COLD MEDICINE

As we embark on the cold and flu season, you’ll hear various new recommendations from your pediatrician, family doctor, emergency physician, or primary care provider concerning how to treat your young child’s cold. One recommendation to take note of is the findings of a recent panel of Federal Drug Administration (FDA) officials who examined the effectiveness and safety of over-the-counter cold medications. Their conclusion was that children under the age of six should not take any over-the-counter cold medications.

Proper dosage. The reasoning is as follows. The panel revealed that cold medications such as decongestants, cough medications, and antihistamines were ineffective treatment for a child at the current recommended dosages. In order for these medicines to be effective, much higher doses would need to be given – but higher dosages compromise the safety of children under the age of six. In fact, several deaths have occurred in children under the age of two after they have received medications such as these. This confirms what I learned in medical school – children are not little adults. The treatment they receive must be directed at their condition, not simply tailored based upon adult guidelines.

Worthy of note is the voluntary recall, by the Wyeth Pharmaceutical Company, of a variety of their cough and cold products – including Robitussin and Dimetapp products – due to a dosing cup error on the bottle. The dosing cup was not marked for a half teaspoon, and thus over dosage can occur. So far, there have not been any untoward events associated with this because a great deal of this product has not yet been placed on store shelves. If you have purchased these products, you may return them.

Effectiveness of cough medicine. Several adult studies have also shown that cough medicines are ineffective in treating a cough in adults. While there may be a psychological factor associated with taking these medications, they do not work. The FDA panel also confirmed that cough medicines do not work on children. If a medical professional deems cough medicine necessary, the use of an inhaler – such as albuterol – would be advised. Albuterol opens the breathing passages and helps suppress the cough.

Common sense treatment.
The American Academy of Pediatrics has been leading the effort for common sense measures to address treating colds in children. They recommend keeping your child well hydrated with lots of fluids, including chicken soup! It will make your child feel better and is a healthy and safe option.

Fevers should be addressed and treated with appropriate dosages of Tylenol (acetaminophen) and Motrin (ibuprofen). It is important that parents monitor temperatures and keep the fever under control. Also, the child will be more comfortable without a fever. Be certain to administer the proper dose so that the medication is effective.

Other common sense recommendations include keeping the air in your home well hydrated with a vaporizer and using salt-water nasal drops to dry up a runny nose. For children that are unable to blow their nose, a rubber bulb syringe is a good way to clean out the nose. Lastly, if it seems the cold is getting out of hand, consult your primary health care provider. Remember, if a child’s behavior shows a marked change, he or she should be evaluated by a medical professional.

Prevention.
The most important mechanism for preventing the spread of colds, which are mostly viral, is good hand washing and hygiene. Sharing of utensils should be avoided. Also, sick children should be kept at home and out of daycare centers and schools because sending them to school only exacerbates the spread of the cold throughout that environment.

Ultimately, my mother and grandmother were right about how to treat a cold – use common sense. Keep well hydrated and eat some chicken soup. Avoid cough medicines entirely, and do not give cold medicines to children under the age of six.

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