Are cough and cold medicines safe for children?

It’s that time of year where if you’re not down with a cough or cold, you probably know someone who is.

Although they can be irritating to deal with, most of the time coughs and colds are caused by viruses in the air and they run their course within a week or so. A simple cold does not need treatment but the associated blocked nose and cough can be a nuisance.

Most of us grew up using cough syrups as a quick way to relieve our symptoms. They are readily available, relatively cheap and often do not require a prescription to purchase.

It is, therefore, by the same token that we often reach for these same drugs when our own children fall ill. The question we need to ask ourselves is, ‘are they safe to use in children?’

How do cough medicines work?

Cough and cold medicines offer only temporary relief of symptoms, such as a runny nose or congestion, cough, fever and aches. They do not effectively treat the underlying cause of a child’s cold or reduce the severity of the infection or make it go away any sooner.

Generally speaking, cough medicines are thought to work in different ways:

Decongestants: These clear up congestion caused by colds or flu by causing the blood vessels in the lungs and nose to narrow.

Cough suppressants: These suppress the urge to cough. They are potentially harmful in coughs caused by infection.

Expectorants: These medicines loosen thick mucus, thus making it easier to get out of the chest when you cough.

Antihistamines: Those medicines block the body’s reaction to allergic irritants which might cause coughing. They also reduce congestion and reduce the amount of secretions made by the lungs.

Cough syrups and children

Children are not small adults. It’s not just their size, it’s the way their body works internally. Their body’s pathways for breaking down drugs are not fully mature, which means that medication can behave in different and sometimes unpredictable ways (as compared to an adult).

The reason we know very little about how cough syrups work in children is that, generally speaking, drug studies and trials are usually not done in children .

Instead, almost all cough syrups are tested in adults, and those results are then applied to children. The only problem with this approach is that it is still not clear whether adults and children will react to these medicines in the same way.

Children over the age of four years tend to tolerate most cough syrups and rarely get side-effects or complications related to using them. Children under the age of two years are, however, a different story.

Most doctors avoid the use of these drugs in this age group because there have been reported cases of severe side-effects seen in infants using these drugs.

They include allergic reactions, increased or uneven heart rate death, excessive drowsiness, convulsions, decreased levels of consciousness and constipation.

Pitfall

A child may appear to have a cold but actually be suffering from a more serious illness (like flu, bronchitis, asthma or allergic nasal congestion), which may require assessment by a doctor. Using cough syrups may sometimes delay this treatment as you wait for the child’s symptoms to ‘hopefully improve’.

In addition, a cold can sometimes lead to an ear or sinus infection which needs different care. Therefore, if your child is not improving after a week or if they are getting worse, take them to their paediatrician.

Cough syrups and pregnancy (safety for the unborn child)

Since pregnancy is a very delicate state, we generally say that no drug is 100 per cent safe for use. The only time you should take a drug is if its beneficial effects are greater than the potential risks for the unborn baby.

Medicines that you safely used when you were not pregnant can be potentially harmful to you and your unborn baby. An especially vulnerable time is the first 3 months of pregnancy.

This is when the baby’s organs are being formed and the potential for developing complications is very high. For this reason, never buy over-the-counter cough medication without consulting your obstetrician first.

Precautions to take when buying cough syrups

Never buy cough syrups without discussing it with your child’s doctor (even by telephone). Let them know what the drug is called and read the side of the package to let your doctor know what the active ingredient of the drug is. This will help them determine if the drug is safe to use on your child.

In addition, talk to the pharmacist about possible side-effects. Before you buy the drug, have a look at the information slip inside the box and see if it has been determined to be safe to use in children (especially those under the age of 4 years).

Most cough syrups in the market have a mixture of components. For example, one may contain an antihistamine and a decongestant. Another may contain a cough suppressant and an antihistamine.

For this reason, it is very easy to overdose your child on a particular ingredient if you give them two different cough syrups at the same time.

Children should not be given medicines that are packaged and made for adults (even in small doses).

How to ease cough symptoms without medicines

Reduce the child’s fever using medication such as paracetamol. Do not use ibuprofen in children under the age of six months or if your child is vomiting. Do not use aspirin with any child because of the risk of a life-threatening complication known as Reye’s syndrome.

Consider using honey for coughs or sore throat for kids. You can mix this with warm water, lemon or ginger. Avoid using honey in children younger than 1 year due to the risk of developing a serious complication known as botulism.

Use saline drops or spray to clear thick mucus out of your child’s nose.

Give your child plenty of liquids to increase hydration and help thin the mucus.

Older children can use steam inhalation under the supervision of an adult.

To ease congestion, keep the child’s head slightly elevated when lying in bed or resting.

Alcohol content

Some cough syrups contain alcohol as part of their active ingredient (this is part of the reason why some people get addicted to certain cough and cold syrups). Alcohol-containing medications should never be used in either pregnancy or in children.

If you are not sure about the possibility of your medication having alcohol, read the package or ask the pharmacist.