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<< Previous   of   Next >>   ADVERTISEMENT   CONTACT THE HERALD Melanie Munk, Features Editor munk@heraldnet.com   Published: Tuesday, January 8, 2008 Children's cold and flu advice has changed By Dr. Elizabeth Smoots Herald Columnist Advice about caring for children's colds has changed. Last summer the Food and Drug Administration issued a public health advisory about the use of over-the-counter cough and cold medications for children. Then in fall, manufacturers voluntarily withdrew many over-the-counter infant and toddler cold remedies from the market. Meanwhile, the FDA convened a panel of pediatricians to further discuss the safety and effectiveness of the medicines. The committee found little value in over-the-counter cough and cold remedies for children less than 6 years old, and raised concerns about potential harm. So now that winter cold and flu season is upon us, what's a parent to do? I think it's an excellent time to review the latest advice about caring for sick youngsters. Adverse drug effects The biggest risk from giving medications to kids is unintentional overdose. "Some reports of serious adverse events associated with the use of these products appear to be the result of giving too much of these medicines to children," the FDA advisory says. "An (over-the-counter) cough and cold medicine can be harmful if more than the recommended amount is used, if it is given too often, or if more than one cough and cold medicine containing the same active ingredient are being used." The Centers for Disease Control and Prevention reports that at least 1,500 children younger than 2 suffered complications from over-the-counter cold remedies in 2004 an 2005. This has led to at least 123 deaths from problems such as seizures, heart trouble, difficulty breathing and loss of consciousness. FDA recommendations "Do not use cough and cold products in children under 2 years of age unless given specific directions to do so by a health care provider," the FDA advisory says. "Too much medicine may lead to serious and life-threatening side effects, particularly in children aged 2 years and younger." The recently convened pediatrics panel went further. It concluded that over-the-counter cough and cold medications should not be used in children under 6. The FDA must conduct a lengthy review process before it decides whether to formally accept these preliminary recommendations. At present, the FDA offers the following advice for parents: Use only products marked specifically for children; those designed for adults are inappropriate. Ask your child's doctor if you don't know what strength or form of a product to use. Tell your child's doctor about all over-the-counter and prescription medicines that your child receives. Ask the doctor to review and approve the combined use. Read all of the information in the "Drug Facts" box on the package label so that you know the active ingredients and the warnings. Follow directions carefully; do not give medicine to a child more often than recommended, or in larger amounts. Use markings on the dropper, cup or spoon that comes packaged with liquid formulations to deliver the recommended dose. A kitchen spoon may not give you the correct amount. Do not use a medicine if you don't understand the directions. Talk to your child's doctor. Popular home remedies For mild cold symptoms, several home remedies may help provide symptomatic relief: Make sure your child gets plenty of rest and fluids. Loosen nasal secretions with saltwater nose drops. Gently suction out clogged nostrils with a suction bulb. Try a cool-mist humidifier in your child's bedroom. Carefully follow product directions for giving plain acetaminophen without added ingredients for pain or fever. And be sure to get medical care if your child's condition worsens or doesn't improve. For more information: Food and Drug Administration, www.fda.gov. Contact Dr. Elizabeth Smoots, a board-certified family physician and fellow of the American Academy of Family Physicians, at doctor@practicalprevention.com. Her columns are not intended as a substitute for medical advice or treatment. Before adhering to any recommendations in this column, consult your health care provider. © 2008 Elizabeth S. Smoots

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