Experts agree that little kids, especially babies, should not be given over-the-counter cough and cold medicines.
But studies have reached conflicting conclusions about whether doctors have been following or flouting that guidance.
Now, a national study by Rutgers University researchers suggests doctors have curbed their use of most, but not all, categories of children’s cold remedies.
The study, published recently in JAMA Pediatrics, analyzed data from pediatric visits to hospital emergency rooms, doctor’s offices, and clinics to see how often physicians recommended cough and cold medications — either by writing prescriptions, providing the drugs, or directing parents to buy drugstore versions.
While it may be hard for parents of sniffling children to accept, a huge body of evidence shows that over-the-counter cold remedies don’t help and can occasionally be harmful, leading to rapid heartbeats, difficulty breathing and even death.
Between 2002 and 2015, doctors recommended dramatically fewer cough suppressants, cough expectorants, and decongestants, with the number per 1,000 visits falling from 38 to 15. But they recommended slightly more antihistamines; the number grew from 15 to about 19 per 1,000 visits.
“We were surprised to see that antihistamines rose, since that is not effective for colds,” said Daniel B. Horton, the Rutgers pediatrician and epidemiologist who led the study. “But as a doctor and parent, I understand the urge to want to do something when a kid is sick. It’s sometimes easy to forget that colds are self-limiting conditions and the best medicine is time.”
Although the researchers did not separate over-the-counter products from prescription medications, they did break out cough and cold medicines containing the opioids codeine or hydrocodone. Opioid products were infrequently prescribed over the 14-year period and usage had been shrinking before last year, when the U.S. Food and Drug Administration said such medicines should be used only by adults age 18 and older.
Thousands of children wind up in emergency rooms each year because of accidental overdoses of cold medicines — although research shows this problem has decreased since 2008.
That year, the FDA strongly recommended against giving over-the-counter cold remedies to children under age 2. Around the same time, manufacturers voluntarily relabeled their products for use by children age 4 and older, and the American Academy of Pediatrics advised against use by children under age 6.
On its website, the AAP says the best way to treat a young child’s cold is with acetaminophen or ibuprofen to reduce fever and aches, a mist vaporizer to ease congestion, and a bulb syringe plus saline nasal spray to clear stuffy noses. “Don’t underestimate the power of TLC,” it says.