Parents always want to make their sick children feel better. But medicine may not always be the best choice -- especially for little ones.

Parents always want to make their sick children feel better. But medicine may not always be the best choice -- especially for little ones.

Due to concerns that cough and cold medicines may be misused and cause serious side effects -- including death -- the United States Food and Drug Administration (FDA) recently changed its guidelines for administering over-the-counter medicines to children younger than 2 years old.

In September the FDA recommended that no over-the-counter cough and cold medications be given to children younger than 2, unless prescribed by a doctor.

These over-the-counter medications were deemed dangerous because in rare cases they were blamed for children's deaths. During the last 40 years, the FDA has linked 54 child fatalities to over-the-counter decongestant medicines and 69 deaths to antihistamines used to treat runny noses. The manufacturers of cough and cold medicines responded by pulling the products from store shelves.

The change in policy has left many parents wondering how to treat runny noses and other cold and flu symptoms.

Doctors warn against trying to estimate how much of a medication designed for older children or adults should be given to young children. Parents should never give small children medicine labeled for older children or adults. "You never want to assume 'my baby is 1 -- I'll just give half the dose,' '' said Shannon Howski, a pharmacist at Nationwide Children's Hospital.

Doctors and pharmacists recommend parents take a non-medicinal approach to treating their children's colds. They're promoting the use of humidifiers and saline drops to relieve the symptoms. They also suggest taking sick children to the doctor for medical evaluation. "From newborn to 2 years, we tell the family not to get any over-the-counter medicines,'' said Dr. Najwa El Dahdah, an assistant professor of pediatrics at Nationwide Children's Hospital and a member of the faculty at The Ohio State University. "A humidifier to help them breathe easier, fluids and Tylenol and that's it."

Howski suggested using saline drops to loosen the nasal mucus, then suctioning it out with a bulb syringe. "For children age 2 to 5 years old, cough and cold medicines can be used in moderation," said Dr. Edward Bope, medical director of the Riverside Family Practice Center. Still, he suggests, "the less medicine, the better.''

Once children turn 6 years old, doctors become a "little more liberal" with over-the-counter medicines, Bope said. Parents can safely treat the symptoms if they read the labels carefully.

Regardless of a child's age, it's unlikely that over-the-counter medicines will speed the child's recovery, El Dahdah said. "There's no scientific proof that they're effective,'' she said. "They will not change the course or length of an illness.'' The medicines can relieve symptoms and help a child feel more comfortable and sleep better.

If you opt to use medicine to treat the symptoms, it's crucial to carefully follow the instructions on the medicine, Bope added. "Never give more medicine than recommended and wait the appropriate amount of time between doses." He added, "It's okay to combine cough and cold medicine with a pain reliever, such as Tylenol -- as long as the cough and cold medicine does not include a pain reliever."

"It's so important to look at all the ingredients,'' said Cara Hoyt, a pharmacist at Uptown Pharmacy in Westerville. "Read all the information. Know what the active ingredients are.'' A double dose of pain reliever would be harmful for a child, the doctors said.

A child who acts lethargic, has breathing difficulties or develops a rash might be having a reaction to the medicine. If those symptoms occur, call the doctor immediately or take the child for medical treatment. If you ever have any doubt about how to treat a child, call your doctor. "If you're worried enough to go look for a product,'' it's probably a good idea to confer with a professional, Hoyt said.

What parents should know about giving cough and cold products to children

Do not give cough and cold products to children under 2 years of age unless given specific directions to do so by a healthcare provider. Do not give children medicine that is packaged and made for adults. Use only products marked for use in babies, infants or children (sometimes called "pediatric" use). Read all of the information in the "Drug Facts" box on the package label so that you know the active ingredients and warnings. Follow the directions in the "Drug Facts" box. Do not give a child medicine more often or in greater amounts than the package recommends. Too much medicine may lead to serious and life-threatening side effects, particularly in children age 2 years and younger. For liquid products, parents should use the measuring device (dropper, dosing cup or dosing spoon) that is packaged with each different medicine formulation and that is marked to deliver the recommended dose. A kitchen teaspoon or tablespoon is not an appropriate measuring device for giving medicines to children. If a measuring device is not included with the product, parents should purchase one at a pharmacy. Be sure that the dropper, dosing cup or dosing spoon has markings on it that match the dosing that is in the directions in the "Drug Facts" box on the package label, or is recommended by the child's health care provider. If you DO NOT UNDERSTAND the instructions on the product, or how to use the dosing device (dropper, dosing cup or dosing spoon), DO NOT USE the medicine. Consult your healthcare provider if you have questions or are confused. Cough and cold medicines treat only the symptoms of the common cold such as runny nose, congestion, fever, aches, and irritability. They do not cure the common cold. Children get better with time. If a child's condition worsens or does not improve, stop using the product and immediately take the child to a health care provider for evaluation.
SOURCE : U.S. Food and Drug Administration


Melissa Kossler Dutton has worked as a reporter for more than a decade. She's a frequent contributor to a variety of Ohio publications. She lives in Bexley with her husband and two sons.