In his monthly column, Dr. Kent Herbert answers your questions related to health care matters. Simply submit your question to deb@newfalconherald.com. It’s your chance to ask the doc.Question: I read recently that I shouldn’t give cold medications to my child. Is this true?Answer: In October, the Food and Drug Administration issued a warning that over-the-counter cold and cough medications should not be given to children under age 2 without specific direction from a physician. In addition, they warned these medications should be used with caution and probably very rarely in children under age 6. While non-prescription medications, such as decongestants, antihistamines and cough suppressants are usually safe for adults, they can have serious side effects in young children. Since 1969, there have been 123 deaths from an overdose of these medications in children under 2 years old, 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 new concerns. First, although the ingredients in cold medications are commonly used in adults, they have never been tested in children under age 12. Because children’s bodies process medications in different ways than adults, medicines that are safe for adults may not be safe for children. Second, many cold preparations come in combinations, with two or three medications mixed together. Because of this, it is easy to get too much of a certain ingredient if two or more combination medications are taken together. Third, there are no accurate dosing guidelines for children under age 2. Because of this, many people use common-sense calculations to decide on a dose, such as giving a 2-year-old child half the dose for a 4-year-old child. While this may make sense at first, the appropriate doses are much more complicated than this.One of the most important factors in these guidelines is the fact that most over-the-counter medicines are not effective. Pediatric cough medications, for example, have been compared to placebo (such as sugar pills) or flavored water and have not been shown to be any more effective at treating cough. Therefore, if there is no real benefit, then any risk is unacceptable. Also, using cold medicines when a child is ill does nothing to treat or prevent the infection itself; they only treat the symptoms. Typically, simple medications, such as an acetaminophen, are enough to make a child comfortable while they are recovering from an illness.A few simple rules are recommended when considering a cold medication for a child:
- Do not give cough or cold medicine to a child under age 2 unless specifically instructed to by a health care provider.
- Do not give children medications that are made for and packaged for adults. Only use products that are specifically designed for babies, infants and children.
- Recognize that medications come in different strengths. Make sure you know the strength or concentration to be given, not just the amount to be taken. A teaspoon of one medicine may contain a very different amount of a certain ingredient than a teaspoon of another.
- Read all of the drug facts on the package label. Know the name and type of medicine of each active ingredient, as well as the warnings of each.
- Take only one medicine at any time. Most combination medications, such as those designed for cough and those for sinuses, contain similar ingredients and using them together can lead to a dangerous overdose.
- For liquid products, use the measuring device that is packaged with the medicine, or purchase a device that is specially marked to deliver the recommended dose. A kitchen teaspoon or tablespoon is not accurate for measurement and is not appropriate for medications.
- Try non-medicine treatments first, such as a bulb suction to clear nasal discharge, a humidifier to loosen a cough and saline or salt-water drops for congestion.
