OTCs Today

Mary Warner

As any parent or teacher knows, children of all ages are likely to catch a cold at least once over the course of cold and flu season, whether from their siblings, neighborhood friends, or classmates. Most colds don’t cause serious complications, but they do cause parents and other caregivers to worry. According to FDA, most children will get better without any medication, and in fact, cough or cold medicines won’t make a cold go away any faster.

Age matters

When treating colds and coughs, age really does matter. Infants and children under 2 years old should not be given any kind of cough and cold product that contains a decongestant or antihistamine because serious adverse effects, including convulsions, rapid heart rates, and even death could occur. Manufacturers of pediatric cough and cold medications voluntarily label these products to state that they should not be used for children under 4 years old.

However, in older children, OTC cough and cold medications can help reduce the discomfort caused by a cold by treating symptoms such as a runny nose, nasal congestion, and cough. Because symptoms will usually resolve themselves without treatment, cough and cold medications are best used when the symptoms are too uncomfortable or make it difficult for the child to breathe or sleep.

An OTC pain reliever such as acetaminophen or ibuprofen can reduce a fever and ease the pain of a sore throat. Dosing guidelines should be followed carefully, especially for small children. Children under 3 months old should not be given acetaminophen unless advised by a pediatrician; ibuprofen should not be given to a child younger than 6 months old or to children who are vomiting or are dehydrated.

Caution should be used when giving aspirin to children or teenagers. Although aspirin is approved for use with children older than 3 years, it has been linked to Reye’s syndrome, a rare but potentially life-threatening condition when given to children recovering from chickenpox or flu-like symptoms.

Dosing

Before giving any medication to a child, parents and caregivers should carefully read the information on the Drug Facts label or talk to their pediatrician or pharmacist about dosing information.  Nonprescription cough and cold products can be harmful to children if they are given more than the recommended dose or are given the medicine too often, or if they are given more than one product containing the same medication (such as acetaminophen in a pain medication and in a cold medication). Children should never be given medications that are packaged and intended for adults.

To ensure that the correct dose is given to the child, FDA encourages manufacturers to provide a dosing container, such as a syringe or a cup, marked with the correct measurements with all oral liquid medications. If a medication doesn’t come with a measuring device, parents or caregivers can purchase droppers and syringes with appropriate measurements in the pharmacy. Other containers, such as household spoons, should never be used to measure medications for children.

Alternative relief

FDA offers several tips for relieving cough and cold symptoms in infants and children:

A cool mist humidifier makes breathing easier by decreasing congestion in nasal passages. However, warm mist humidifiers should not be used because they can cause nasal passages to swell and make breathing more difficult.

Saline nose drops or sprays keep nasal passages moist and help avoid stuffiness.

Nasal suctioning with a bulb syringe or a similar product, with or without saline nose drops, works very well for children younger than a year old.

Encourage children to drink plenty of liquids to stay hydrated.

Homeopathic products

Cough and cold medications advertised as homeopathic are intended to mitigate cold symptoms but may look similar to dietary supplements. They are not approved by FDA and should be used with caution, as FDA has found that some of these products contain active drug ingredients in levels that far exceed the amount stated on the product’s label and could cause significant harm to children. FDA states that it is not aware of any proven benefits from homeopathic cough and cold products and urges parents and caregivers to avoid these products, especially for children younger than 4 years old.

What to tell your patients

Advise patients that colds and coughs are a normal part of childhood and will generally resolve with rest. Advise them to consult with their pediatrician if a child has a fever of 102°F or higher, a fever of 100.4°F or higher in an infant 2 months or younger, blue lips, labored breathing, signs of dehydration, excessive sleepiness, or persistent ear pain. ■