Skip Over-The-Counter Meds For Your Kids' Colds

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Over the holidays, my entire extended family travelled to Disney World. Six adults and four kids trekking our way first across several states to get there, and then across four different parks over the span of a week.

Disney World may be the happiest place on Earth, but this time of year (any time of year?), it’s also among the germiest. When I arrived, my Dad was already battling a particularly nasty cold. By Day 3, just as he was starting to feel better, he caught a second cold, which he promptly passed along to my Mum. By the next day, scratchy throats were running rampant around me. Since I hadn’t brought the bottle of Vitamin C I usually travel with, I found myself pondering whether to spent $15 on a small dose of gift-shop immune-boosting medication.

“You know that stuff doesn’t work, right?” my brother said. “You’ll spend $15 for a placebo effect.”

We’ve all heard that there is no cure for the common cold, but even the over-the-counter stuff that proclaims to alleviate our symptoms is largely found to be ineffective, according to a new review in The BMJ. And, worse, for kids under age six, cough and cold medications can do more harm than good.

Dr. Mieke van Driel, head of the primary care clinical unit at the University of Queensland in Australia and an author of the study, told the New York Times that there is little parents can do by way of medication to relieve a child’s discomfort from a cold.

“Unfortunately, our research shows there’s very little evidence,” she said, and especially in children, “we were actually quite amazed by how little there was — hardly anything to be enthusiastic about.”

In addition to understanding that there is no evidence that these medications help, Dr. van Driel said, parents need to understand that there are clear risks in using them in young children. The Food and Drug Administration originally recommended against any over-the-counter cough and cold preparations in children under 2; the American Academy of Pediatrics has extended the recommendation to apply to all children up to 6.

According to the report, the only potentially beneficial treatment for children is a simple saline nasal irrigation. All other medications—including decongestants, cough suppressant rubs, antihistamines and probiotics — showed no clear evidence of effect.

So, when it comes to battling the common cold (or helping our kids battle it), the best advice doctors can offer is to buckle in and try to get as comfortable as possible.

When it comes to the sniffles or the cough associated with the common cold, “these symptoms are self-limited,” said Dr. Shonna Yin, an associate professor of pediatrics and population health at N.Y.U. School of Medicine. Parents can help comfort their children without giving medications, she said, offering 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.

The Mayo Clinic also recommends a saltwater gargle for adults and kids who have a sore throat and are old enough to pull it off (likely over age 6), pain relievers and running a humidifier to add moisture to the air. Warm liquids, such as chicken soup, tea or warm apple juice, may also feel soothing.

When should you get a little more concerned and head to the doctor? Dr. Perri Klass, author of the New York Times column, lays that out for us:

Any respiratory difficulty in a child has to be taken seriously, so a baby who is breathing too fast or a child who is working harder than normal to breathe should be checked out. High fevers are concerning, as are any of the signs of influenza, such as shaking, chills and body aches; influenza in children can be treated with antiviral drugs—and prevented with flu shots.

Children with the “common cold,” on the other hand, should generally be able to eat and drink, should be alert and able to play—or at least, susceptible to distraction.


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