Cough and cold medicines can pose serious risks for young children. Know the facts and understand treatment alternatives.

By Mayo Clinic Staff

Over-the-counter cough and cold medicines are the best way to help a child who has a cold feel better — right? Think again. Here's practical advice from Jay L. Hoecker, M.D., an emeritus pediatrics specialist at Mayo Clinic, Rochester, Minnesota.

Over-the-counter cough and cold medicines are intended to treat the symptoms of coughs and colds, not the underlying disease. Research suggests that these medicines haven't been proved to work any better than inactive medicine (placebo). More important, these medications have potentially serious side effects, including fatal overdoses in children younger than 2 years old.

Don't use over-the-counter medicines, except for fever reducers and pain relievers, to treat coughs and colds in children younger than 6 years old. Also, consider avoiding use of these medicines for children younger than 12 years old.

Antibiotics can be used to combat bacterial infections but have no effect on viruses, which cause colds. If your child has a cold, antibiotics won't help. Remember, the more your child uses antibiotics, the more likely he or she is to get sick with an antibiotic-resistant infection in the future.

An over-the-counter pain reliever — such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Children's Motrin, others) — can reduce a fever and ease the pain of a sore throat. However, fevers are generally harmless. The main purpose for treating them is to help your child feel comfortable.

If you give your child a pain reliever, follow the dosing guidelines carefully. For children younger than 3 months old, don't give acetaminophen until your baby has been seen by a doctor. Don't give ibuprofen to a child younger than 6 months old or to children who are vomiting constantly or are dehydrated. Also, use caution when giving aspirin to children.

No. The Food and Drug Administration has issued its strongest warning against the use of codeine to treat a cough or pain and the narcotic tramadol (Ultram) to treat pain in children younger than 12 years old. This is due to the potential for serious side effects, such as slowed or difficult breathing.

To help your child cope with a cough or cold:

  • Offer fluids. Liquids such as water, juice and broth might help thin secretions. Warm liquids, such as tea or chicken soup, might have a soothing effect, increase the flow of nasal mucus and loosen respiratory secretions.
  • Run a cool-mist humidifier. This can help shrink nasal passages and loosen nasal secretions.
  • Use a suction bulb. Use this device on a baby or young child to draw mucus out of the nose.
  • Use nasal saline. Over-the-counter saline can keep nasal passage moist. In younger children, use saline nasal drops. For older children, use a saline nasal spray or saline nasal irrigation.
  • Offer cold or frozen drinks or foods. Ice cream, frozen fruit pops, ice or cold beverages might feel good on a sore throat.
  • Encourage salt water gargling. For children age 6 years and older, gargling salt water might soothe throat pain.
  • Offer hard candy. For children age 5 years and older, sucking on a piece of hard candy might soothe throat pain. Hard candy is probably as effective as medicated lozenges and less likely to have harmful effects. However, hard candy is a choking hazard and shouldn't be given to younger children.

To help your child stay healthy:

  • Keep it clean. Teach your child to wash his or her hands thoroughly and often. When soap and water aren't available, provide an alcohol-based hand sanitizer or hand wipes. Keep toys and common household surfaces clean, too.
  • Cover up. Teach your child to cough or sneeze into a tissue — and then toss it. If he or she can't reach a tissue in time, show your child how to cough or sneeze into the crook of the arm.
  • Steer clear of colds. When possible, help or encourage your child to avoid close contact with anyone who has a cold.
Nov. 11, 2017