Published on Thursday, Oct. 25, 2007 12:00AM EDT Last updated on Saturday, Mar. 14, 2009 1:20AM EDT
Last Friday, an advisory panel to the U.S. Food and Drug Administration called for all over-the-counter pediatric cough and cold medicines to be banned.
The advice from the independent experts was unequivocal: These drugs should never be given to children under the age of 6 because they are potentially dangerous.
The panel members were also clear about this key point: The drugs don't work in children. They don't make a cough go away and they don't alleviate any other cold symptoms. Never have and never will.
Most manufacturers have voluntarily withdrawn some products from the market, namely those aimed at children under the age of 2.
But many more pediatric cold and cough medications remain on the shelves, and drug makers continue to insist that, when used as recommended, they are not dangerous.
Perhaps. But telling people that "they don't work but, hey, they won't kill you" is hardly a glowing endorsement.
When cough and cold medicines are misused - which is easy to do inadvertently - they are dangerous.
U.S. regulators have documented dozens of deaths and thousands of adverse events.
These over-the-counter medications contain combinations of drugs such as dextromethorphan (a cough suppressant), diphenhydramine (an antihistamine designed to reduce swelling in the respiratory tract), and pseudoephedrine (a nasal decongestant).
Given in too large a quantity these drugs can send a child's heart racing, or stop their breathing.
Banal errors can and have killed and gravely harmed children: mistaking a teaspoon for a tablespoon; using the measuring spoon from one product for another; giving a child two drugs (say, one for cough and one for cold) thinking they are different; giving the medication to a child with an undiagnosed heart problem (which are far more common than people realize.)
Health Canada, in its inimitable fashion, has declared that it "strongly advises parents and caregivers to carefully read the labels and instructions for these products and to check the medicinal ingredients before giving them to any child, especially under the age of 2."
Forget the wishy-washy bureaucratese.
Parents, if you value your child's well-being, take all the cough and cold medicines in your home - beginning with those with cutesy pictures of babies on the package - and chuck them in the garbage.
Get rid of the adult cough and cold medications too, because the temptation will be to give them to kids, which is even more dangerous.
The ingredients in adult formulations are more powerful and more concentrated, and they can also contain alcohol. Keep out of reach of children.
We should ask ourselves, too, if adult cough and cold medications are of any use either for adults or older children. The scientific evidence is scant. These products lighten your wallet more than they relieve your symptoms.
At least the evidence of harm is less in adults - aside from the abuse of cough syrups containing dextromethorphan (street name DXM), a psychedelic at high doses, and the fact that cold medications containing ephedrine can be transformed into the street drug crystal meth.
But back to the issue at hand - the utter uselessness of cough and cold medications for children.
Sure, listening to a child cough all night is horrible. It's heart-wrenching. You want your baby to feel better. You want to do something.
That something should not include putting the little ones' lives at risk.
Hard as it may be to be rational when you are sleep-deprived and junior is crying and hacking in the middle of the night, keep reminding yourself: These drugs don't work.
So what to do?
The common cold will resolve itself in a few days whether it is treated or not. The simplest and best treatment is getting enough rest and drinking plenty of fluids - especially warm or hot ones like chicken soup.
Take a couple of days off and spend them with your sick child. Modern parents don't spend nearly enough time with their kids, and that's what sick days and family days are for.
If your child is in pain or has a fever, by all means give them a pain reliever. But use a single-ingredient product such as acetaminophen or ibuprofen, and use it sparingly. (What makes cough and cold medications potentially dangerous is the multiple ingredients.)
As medical experts advise: Disaggregate the symptoms. In other words, don't treat a cold, because there is no single treatment for a cold; rather, treat the symptoms individually.
Symptom relief comes in many forms: A painkiller for fever, a humidifier for a stuffy nose, a cup of chicken soup for an empty belly, a favourite video for distraction, and a hug for reassurance.
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