There Are No Safe And Effective Cold Medicines For Small Children

Dr. Benjamin Brewer, who writes “The Doctor’s Office” column in the Wall Street Journal, addresses the issue of giving cough and cold medicines to children.

As a parent, he gives his 3-year-old combination cough-and-cold medication. As a doctor, he recommends against it.

After the recommendations against over-the-counter cold medicines came out, we heeded them for less than 24 hours in our house. Once my sick son took the medicine, his sniffles and coughing abated a bit. His symptoms returned later that day, after we discontinued the treatment. Our experience showed that whatever mild benefits these medications offer, they don’t last long.

The risks with cough-and-cold medication are clear. If you don’t know your phenylephrine from your acetaminophen, you can deliver more potency than you had intended by unknowingly combining products with similar ingredients and confusing chemical names.

Overdoses of medication occur all too often; the FDA has linked over-the-counter medicines to 123 pediatric deaths since 1969. Most of the fatalities were in children younger than 2.

Professionally, he seems pleased that the infant cough and cold meds are off the market, if only because it cuts down on the nighttime calls for advice:

The crackdown on cold medicines for kids may have an unintended benefit for me. With infant cold medications off the market, I won’t miss the parents calling in the middle of the night for recommendations on how much to use. I won’t miss meticulously documenting how many tenths of a milliliter I advised a person to give or the liability risks associated with my advice.

My new answer is simple: “It’s just a virus, and, unfortunately, there is no safe and effective cold medication on the market that I can recommend to you.”

At my house, though, I have found that the advice to hold off on a kid’s cold medicine is much easier to give than it is to heed.

Do you give your children cough and cold meds?

It’s Hard to Heed the Experts When Your Kid Has the Cold [Wall Street Journal]


Edit Your Comment

  1. joeblevins says:

    To be safe they have been so reduced in strength as to not be effective. Then because of that, parents start doubling/tripling doses to the point of danger. Just not a good idea.

  2. Nemesis_Enforcer says:

    Yes we give our 1 year old decongestant and ibuprofin when necessary. We consulted with our pediatrician several times. We usually take whatever the recomended dosage is and half it. By using the least amount of medicene we can that works, it helps to prevent overdoses even by accident. I don’t think we have ever actually used the recomended dosage.

    And even with the reduced dosage we still follow the doseing schedule. Sure it makes for some sucky nights now and then but at least we know he is safe. From experiance yes used correctly we have found most medicenes marketed for kids work, not the same as adult medecine naturally, but hey do you really want your child in a nyquil induced coma?…wait I am sure there are people out there who do..

    I remember as a kid being given dosages of adult nyquil and benadryl before road trips to knock me out..LOL!

  3. Red_Eye says:

    Its all a matter of how good a parent you choose to be. If an anonymous advice nurse at midnight on a Sunday says give your kid x amount of y you may want to go look up the active ingredients of medicine y and see what the dose/weight scale is when its a prescription. I do it all the time.

    Does that mean I give my kid more than the recommended dose, no. But it does mean that if the written pharma disagrees with the person on the phone, I am going with whats in writing because chances are it errs in caution to prevent lawsuits and the only way top prevent those lawsuits is to prevent death or injury from overdose.

    Also the combined medication argument is hogwash for lazy people, If you give your Kid 3 drugs with acetaminophen in it and the labels all say its in it you’re being a fool. If in doubt don’t medicate or go to the dr.

  4. junkmail says:

    We used to give our daughters (2 & 3yrs) the kid’s stuff until all this came out. Now, there’s nothing a snuggle on the couch or a night in Mommy and Daddy’s bed won’t fix.

  5. Murph1908 says:

    I refuse to take any medication myself that is designed only to alleviate symptoms. I won’t take cold medicine, cough medicine, or even tylenol or advil.

    We are making our bodies weaker by overmedicating. We are making our immune systems weaker by overuse of ‘antibacterial’ everything.

    I don’t get sick often, and when I do, it nearly always lasts just one day. I take the day off, drink lots of fluids, and rest. Wow, amazing that our bodies figured out how to keep us well.

    I won’t give my kids cough and cold meds. They’ll be stronger for it.

  6. B says:

    I thought the best cold medication was wait seven days.

  7. bestuser says:

    “Also the combined medication argument is hogwash for lazy people”

    no it’s not. just because someone doesn’t know any better, doesn’t mean they’re lazy.

  8. paco says:

    I’ve given my 5-year old daughter Benadryl the last couple of nights because it dries out the runny nose enough to help her sleep. I feel a little better about that than bombarding her with a full array of cough/cold meds.

    If the sniffle builds, however…

  9. Hambriq says:

    Heh. I regularly have the conversation where a patient asks me what kind of cough medicine he should give to his infant, and I tell him that he shouldn’t give anything to any child under the age of two. Probably one out of three times, the patient pauses and then asks me where he can find the cough medicine for children OVER the age of two.

    My standard response is now, “It depends. Are you going to give it to a child OVER the age of two?”

    I’ve gotten mixed responses to that. One time, someone even told me, “No, but how much harm can it really do?”

  10. paco says:

    Meant to add: I still won’t do any more than tylenol to pull a fever down. I’d rather take a day out of school and let her fight it off.

  11. hornrimsylvia says:

    As an seasonal allergy sufferer, I was given nasal medication (like afrin) and half-tablets of benadryl and sudafed as a very young child. With seasonal allergies, it is all about treating the symptoms during hay fever season. The OTC medication did much better things than the cortisone steroid shots (massive weight gain) and preventative allergy shots (2 hour drive, 45 minute doctor’s office stay, weekly, red and puffy arms). The pills worked for the symptoms. Of course these medicines don’t cure a cold! You can’t cure allergies either, but you can lessen the symptoms. For colds, I still think nothing is better for a kid than a half-shot of whiskey. Numbs the throat, and makes you drowsy without the corn syrup or artificial colors of regular “cold medicine” for kids.

  12. G1ZM0 says:

    The real problem is that people don’t bother to read the labels. If they did they’d probably by the generic to begin with. I rarely use combo formulas. I use only what it necessary for my symptoms.

    The problem I see with pulling children’s formulas is that people will end up using the adult version. This will just lead to more problems.

    Was it one or multiple studies that led to this change of heart? It seems like a knee jerk reaction to me.

  13. We are making our bodies weaker by overmedicating. We are making our immune systems weaker by overuse of ‘antibacterial’ everything.

    @Murph1908: But there isn’t anything antibacterial in stuff like Nyquil and Benedryl.

  14. hapless says:

    Generations of children grew up with over the counter cold and flu remedies. 130 deaths in 40 years strike me as perfectly acceptable. How many kids strangled themselves with shoelaces? How many died from accidents with the family dog? How many slipped on doormats?

    Press hysteria. Move along: nothing to see here.

  15. jstonemo says:

    Hell, OTC cough medicine isn’t even shown to work on adults in medical studies. It is just a money maker for the producers. Kind of like buying Excedrin Migraine which has the exact same active ingredients as regular Excedrin. It is all marketing.

  16. shan6 says:

    @hapless: I was just going to say that it seems funny how none of this stuff was dangerous when we were kids lol. The fact that the information is all over every avenue of news is why people are freaking out, not because the numbers are so great.

  17. Floobtronics says:

    This is all driven by the current philosophy about child safety. Kids are supposed to grow up in a padded world, where they never fall down, never skin a knee, never flip over the handlebars of their bike, fall out of a tree, break a bone while playing some sport, etc. I’ve done every one of those things, and yet I’ve survived to the ripe old age of 35, long enough to even get married and have kids of my own.

    This is the culture that has produced helmets that are supposed to be for everyday wear for kids. And I’m not talking bike helmets either. Kids that get seizures – fine, but these are for “normal” kids.

    I’d bet more kids died from any number of normal activities over those same 40 years.

    Another part of our problem is the overly litigious culture we have today. Despite the fact that the directions state clearly things like, “Under 2, consult your doctor”, people don’t read, then get all sue-happy when their actions create tragic results. It’s like suing Stanley because you smashed your thumb with a hammer.

  18. Dilbitz says:

    My one year old has a cold right now and has been taking what’s left of our supply of Infant’s Tylenol cold/cough. Sure, it doesn’t do all the things that I want it to do, but it keeps the snot from dripping off her lip. And that’s good enough for me.

    Especially when she comes up to me and wipes her face on my shirt. Nothing like a baby blowing snot rockets at the dog.

  19. Crymson_77 says:

    This whole thing is an overreaction. My son has had some pretty hefty sicknesses in the cold and flu variety. I medicated my son and was very cautious about doing it. It is very simple. RTFM! If there is any parent out there giving a child medicine without checking the label and dosage, as well as getting some general advice from a doctor, then they should be locked up for endangerment. Prior to administering anything to my child I verified what the contents were and, in the cases where a fever or pain was included, compared the contents to make sure that nothing was overlapping. By utilizing the medication properly, we saved our son a world of troubles and helped him to feel better in a much quicker way. While a cure would be better, and there probably is one locked in a safe somewhere, treating the symptoms will help my child rest considerably better and heal that much faster.

    The real cure for sickness is sleep. When you sleep, your body goes into “standby” mode and has more resources to fight whatever sickness, be it virus or otherwise, and more quickly heal itself. When you can’t breathe, or are coughing continuously, it is incredibly difficult to sleep and therefor the healing process is extended that much further.

  20. Crymson_77 says:

    @Floobtronics: “It’s like suing Stanley because you smashed your thumb with a hammer.”

    Beautiful! :)

  21. CamilleR says:

    I read once that most kids’ cold medicines exist to make the parents feel like they’re doing something. Time and rest are the only things that will make the kid better.
    I’ll take an antihistamine to help a runny nose and suck on cough drops for a cough or sore throat but avoid multi-symptom products since they cost a lot and don’t seem to do anything. Since the medicines don’t work on adults, I doubt I’d give them to kids if I had them.
    I was a sickly kid and when I’d get a cough my older than dirt, Pennsylvania Dutch doctor recommended Vapo-rub and a cough syrup made of a mixture of whiskey and honey. If nothing else, the booze would make me sleep, and I’d always feel better when I woke up. Pity you can’t liquor up your kid these days.

  22. swalve says:

    @Murph1908: I appreciate the sentiment, but OTC painkillers are (mostly) harmless.

  23. RvLeshrac says:


    You can! At least, you can in Georgia. It is illegal for a minor under the age of 21 to drink in public, and illegal to provide (IIRC) alcohol to a child under the age of 5, but as long as they’re 5+, you can give it to them.

    Of course, you have to be extremely careful if you’re dosing alcohol to a small child. A little bit goes a long way on a small body.

    Safer by far than having them OD on pharmaceuticals, though – and easier to tell if you’ve given them a little too much.

  24. mconfoy says:

    @Murph1908: Sure. Got some cool property at a great price in Florida for you bud.

  25. mconfoy says:

    @paco: Yes, benadryl can help for sure. however, I have used the cold medicines, under 2 with doctor’s ok only, and to say they don’t work at all is not true from what i have seen with my kids. they have help running noses and coughs.