Over-the-Counter Cold Medicines: What You Need to Know

There’s a whole aisle devoted to them in the pharmacy sections of stores that carry medicines. But do you need them? Or, more importantly, should you ever use them for your child? The FDA says definitely not to give them to children two years and younger. And the American Academy of Pediatrics, which has found that cold medicines are ineffective in children younger than six years of age, recommends against using them.

What are the concerns with these medicines?

  • Side effects of over-the-counter (OTC) cold medicines can be potentially life-threatening, especially in children less than two years old.
  • There’s a risk in giving a child too much medicine (overdosing the child).

But can’t these medicines help?

Not really. There is little evidence that these medicines really help with cold symptoms. And we know for sure that they don’t make the illness go away any faster.

What if you want to try an OTC cold medicine anyway?

  • Review the “active” ingredients listed on the box.
  • If you are giving your child more than one medicine for a cold, make sure that the two medicines don’t share some of the same active ingredients. A good example is someone giving a “cold medicine” along with Tylenol: Sometimes a cold medicine will actually contain acetaminophen, which is Tylenol—and giving double the dose would be dangerous.
  • Only measure doses with measuring utensils that have been designed for measuring out medicines—i.e., those that either come with the medicine itself or from the pharmacy. Don’t use kitchen measuring spoons you use when baking because their actual volumes may be too high.
  • Remember that antibiotics do not and cannot cure a cold, which is caused by a virus.

But my child is miserable with this cold! What can I do?

  • Acetaminophen or (for those children older than six months of age) ibuprofen can help with fever, headache, and sore throat.
  • Note that a low-grade fever that doesn’t appear to bother a child does not need any medicine. In fact, not administering any meds may help the child’s immune system to fight the illness faster.
  • Cool drinks, popsicles, ice cream, etc., may help with a sore throat. And some people really do get sore-throat relief by gargling warm salt water.
  • Saline spray or saline drops can help relieve stuffy-nose symptoms. And, for infants, saline drops followed by gentle suction of the nostrils with a bulb syringe can help clear out a nose.
  • A cool-mist humidifier (vaporizer) can help with the symptoms of cough and nose congestion. (Note: Be sure to follow the manufacturer’s instructions for cleaning the machine, so as to keep it free of mold.)

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