Many parents have stood in the medicine aisle at the local drug store staring at the many different options. Choosing between cough suppressants, expectorants, antihistamines and decongestants or any possible combination of these can literally give parents a headache. As a pediatrician and a parent, I've tried to design a helpful guide to help you sort your way through the many cold medications.Choosing the right medication Choosing the correct medication is easier if you understand your child's symptoms and how cold and cough medications work. Here is a quick review.
Treat your child's specific symptoms: If your child simply has a bad cough, but no nasal congestion, then you probably don't need a multi-symptom cough and cold medication. You only need a cough suppressant.
If your child's cold symptoms are not interfering with his sleep or daily activity, then you probably don't need to use medication. Often the most effective treatments for colds are "non-medical" such as nasal saline spray, hot steam and simply drinking plenty of fluids. Click to learn about "natural cold treatments".
Four major cold medication ingredients: Cough and cold medications come either as one of the following types of medicines, or a combination of two, three or all four ingredients:
Nasal decongestant – This will clear nasal passages making it easier to breath through the nose. It also has a mild drying effect so it will also help relieve runny nose a bit. I like to use decongestants during the day because they won't make your child drowsy. This is important if your child is going to school. Side effects may include excitability, which might interfere with sleep.
Anti-histamine – This helps relieve a very itchy, runny nose. It decreases mucous production in the nose. The most likely side effect is drowsiness, which is fine at night, but could interfere with daytime activities.
Cough suppressant – this helps with a persistent annoying cough. It acts by suppressing the cough reflex in the throat and lungs so that the mucous or irritation there won't trigger coughing. There are no likely side effects.
Expectorant – this helps when your child has thick chest congestion, which he is unable to cough up. It loosens thick mucous, making it easier to cough up. There are no likely side effects.
Helpful Tip: The brand name of the medication is not important, and don't get confused by the long scientific names of the ingredients. Under the name brand on the front label will be listed the types of ingredients (i.e. decongestant, cough suppressant, etc) that are in the bottle. This should make your buying decision easier. Also, it is okay to use more than one medicine at a time, as long as you are not overlapping any of the above four types of medications. For example: you could use an antihistamine/decongestant combination along with a cough suppressant/expectorant combination.
Warning: All four types of cough and cold medications are NO LONGER APPROVED for kids younger than 4 years of age.
All bottles of cold and cough meds that have dosing labels for kids under 2 have been taken off the shelves and are no longer available. Manufacturers have also just declared that these meds should not be used in children under 4 years of age as well. The reason for this is two-fold: First, there have been a number of infants and young children harmed by accidental overdoses of these meds when a parent mixed different meds together OR gave too high a dose, this is the reason that the FDA decided to step in and make them no longer available. Second, there has been very little research done on young kids to prove that cold and cough meds are safe and/or effective. Even though they seem to work well and rarely cause any problems when dosed properly, the FDA felt it was prudent to put a hold on their use until further safety and efficacy data become available, and we agree.
In addition, the FDA is considering removing cough and cold meds for kids as old as 12, due to the lack of safety and efficacy research in these age groups. The decision for older kids may not come until 2009.
What can parents do in the meantime when their young kids catch a cold or flu?
We suggest you try a natural alternative called SINUPRET. This plant-based pharmaceutical grade natural remedy has been used in Europe for decades as the number one doctor recommended natural remedy for sinus and respiratory support, and it is now available in the U.S. Not only does it promote healthy airflow and drainage of mucus in the sinus and respiratory tracts, it also supports the immune system. Sinupret comes as a liquid or capsules. For more information visit www.bionoricausa.com/.
Here are some common symptom scenarios and how to treat them. You can click on the recommended medication for a list of brands to use, as well as dosing information. Don't forget that these medications are not curing the problem they simply offer temporary relief.
If your child's cough is very mild – only a few coughs per hour – and it is not interfering with sleep; or if he has chest congestion with mucous that is difficult to cough up, then I recommend an expectorant. This will thin the mucous that is causing the cough and make it easier to cough up.
If your child has a wet, productive cough that is interfering with sleep or daily activity but does not have a bothersome runny nose or sinus congestion, I recommend a cough suppressant and expectorant combination. It is okay to use a cough suppressant alone if that is all you have.
If your child has nasal congestion without severe itchy, runny nose, a decongestant should help. It will also help dry-up mild mucous. An expectorant can help if the mucous is really thick, but is not necessary. Decongestants can interfere with sleep (unless they are combined with an antihistamine) so this combination is best for daytime use.
If your child has a wet, productive cough with chest congestion and nasal or sinus congestion but not itchy runny nose, then I recommend a cough suppressant, decongestant combination. An expectorant can help if the mucous is really thick, but is not necessary. Decongestants can interfere with sleep (unless they are combined with an antihistamine) so this combination is best for daytime use. Some preparations will also contain Acetaminophen (fever reducer), which will help relieve any aches or fever that your child may have.
This combination is great for an itchy, runny nose, nasal congestion and frequent cough that are interfering with sleep. This is good for nighttime use because the antihistamine will make your child drowsy. Some preparations will also contain Acetaminophen (fever reducer), which will help relieve any aches or fever that your child may have.
Like above, but without the annoying cough. This combination is great for an itchy runny nose, and nasal congestion that is interfering with sleep. This is good for nighttime use because the antihistamine will make your child drowsy. Some preparations will also have Acetaminophen (fever reducer), which will help relieve any aches or fever that your child may have.
AskDrSears.com is intended to help parents become better informed consumers of health care. The information presented in this site gives general advice on parenting and health care. Always consult your doctor for your individual needs.