Young children usually get at least six colds a year. In previous generations, parents may have used cough syrup to relieve dry or chesty coughs.
But now we know that cough medicines are not very effective in treating children’s coughs.
Amid growing evidence of poisonings and deaths, many countries, including Australia, have placed restrictions on cough medicines so that they cannot be given to children under the age of six.
What is in the cough medicine?
The active ingredients in cough syrups vary depending on their intended benefit. They may contain cough suppressants (moisturizing the body’s cough reflex), expectorants, and expectorants (both of which help clear phlegm).
Other cold and flu medicines often contain decongestants (to relieve nasal congestion) and sedative antihistamines to ease sneezing, stop a runny nose, and improve sleep. The most dangerous drugs are sedatives, such as sedative antihistamines or opioid cough medicines.
While sedation may be desirable for the parents of a child who suffers from poor sleep, young children are especially at risk for serious injury or death. Sedatives can also cause agitation and hyperactivity.
Although over-the-counter cough medicines are probably safer, there is very little research on the safety and effectiveness of these products in children. Adverse events have been reported, including agitation and psychosis, especially with excessive use.
Overuse can occur because parents misread the label, deliberately used more in the hope that it would work better, unintentionally added doses, and used inaccurate measuring instruments such as household spoons.
How are cough suppressants restricted?
Young children under 2 years of age are most at risk of fatal overdose of cough medicines. But the Australian Medicines Regulatory Authority recommends that cough medicines should not be used by persons under the age of six.
Thus, there are no dosage instructions on the labels of these products for children under the age of six.
Cough medicines are still available for older children and adults. Pharmacists will likely ask about the age of the person who will be taking it and give advice on dosage and proper use.
Research published in the Australian Medical Journal found that limiting the use of cough and cold medicines in children resulted in a significant and sustained reduction in poisoning.
The study looked at dosing errors, side effects at the correct doses, and accidental “trial swallowing”.
In 2012 and 2020, the government introduced changes to the labeling of these products.
In 2012, cough and cold medicine labels no longer included dosage instructions for children under the age of six and were required to carry additional warnings.
In 2020, sedative antihistamines were posted with warnings not to be used in children under two years of age for any reason (including allergies and hay fever).
This halved the number of calls to poison control centers and halved the number of hospitalizations. Despite this, Australian poison control centers still receive hundreds of calls each year about these products for young children.
When is it okay to use cough medicine?
Harm has been documented mainly in young children. This is probably due to their small size.
Cough syrup can be used for children aged 6 to 11, but with caution. These products should only be given after consultation with a doctor, pharmacist, or nurse practitioner.
Some herbal products are available and sold to children. Unfortunately, there is no strong evidence that these medicines help with cough symptoms. But the risk of poisoning is low.
Perhaps the best thing you can do for your child is to give him comfort and reassurance. Antibiotics will only be needed if a doctor diagnoses severe bacterial pneumonia or a chronic cough caused by a bacterial infection, such as persistent bacterial bronchitis, whooping cough, or lung abscess.
Paracetamol or ibuprofen can be used if they have a fever and cough pain. Check the correct dose on the package for your child’s weight and age.
If your baby is over 12 months old and has a wet cough (phlegm in the throat), consider giving him honey. There is growing evidence that honey can reduce mucus production and thus reduce coughing.
The report was prepared by Rose Cairns, Lecturer in Pharmacy, University of Sydney, and Niall Waite, Associate Professor, University of Sydney School of Pharmacy.
Source: Science Alert
