Cold medicines for kids: What's the risk?

Cough and cold medicines available without a prescription are not the best way to help a child who has a cold feel better. Here's practical advice from Jay L. Hoecker, M.D., an emeritus pediatrics specialist at Mayo Clinic in Rochester, Minnesota.

What's the concern about giving kids cough and cold medicines you can get without a prescription?

Cough and cold medicines don't work well in children. Also, they have ingredients that could cause serious side effects.

These medicines you can buy without a prescription often try and treat more than one cold symptom. So these products may combine active ingredients. Caregivers can accidentally give a child an overdose of a combination drug. This could happen if a child takes a combination cold and cough medicine product, then takes the same active ingredient in a different product either too often or at too high a dose.

Public health agencies and medical organizations typically do not recommend using cold and cough medicines in children younger than 12. These medicines treat coughs and symptoms of a cold. But they don't treat the infection so taking other actions to help your child feel comfortable may work as well. But if your healthcare professional suggests a cough or cold medicine for your child, make sure to write down how often and how much is recommended.

What about antibiotics?

Antibiotics can fight germs called bacteria. But they don't work on viruses, which cause colds. If your child has a cold, antibiotics won't help.

Can any medications help treat the common cold?

Some medicines ease the symptoms of the common cold. Pain relievers you can get without a prescription can reduce a fever and ease the pain of a sore throat. These include acetaminophen (Tylenol, others) and ibuprofen (Advil, Children's Motrin, others). But fevers most often are a good sign that the body is clearing out the virus. The main reason to treat a fever is to make your child more comfortable.

If you give your child a pain reliever, follow the dosing guidelines closely. For a baby younger than 3 months old, don't give acetaminophen until a healthcare professional has seen the baby. Do not give ibuprofen to a child younger than 6 months old or to children who keep vomiting or have lost body fluids. The condition in which a child has lost body fluids is called dehydration.

Do not give aspirin to children or teenagers. Aspirin has been linked to Reye's syndrome, a rare life-threatening condition, in children and teenagers who have the flu or chickenpox.

Is codeine OK?

No. The Food and Drug Administration limits the use of prescription cough and cold medicines that have the opioids codeine or hydrocodone to people age 18 and older. This is because opioid medicines can cause slowed breathing or trouble breathing, misuse, risky use, addiction, overdose, and even death.

How can I help my child feel better?

To help your child cope with a cough or cold:

• Give fluids. Liquids such as water, juice and broth might help thin mucus. Warm liquids, such as tea or chicken soup, might have a soothing effect, increase the flow of nasal mucus and loosen mucus in the lungs. Giving honey to children older than 1 year also might help a cough.
• Run a cool-mist humidifier. This can add moisture to the air, which might lessen the drying of the nasal passages and throat. Place the humidifier near your child's bed. Clean the humidifier after every use.
• Use nasal saline. Saline you get without a prescription can keep nasal passages moist and loosen mucus. Give saline nasal drops to younger children. After a short time, use a rubber-bulb syringe to draw mucus out of each nostril. For older children, use a saline nasal spray or saline nasal wash, called irrigation.
• Offer cold or frozen drinks or foods. Ice cream, frozen fruit pops, ice or cold beverages might feel good on a sore throat.
• Offer hard candy or lozenges. For children age 6 years and older, sucking on a piece of hard candy or a lozenge might soothe throat pain. But hard candy and lozenges are a choking hazard. Don't give them to children younger than age 6.

What's the best way to prevent the common cold?

The best way to keep from getting the common cold is by following standard safety measures.

One of the most important is to wash hands and keep hands clean. Wash hands with soap and water and scrub for at least 20 seconds. If soap and water aren't available, use an alcohol-based hand sanitizer with at least 60% alcohol.

Make sure friends and family that you're around regularly, especially kids, know the importance of hand-washing.

Regularly clean often-touched surfaces to prevent spread of infection from touching a surface with the virus on it and then your face. Examples of high-touch surfaces include shared toys, doorknobs, light switches, electronics and counters.

Cover your mouth and nose with the inside of your elbow or a tissue when you cough or sneeze. Throw away the used tissue. Wash your hands right away.

Try to stay away from people who have cold symptoms, if possible. And teach kids to keep their hands away from the face. Children can get sick by touching their eyes, mouth and nose after touching something that has germs.