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Coughs and Colds in Kids: A Doctor's Advice

There's a reason the FDA is cracking down on some cough medicines

By Henry J. Fishman, M.D.
ConsumerAffairs.com

October 1, 2007

• FDA Claims Proctor & Gamble Unlawfully Marketing Meds • Start 2009 With a Medicine Cabinet Checkup • Kids Cough Medicine Gets Warning Labels; Critics Not Impressed • Parents Urged To Shun OTC Cough Medicine • Children and Prescription Drug Abuse: The Threat at Home • Feds to Toughen Rules for Over-the-Counter Kids' Cold Medicines • Children Still Taking Dangerous OTC Medicine, Study Finds • Study: Children Should Not Take Antihistamines for Chronic Cough • More Bad News about Cough Medicine • Saline Nasal Wash Improves Children's Cold Symptoms • Cough Medicine Might Not Help Adults, Either • Parents Warned Camphor Can Be Toxic to Children • FDA Warns of Cough, Cold Medicine Risk to Children • Feds Find Kids Getting High On Cough Meds • Honey May Relieve Children’s Cough • Kids’ Cough Medicine Recalled Over Dosing Issue • Kids' Cough & Cold Remedies Under Fire • Drug Companies Withdraw Infant Cold Remedies • Coughs and Colds in Kids: A Doctor's Advice • FDA Cracks Down On Cough Medicine For Kids • FDA Targets Cough Medicine For Kids Under Two • Experts: Skip The Cough Medicine • Despite the Ads, Cough Syrup Does Little Good • FDA Warns Against DXM Abuse --- • More Health News ...

It's 2 a.m. Your three-year-old is coughing, sneezing and hacking up a storm. The kid needs to get some sleep, and so do you.

Guess it's time to reach for your tried and true, multi-symptom, one-product-cures-everything, over-the-counter cold and cough formula.

Or is it?

The Food and Drug Administration says maybe not. It is considering taking hydrocodone, a powerful prescription cough suppressant, off the market, along with a lot of the over-the-counter cold, cough and allergy products for kids that use hydrocodone in small amounts.

How come? Well hydrocodone is a powerful narcotic. And truth be told, not a single study shows it works in kids. Not only that, it can cause serious side effects, even addiction.

Most of the time you're better off talking to your doctor first, treating the underlying cause of your child’s cough, and skipping narcotic cough suppressants, which just treat symptoms.

Ditto for the multi-symptom five-in-one cocktails you get over the counter. They can have five or six drugs at a time, when your child just needs one or two. Not a single OTC multi-symptom cough or cold medicine has been adequately tested in kids under 6 and frankly, a lot of the stuff does not work.

For example, there are few if any studies to show that dextromethorphan, a semi-synthetic narcotic analogue suppresses coughs. There is little to show that guaifenesin, a mucous thinner and expectorant, does what it says. Finally, multi-symptom products cause lots of side effects. Some teenagers even use them to get high.

What to do

So what’s a parent to do? Here are some suggestions:

1. Call your doctor when your child is sick.

2. Discuss the benefits and risk of prescription and OTC medicines.

3. Ask if the medicine you are thinking about using is proven safe and effective in kids.

4. Find out what the underlying cause of your child’s symptoms is and treat the cause, don’t just suppress the cough. For example, treat the cough of asthma with asthma medications, pneumonia with antibiotics.

5. If you go the OTC route, use single agent medicines. They have not been tested in kids under 6 but have passed the test of time. Most have been around for years. For example, Phenylephrine and Sudafed work for congestion, though Sudafed is now behind the counter, so you have to ask for it. OTC nose sprays can be used for a few days. Antihistamines help allergies, not colds.

6. You should usually use acetaminophen for aches and pains. Aspirin and non steroidal anti-inflammatories can combine with viruses to cause a rare but potentially dangerous problem called Reyes Syndrome.

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