Q: There's been a lot of talk lately about how OTC cold medicines may be ineffective and even dangerous for children. What should parents with sick kids do?
A: The data have been piling up, and the studies are becoming more and more conclusive. According to the American Academy of Pediatrics, cold medicines are ineffective for children under 6 years old and even dangerous for children under 2 years of age.
With this information, the manufacturers of these medications aimed at treating cold symptoms have pulled all products for children less than 2 years of age from store shelves. Labels will now read, "Not recommended for children under 2," instead of "Consult your doctor for proper dosages." And an advisory panel to the U.S. Food and Drug Administration has recommended against the use of these products for all children less than 6 years of age.
How serious is this? These products have been used for years by large numbers of children, but study after study has failed to show any benefit to the vast majority of them. What's more, the labeling and marketing involved can easily lead to parental confusion. For example, one company's "cough and congestion" medication can include the very same active ingredients as another company's "cold and allergy" medicine. In this confusion, many infants have received higher-than-recommended doses of these medications, resulting in side effects ranging from irritability and sleeplessness to even a few cases of infant death.
Instead, parents should be offering their children safe, effective treatments, starting with some tender loving care. Humidifiers or vaporizers can also be helpful, as can nasal saltwater drops or sprays and increased fluids and rest. Children who aren't old enough to blow their noses frequently can be helped with a bulb syringe or nasal aspirator. And acetaminophen, the medication in regular Tylenol, and ibuprofen, the active ingredient in Motrin and Advil, are still safe and effective in relieving the discomfort associated with colds.
Bradley Kirschner, M.D., F.A.A.P., is a pediatrician with Children's Medical Group, a member of Children's Hospital and Health System in Milwaukee. He is board certified in pediatrics, received his medical degree from the Medical College of Wisconsin, and completed his residency in pediatrics at Children's Hospital of Wisconsin. After that time, Kirschner provided primary pediatric care for the Oneida Indian Tribe outside of Green Bay before returning to Milwaukee to spend a year working in the Emergency Department at Children's Hospital. In July 2006, he joined Children's Medical Group Westbrook Pediatrics.
