Ask Dr. Marla: Treating kids’ coughs safely

Question

Are there any safe cough syrup preparations for kids under six, or do we just hunker down when they have a cough? What can we do to make our little ones more comfortable when they have a cold?

Answer

Here is the bottom line: Do not use over-the-counter cough and cold medicines in children under six.

The safety of over-the-counter cough and cold preparations in young children was reviewed both in Canada and the United States. On both sides of the border, there were several adverse events reported, especially in children under age six. As a result, Health Canada decided that these products should no longer be recommended.

Initially Health Canada had warned parents about giving the medications to children under the age of two and then expanded the restriction to age six because it received 124 reports of adverse reactions – 80 of them serious – in children under six from January 1995 to 2008.

The Food and Drug Administration in the United States issued a public health advisory in January 2008 recommending that over-the-counter cough and cold medications not be used in children under two because of the risk of serious, life-threatening adverse events. Additionally, the FDA agreed to the manufacturers’ request to change the product labeling to warn parents not to use antihistamine products to sedate children. That statement was then expanded to children under four with respect to cough and cold preparations, however, I advise my parents not to use these preparations in children six and under.

Remember that these infections are typically viral and self-limited. Increase your child’s intake of fluids, humidify the room and elevate the head of the bed. The increase in fluid will prevent dehydration and moist air is easier to breathe. It is important to change the water often in cool air humidifiers so as not to allow bacteria to thrive in that moist environment.

In smaller children you can consider the use of saline drops to help clear the nasal passages. In addition, some studies have shown the use of vitamin C as possibly decreasing the length of the common cold in children.

Remember that if your child’s symptoms get worse or do not improve, they have fever or any respiratory distress, you should see your healthcare practitioner.

Originally published in ParentsCanada magazine, November 2014.