Think before you dose that sniffling kid

Some children's cough and cold medicines don't do much to improve symptoms; others can have unexpected, and dangerous, side effects. Parents know this. But when Junior or Juniorette has the sniffles or a cough, Mom and Dad still want to feel as if they're doing something to help.

And so ... a new study in the journal Pediatrics has found that, in any given week, 10% of U.S. children are being dosed with cough and cold medicines.

Among the findings:

* Decongestants (usually pseudoephedrine) and antihistamines were the most popular ingredients, each given to 6% of children.

* Antitussives, known as cough suppressants to you and me, were the next most popular, with 4% of kids getting these chemicals.

* Then came expectorants (you know, when you really want that nasty stuff out of your little one's airways) at 1.5%.

Also of note: Multiple-ingredient products were much more likely to be used than single-ingredient products; children ages 2 to 5 were the most likely to be dosed; and overall use of such products declined from 1999 through 2006.

Here's the full study. Here's what the Food and Drug Administration has to say about children's cough and cold medicines (it's not much of a fan anymore). And here's a recent, related take from NHSblogdoc in the UK about some of these drugs:

"Why do we not go the whole hog and remove all children's cough medicine from the shelves? And then all the adult cough medicine as well. Are they all dangerous? Not at all. They are crap."

Say the study authors, more circumspectly: Maybe parents need to be educated a bit more about the risks of children's cough and cold meds.

-- Tami Dennis

Photo credit: David Paul Morris / Getty Images

Comments

[Jeff]

As a dad and a doctor, I find this a very scary topic. I used to think that as long as my patient’s or I dosed the children’s cold & cough medications right, then everything would be OK. But when I researched this further, it turns out that children have died from “over dose” of ALL THE MAJOR CHILDRENS COLD AND COUGH MEDICINES even when given the correct dose (http://pediatrics.aappublications.org/cgi/reprint/108/3/e52?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=cough+medications&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT).

Here are a few interesting facts:

1. Last October 2008, the drug companies promised the FDA that they would change all their labeling to say “do not use” for children under the age of 2, but I was just in the store last week, and a number of packages still had the old labeling!

2. The FDA reviewed safety and effectiveness data this last fall and its expert panel said that “right now the current cold & cough medications should not be given to children under 6.” Here is a link to the FDA’s minutes, “http://www.fda.gov/ohrms/dockets/ac/07/minutes/2007-4323m1-Final.pdf”, see page 6. The FDA made a public advisory in January 2008 about never using it for children under 2, because the Drug companies are fighting them on the panels ruling to never use cold and cough medications on children under 6. Since these drugs were previously allowed by the FDA, the FDA is forced to go though due process before they are willing to make an official public statement about never giving these medications to children under 6.

3. The number of infant deaths attributed to cold and cough medicines is dramatically underreported. New research published in the Journal of the American Academy of Pediatrics demonstrated that there were at least “10 unexpected infant deaths that were associated with cold-medication” in 2006 alone in the state of Arizona. Extrapolated over the US and Canadian population, that would be over 500 deaths a year associated with cold-medication! (http://pediatrics.aappublications.org/cgi/content/abstract/122/2/e318)

The thing that the drug companies don’t want anyone to know is that these medications never underwent the rigorous safety and effectiveness studies modern medications have to go though, they we grandfathered in the early 1970’s because at that time experts felt like they seemed to work, and they seemed safe enough.

Interestingly, some researchers from Penn State have shown that Buckwheat honey is better then the OTC drugs for children’s cough. There is a web site that talks about this, and gives lots of research to help parents be better informed about how to help their kids. Check out http://www.honeydontcough.com/

-Daddydoctor