Dr. Jeremy F. Shapiro
Pediatrician
Dr Shapiro completed his undergraduate education at UC San Diego earning a B S in Biochemistry and Cell Biology and a B A in Political Science He furthered his education at UCLA where he earned a Masters Degree in Public…
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LOCATION: Los Angeles, CA, USA
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  • Attending Physician, Providence Tarzana Regional Medical Center
YEARS IN PRACTICE: 6
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OTC Cold Medicines and Children: Not a Good Mix?
12
Posted in Adoption by Dr. Jeremy F. Shapiro on Oct 08, 2008

Just last week, the Food and Drug Administration (FDA) heard its most recent request to remove over-the-counter (OTC) cough and cold medications from the marketplace for children under 6 years of age (although some were asking for less than age 12).  Why?  Well, two reasons...no real data has shown them to be effective and the concern surrounding the safety profile of these medications when used in younger children.  And interestingly enough, this follows last year's voluntary recall of these same medications for children less than 2.


And after yesterday's announcement from the makers of these OTC cough and cold medications, it appears a compromise has been reached.  Prior to any formal recommendations from the FDA, the manufacturers have stated their medications should not be used for children less than 4 years of age.  Not exactly the 6 years most were looking for, but by all accounts, quite satisfying to many involved in pediatric care.  And piggybacked with these changes is there will also be a warning in the packaging not to give antihistamines to children in order to make them sleepy.


Now I'm sure there are some who believe these medications work but when we look at the data...well, there really isn't any to support the benefits of these OTC remedies.  And when research shows dosing errors and accidental ingestions annually sending roughly 7,000 children (with many of these being less than 4 years of age) to the emergency room each year, the risk of these medications certainly outweighs any benefits.


So what can we do for children with cold and cough symptoms?  A few things I enforce with my parents include maintaining good hydration (i.e. pushing the fluids), using saline nasal sprays to deal with some of the nasal congestion, creating a humidified environment as the viruses that cause these colds love dry conditions (a cool mist humidifier is what I recommend), getting good rest, and since recent research has found a reduction in nighttime cough when using honey prior to bedtime in children 2 years and older, a trial of 2 teaspoons of honey with the caveat of never giving honey to children less than 1 secondary to the risk of infant botulism.


And what to expect in the future?  I anticipate seeing this age range eventually climbing to 12 years of age...unless new data demonstrates otherwise.


And please, please remember to wash your hands and if no tissue when sneezing/coughing, please direct it to the flexed region of your arm (near the biceps) and not toward your hands.


 


Dr. Jeremy


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Displaying comments 12-1 of 12
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Fall is here, and that means the leaves turn pretty colors, people are dressing warmer, football is on every Sunday, but there is something far less cheery about the season. This means that you’ll be always exposed to an environment full of unseen viruses, like flu virus. Fall usually means the beginning of the best season to catch the flu. Influenza is one of the deadliest diseases in human history, and its death toll is estimated to be greater than the Bubonic Plague, yet the easiest prevention is simply to wash your hands. A very practical preventive measure! Here’s what you may not know: around 226,000 people are hospitalized every year from the flu, and about 36,000 people die from it each year. Treating it once infection has begun can be costly, and prevention can be as well. Health experts recommend a yearly flu shot, which costs in the neighborhood of $20 – 30. If you have children, then getting a shot for yourself, your spouse/partner, and the kids can add up fast. If you get the virus anyway, treatment is expensive, especially if it means hospitalization. This is just a reminder that a payday cash loan can help cover unexpected medical bills, and to wash your hands.

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By PaydayLoan  Nov 13, 2008
11
I am a Chiropractor, and I've been reading a plethora of articles recently about how kids and common OTC drugs are bad news together. I'm glad to see a Medical Doctor (besides Joseph Mercola) agreeing. Thank you. It'll be a long time before saline rinses become common practice for kids or adults, but I live on them!!! DrDimmie
By drdim  Oct 10, 2008
10
Hi TJMV12,
The current guidelines are for less than 4. Just make sure follow the directions perfectly if going to try.
Dr. Jeremy
By DrJeremy  Oct 10, 2008
9
Thanks for that Dr. Jeremy.

I'm in NZ and we all go to a practice with lots of doctors. Clare's doctor is a very busy man as he has a pediatric qualification and experience so we sometimes have to see a different doctor. One of them has always been hugely keen on prescribing Dimetapp. I've never been happy with it and have given it to her in a very limited way, feeling that I'm being cruel to her by not giving her more regular doses. She is 2 BTW. Reading this article and getting your response makes me feel like I've been right all along.

I tend to just give paracetamol for fever (I'm very allergic to Ibuprofen and am very worried that Clare may have inherited that allergy.) and pump the fluids in.
By ClaresMom  Oct 09, 2008
8
I work as a pharmacy assistant. In Australia. I havn't heard all the cuffufol here but we are always to involve the pharmacist in any medicine that is for children under 12mths or was that 2yrs?? See how confusing it is, even for me! And I work in this field. I know a lot of things have to run their course but all mums (including myself) hate to see little ones suffer and sometimes it seems necessary to offer them something.
By rattles  Oct 09, 2008
7
I don't understand...when I am sick, I take something and feel better. How come it doesn't work for children? Is it really not working or is it the fear that people can't read and give the wrong dose? My son has been congested for several days now. I feel bad to not give him anything because I know the relief that decongestants bring me. He is 6, but maybe I'm doing the wrong thing. I just want to make him more comfortable. What about the medicines like mucinex, that is supposed to losen it up? I am just confused!
By tjmv12  Oct 09, 2008
6
Usually the quieter the better. OK to run through the evening but with breaks during the day.
By DrJeremy  Oct 09, 2008
5
I am thinking of putting a cool mist humidifier in my kids room. Is there any particular kind you recommend? Should I run it all of the time?
By daddy2x  Oct 08, 2008
4
ClaresMom-
Not sure how old Clare is but if less than 4, it's not recommended. You may try some of the methods I discussed...even some chicken soup.
By DrJeremy  Oct 08, 2008
3
So what do I do if my doctor prescribesDimetapp for nasal congestion and a cough?
By ClaresMom  Oct 08, 2008
2
My own personal experience is that nearly every single time I've ever given my child (who is now 6) any type of children's cold medication (OTC) he has developed an ear infection shortly thereafter. My husband would forget about this and give it to him while I was out and then a few days later we'd be getting an antibiotic for his ears...
By mechellebelle  Oct 08, 2008
1
THANKS DR JEREMY FOR CLEARING UP SOME OF THE CONFUSION ALOT OF US PARENTS HAVE!!!
By Theresa42266  Oct 08, 2008
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