No cough/cold meds for kids under 4 - Don't worry, be happy

With the frequent weather changes, I'm preparing myself for colds in one, if not both, of my children.  Kids get 6-10 colds a year, according to the NIH.  This was definitely true when my daughter was an infant.  Yes, I had many nights of interrupted sleep because of her colds, but I never gave her any OTC cough or cold medicines.   No antihistamines to help her fall asleep, either.  Instead, I tried putting saline drops in her nose, suctioning it out with a bulb, propping her up on a pillow, using a cool-mist humidifier when the heat was on in the room, giving her plenty to drink, and just being patient.  Sometimes it took more than one of these methods, but in the end we both got more sleep.  

I avoided the medicines because I didn't want her to feel more miserable with palpitations from decongestants or excessive drowsiness from the cough medicines.  Besides, she wouldn't have been able to tell me any of that.  Of note, most of the products that had "infant" on their labels referred consumers to their physicians for dosing in children under 2.  As a pediatric pharmacist, I have been asked by pediatricians for my recommendations.   I did not always have an answer, though, because some products have not been studied in children.  So, when the drug companies pulled their infant cough/cold products off of the shelves a year ago and the Food and Drug Administration (FDA) made the recommendation this past January to forgo these products in children under the age of 2, I voiced my support.  Until we have more data to support their use in young children, they should be avoided.  Earlier this month, the members of the Consumer Healthcare Products Association (CHPA) volunteered to update the product labels to state "do not use" in children under 4 and to provide new measuring devices with the products.   The FDA will continue to seek more information about these medicines.

In the meantime, don't worry about these medicines being removed from your ammunition against colds in younger kids.  Instead, be happy that the FDA is taking action to make sure that the medicines indeed work and are safe for our children.  For tips on using OTC medicines safely in older children, check out this Daily News article.  The American Academy of Pediatrics has some great additional non-medicine tips for relieving the symptoms of a cold.  Remember that a cold is caused by a virus, and even these methods will not shorten the course of the illness (1-2 weeks), but it can help your child feel better without your worrying about side effects.  Do NOT give adult medicines to your child.  As a pediatrician I worked with always used to say, "a tincture of time" will do wonders.   Oh, and don't forget to give your child the flu shot this year.