More research reveals that over-the-counter medication doesn't work for kids .... and even worse, can have negative side effects.
I was pretty shocked (and also kind of not shocked at all) by a study a while ago showing that honey outperformed the popular cough suppressant dextromethorphan (DM) in treating cough symptoms in children. Humble lil’ honey, doing the good work – even though so many of us are convinced that we need to administer awful-tasting candy-colored over-the-counter medicine to ensure the comfort of our sick kids.
“Parents are often disappointed or even a little bit upset when I tell them there’s no medicine to help their coughing, sneezing, drippy-nosed children feel better,” writes Perri Klass, M.D. in The New York Times. “There’s nothing that works, I say, and medicines can have bad side effects. We don’t recommend any of the cough and cold medications for children under 6.”In a similar vein of the earlier honey study, now a new review published in The BMJ, looks at evidence on whether a variety of over-the-counter (OTC) cough and cold medicines are effective in treating cold symptoms, and even more, if they are actually harmful.
You can probably guess where this is going.
“Parents are always worried that something bad is happening and they have to do something,” says first author of the study, Dr. Mieke van Driel, professor of general practice and head of the primary care clinical unit at the University of Queensland in Australia. “Unfortunately, our research shows there’s very little evidence [that these medications help]. We were actually quite amazed by how little there was – hardly anything to be enthusiastic about.”
You can look at the study and see the chart showing which medications are effective (very few) and which are potentially harmful (more than there should be). It’s scary, especially given the number of children who end up in the emergency room every year for problems associated with these kinds of medicines.
The FDA advises no cough and cold medicines for children under the age of two, while the American Academy of Pediatrics says the same for all children under the age of six. Klass points out that after manufacturers decided to stop making products marketed for infants and stopped recommending them for young children, there was a notable drop in children’s ER visits for things ranging “from hallucinations to cardiac arrhythmias to depressed level of consciousness.”
Dr. Shonna Yin from the N.Y.U. School of Medicine says that comfort for sick kids can come in the form of “plenty of fluids to keep children well hydrated, and honey for a cough in children over a year old (no honey for babies under a year because of the risk of botulism). Other measures may include ibuprofen or acetaminophen for fever and saline nose drops for congestion.”
“In my own practice, I reassure them, I check the child, I make sure I’ve covered the ears, the lungs, the throat,” van Driel says. “I reassure the parent, this is a cold, a cold is a self-limiting disease, we have capable immune systems that will take care of it, it will take about a week.”
“I would tell them, there’s not a lot we know that helps. Don’t give him anything you might give your older child or take yourself,” she adds.
Klass reminds us to look out for symptoms of something more serious: respiratory difficulty; a baby who is breathing too fast; a child who is working harder than normal to breathe. “High fevers are concerning, as are any of the signs of influenza, such as shaking, chills and body aches,” he writes.
But for the common cold, think Grandma, not pharmacy. Lots of liquids, a spoonful of honey, and plenty of rest.