Cold medicines: Are they really safe and effective for your child?

When your child has a cold they are miserable, and as a parent we say to ourselves, “There must be something I can do!” So we visit the cold medicine section of our local pharmacy and are faced with hundreds of products to choose from. What helps? Are they safe? Are there side effects? Will home remedies be enough? Viruses cause colds and there are no medications that cure a cold, but there are some things we can do to make our child feel a little more comfortable.

What is in cold medicine?

There are four basic components to cold medicines: decongestants, antihistamines, expectorants and cough suppressants. Almost every product on the shelves contains a single one of these components or a combination of several of them. Most over-the-counter cough and cold medications are made for children over the age of six. Use of these medications in younger children should only be done in consultation with your pediatrician.

Decongestants

Decongestants, such as phenylephrine or pseudoephedrine, cause vasoconstriction and thereby shrink the swelling in a stuffy nose. They can make a child feel a little less congested, but the side effects are jitteriness and increased heart rate. These effects may interrupt sleep and make a child feel worse.

Antihistamines

Antihistamines show up in lots of cold medications. Yet, histamine is a chemical the body releases due to an allergy causing watery eyes and itchy nose. Histamine is not released in the body with a cold. The reason that antihistamines are used in cold medicine is that the side effects are the drying up and decreasing of the production of mucous. Diphenhydramine, chlopheniramine and brompheniramine are the most common antihistamines in cold medications. They may be helpful in decreasing cough and congestion and allowing a child to rest more fully at night; these medications also make a child drowsy. They also may have the undesirable effect of thickening mucous and should be used sparingly with a cold.

Expectorants

The most common expectorant found in cold medications is guaifenesin. Expectorants actually increase and thin mucous. This allows your body to remove secretions more effectively through cough and nose blowing. This medication is more helpful during the day.

Cough suppressants

Most cough suppressants contain the medication dextromethorophan. This medication acts on the cough centers in the brain to tell the body not to cough. Dextromethorophan can be helpful in decreasing cough and making a child feel more comfortable, but it rarely will stop a cough completely. This is because mucous production from the viral infection is continuous. Until that production goes away, children will continue to cough from postnasal drip.

Home remedies, real impact

Having seen great success with my three girls and my patients over the years, I am a firm believer in chicken soup and tea. The warmth and steam from hot liquids loosens and thins the mucous from a cold. Similarly, a long hot shower goes a long way to clear the nose and loosen the mucous. Clear liquids, especially water, are the best expectorant. Increasing consumption of clear liquids is the most important step a parent can take in decreasing the symptoms of a cold.

For a young child, I recommend elevating the head of the bed to prevent the accumulation of secretions in the back of the throat. Running a humidifier or vaporizer with clean water will also help thin mucous.

There are a number of great products on the market to help wash the mucous produced in a cold out of the nose. Using a few drops of saline in the nose of an infant will help liquefy the secretions so they are more easily removed with a bulb syringe. For older children, there are a variety of squeeze bottles or aerosol containers with saline solution that allow a child to loosen secretions and blow them out. A neti pot can also be used, but should always be used with sterile saline.

Sucking on a hard candy or lozenge can help calm a cough and there are some honey containing cough products on the market that are also soothing.

Acetaminophen or Ibuprofen can be used sparingly for the general discomfort one may feel with a cold. Be careful if you are using these with other cold medications. Some multi-symptom cold preparations already contain pain relievers and you run the risk of overdosing with these medications.

Fortunately, colds will go away no matter what we do or don’t do. If your child’s cough is worsening, fever is persisting or increasing, or appetite and sleep is significantly disrupted, it is time to make that appointment with your pediatrician.

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