids, the use of saline nasal drops or spray, and a humidifier. Use disposable tissues, and remind everyone members of the family to wash their hands frequently to minimize the spread of the virus.

Paulette Avery is a registered nurse and a freelance writer specializing in health issues. She can be reached at averyfam\