by Katherine Brind Amour
November 19, 2009
According to a recent study published in Canadian Family Physician, cough syrup may be dangerous for children younger than 4 to 6 years of age.
Doctors Shefrin and Goldman of British Columbia Children’s Hospital in Vancouver, Canada, reviewed a collection of studies examining the effectiveness of over-the-counter (OTC) cough and cold medications in young children. Surprisingly, although children ages 0 to 5 years are the most common users of these medications, there is little to no evidence indicating the efficacy of the drugs to improve cough and cold symptoms in this population.
There might be significant evidence indicating the opposite: OTC cough and cold medications may put young children at risk for serious health complications and in some cases may be involved in infant or child death.
The facts about kids and cough medicine
Experts suspect that OTC cough syrups and cold medications may be dangerous for young children because of certain ingredients they contain (such as antihistamines, antitussives, and decongestants), some of which have a sedative effect. Even when doses are reduced, such as a half dose for 5- to 12-year-olds and a quarter dose for 2- to 5-year-olds, there still may be risks.
There are no guidelines for using OTC cough and cold medications in children younger than 2 years old. Children under the age of 2, however, were the most likely of any group to have adverse reactions to the medications, despite the fact that 2- to 5-year-olds are the age range with the highest rate of OTC cough and cold medication usage.
In 2004 and 2005, use of OTC cough and cold medicines were the cause of over 7000 emergency room (ER) visits in children under 12. Although the majority of these cases involved unsupervised consumption of the medications, one in four cases involved properly administered medication with unexpected negative outcomes.
OTC cough and cold medication complications were eight times more likely to result in ER visits than problems with other types of medications. Shefrin and Goldman believe that complications with these medications may be underreported, as OTC cough and cold medications are frequently found in toxicology screens when young children are admitted to the hospital for apparent life-threatening events. These medications have been causally implicated in numerous infant deaths, both intentional and accidental.
Because of the scarcity of evidence in favor of safe and effective OTC cough and cold medication use in children, the Food and Drug Administration warns against their use with children under 4 years of age. Taking an even stricter stance, Health Canada recommends against the use of OTC cough and cold medications with children under 6 years of age and advises parents to exercise caution with children older than 6.
If it’s not safe to use cough syrups and OTC cold medications, how should parents ease coughing and cold symptoms in their young children?
The Mayo Clinic has a variety of natural and safe home remedy suggestions for easing coughs and colds in young children and infants. Suggested remedies include suctioning mucus from a baby’s nose, using a home humidifier, and administering a spoonful of honey (for those over the age of 1), or a cup of tea.
While no parent likes a fussy baby, it’s a small price to pay, given the risks associated with OTC cough and cold remedies.
Editor’s note—November 11, 2014
The American Academy of Pediatrics (AAP) recommends against the use of such medications in children under 6 years of age. A 2013 study suggests that, in spite of this recommendation, many parents remain unclear about the use of OTC medications in children younger than 6.
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