In his monthly column, Dr. Kent Herbert answers your questions related to health care matters. Simply submit your question to stefaniw@newfalconherald.com. It’s your chance to ask the doc.Question: When my child is sick, what medication can I give them?Answer: Last year, the U.S. Food and Drug Administration issued a warning that over-the-counter cold and cough medications should not be given to children under the age of 2 without specific direction from a physician. In addition, they warned that these medications should be used with caution – and probably rarely – in children under the age of 6.Last month, the FDA issued a stronger warning, and many manufacturers have started to withdraw their products from the market. The concern is that, while OTC cold medications are usually safe in adults, they can have serious side effects in young children. Since 1969, there have been 123 deaths from overdoses of medications in children under 2, and each month 1,500 children in the United States are taken to an emergency room for an accidental overdose.There are several reasons for these recommendations. First, the ingredients in cold medications have never been tested in children under the age of 12. Because children’s bodies process medications differently than adults, medicines that are safe in adults may not be safe in children. Second, many cold preparations come in combinations, with two or three medications mixed together, making it easy to get too much of a certain ingredient. Third, there are no accurate dosing guidelines for children under the age of 2. Because of this, many people use common sense calculations to decide on a dose, such as giving a 2-year-old child half of the dose for a 4-year-old child. While this may make sense, the appropriate doses are much more complicated than this.One of the most important factors in these guidelines is the fact that most OTC medicines are simply not effective. For example, studies have compared children’s cough medications to flavored water and they are no more effective at controlling the cough.The stronger FDA warnings state there is no justification for using cold medicines in children under age 2. In addition, the FDA includes the following warnings that can ensure that medications are used safely:
- Choose only OTC cough and cold medicines with child-resistant safety caps, when available.
- Check the active ingredients section of the “drug facts” label of the medicines you choose. Choose products that address the child’s symptoms, such as an antihistamine for a runny nose or a decongestant for stuffiness. Many products contain ingredients that are not needed, and these should be avoided. If you have questions about an active ingredient, call your doctor.
- Never give a child two medications that have the same active ingredient. For example, many cold medications contain acetaminophen, or Tylenol, as do non-aspirin pain relievers. Taking both together will exceed the recommended dose for that ingredient.
- Carefully follow the directions for how to use the medicine in the “drug facts” part of the label. These directions tell you how much medicine to give and how often you can give it. If you have a question about how to use the medicine, ask your pharmacist or your doctor. Overuse or misuse of these products can lead to serious and potentially life-threatening side effects such as rapid heartbeat, drowsiness, difficulty breathing or seizures.
- Only use measuring devices that come with the medicine or those specially made for measuring drugs. Never use household measuring devices, as these are not standardized to be as precise as they need to be.
- OTC cough and cold medicines do not cure the cold or cough. These medicines only treat the symptoms of a cold such as runny nose, congestion and fever. If these symptoms are not bothersome, such as a low-grade fever, it is best to let them go untreated.
- Try non-medicine treatments first, such as bulb suction to clear nasal discharge, a humidifier to loosen a cough and saline or saltwater drops for congestion.
