Children under 4 should not be given over-the-counter cough and cold remedies, drug companies said in Oct of 2008 in a concession to pediatricians who doubt the drugs work in kids and worry about their safety.

Why not give cold medicine to kids?

The voluntary changes came less than a week after federal health officials said they also saw little evidence that the drugs work, but feared that parents would give kids adult medicines if the products were not taken off store shelves.

In addition, the drug makers said they will add a warning to their products that parents should not give children antihistamines to make them sleepy. These are allergy-relief medications often found in medicines that combine several ingredients to treat a variety of symptoms.

“It’s a huge step forward,” said Dr. Joshua Sharfstein, Baltimore’s health commissioner. “There is no evidence that these products work in kids, and there is definitely evidence of serious side effects.”

Tips for easing a kid’s cold

With the safety and usefulness of cold medicines now in doubt for children under 6, what alternatives can parents try? Old-fashioned remedies are poised to make a comeback.

You have to wait out a cold; treating symptoms, at any age, doesn’t make the cold go away faster.

To make stuffy tots feel better and help them rest, pediatric specialists recommend:

• Plenty of liquids, from water to chicken soup.
• Suction bulbs can gently clear infants’ clogged noses.
• Saline nose drops loosen thick secretions so noses drain more easily.
• A cool-mist humidifier in the child’s bedroom.
• Some chest creams can ease stuffiness with menthol or other fragrances, but check labels for age restrictions.
• Acetaminophen or ibuprofen, as recommended by your doctor, to alleviate pain or discomfort — but check that they don’t contain extra ingredients like decongestants or antihistamines.

Parents should never:

• Give adult medicines to a child.
• Give two or more medicines with the same ingredients at the same time.
• Give antihistamines to make a child sleepy.

Parents should:

• Give the exact recommended dose, using the measuring device that comes with the medicine.
• Keep OTC medicines out of sight and out of reach.
• Consult their doctor if they have any questions

More on problems with cold medicine for kids

Problems with OTC cough and cold medicines send some 7,000 children to hospital emergency rooms each year, with symptoms ranging from hives, to drowsiness, to unsteady walking. Many kids overdose by taking medicines when their parents aren’t looking.

Since a majority of the problems involve 2- to 3-year-olds, the industry’s new instructions, if followed by parents, should help.

“The 2- and 3-year-olds are definitely the highest risk,” said Sharfstein. “More than 50 percent of the problem is with these kids.”If they don’t have this stuff around the home, they’re less likely to grab it and ingest it.”

Pediatricians still support recalling the medicines for children under 6, and the Food and Drug Administration is studying their effectiveness for children under 12. But it could take a year or more for federal health officials to reach a final decision.

The industry is also expanding an educational campaign aimed getting parents to be more careful in giving their kids cough and cold medicines.

An extra dose of TLC

Although many parents believe that these cold and cough medicines have always worked for their children, Danielson points out that it may be the additional care parents are giving that’s really solving the problem.

“Sometimes things can really feel like they’re effective, and there may be instances where it is helpful,” Danielson says. In other words, it’s likely the extra TLC, hydration and sleep that are helping the child recover.

“If you’d done those and not given the cold medicine, they may have gotten better anyway,” Danielson says.

Many pediatricians hope that the FDA’s recommendation will allow parents to change their thinking about kids and the common cold. Fighting a cold helps a young child develop his own immune system, and suppressing symptoms such as a cough or congestion may be working against that, and could even lead to the child developing a secondary infection.

“Some of the kids who have those many colds in the first few years end up having fewer illnesses when they reach school age,” Danielson says.

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