November 11, 2013
News Review From Harvard Medical School -- Child Cough-Cold Drug Emergencies Drop
Since drug makers stopped selling cold and cough medicines for young children, emergencies related to these drugs have dropped, a study shows. Manufacturers withdrew cold and cough medicines for children under age 2 in 2007. The next year, the government required label changes. New labels said these medicines should not be given to children under age 4. Researchers compared emergency room data before and after the changes. They looked at the years 2004 through 2011. After the changes, ER visits related to cold and cough medicines dropped for all young children. For children under age 2, visits for side effects of these drugs dropped 41%. For children ages 2 and 3, visits dropped 32%. Among the emergencies that did occur, the vast majority of children had swallowed the medicines when no one was watching. Besides the risk of side effects, researchers noted that these drugs actually do not help symptoms in small children. The journal Pediatrics published the study online. HealthDay News wrote about it November 11.
By Henry H. Bernstein, D.O.
Harvard Medical School
What Is the Doctor's Reaction?
In the winter months ahead, your infant or toddler might come down with sniffles or a cough. Your first thought might be to look in the medicine cabinet. Think again. Over-the-counter cold and cough medicines do not really help in this young age group. Even worse, they can be harmful.
Young children used to be brought to the emergency room (ER) often with problem side effects from cold and cough medicines. These safety concerns led drug makers to:
- Take all over-the-counter cold and cough medicines for babies less than 2 years old off the market in October 2007.
- Change their labels a year later to say that cold and cough medicines should not be given to children younger than 4 years.
The U.S. Food and Drug Administration (FDA) supported both decisions. Did these safety steps work? Did the number of ER visits for cold and cough medicine side effects actually go down? The journal Pediatrics just published the answers.
Researchers looked at data collected from a national sample of hospital ERs between 2004 and 2011. They compared data before and after these safety changes were made. They found that fewer infants and toddlers have been harmed by cold and cough medicines since the changes.
For children less than 2 years old, they found that:
- Before the infant medicines were taken off the market, 4.1% of all ER visits for drug side effects were because of cough and cold medicines.
- After the change, only 2.4% of these visits were because of cold and cough medicines. That was a 41% decrease.
For children 2 to 3 years old, researchers found that:
- Before the product label was changed, 9.5% of all ER visits for drug side effects were because of cough and cold medicines.
- After the change, 6.5% of these visits were because of cold and cough medicines. That was a 32% decrease.
Since the product label was changed, most ER visits for cold and cough medicine side effects occurred because the child was not being watched (was unsupervised).
What Changes Can I Make Now?
If your child younger than age 4 is sick, do NOT give her over-the-counter cold or cough medicines. The American Academy of Pediatrics says these medicines should:
- Never be given to children under the age of 4
- Be used in children 4 to 6 years only if recommended by your child's doctor
There is no simple cure for a cold or cough. The symptoms might be uncomfortable, but they usually are not dangerous. They go away with time.
Here are some ways you can help your infant or toddler feel better:
- Put a cool-mist humidifier or vaporizer in your child's room. This makes the air moist to help clear congestion in the nose and chest.
- Use saline (salt-water) nose drops and a rubber suction bulb to clear a stuffy nose. This works best for babies younger than 6 months.
- Make sure your child is drinking lots of liquids.
- If your child has a fever, ask your doctor about giving medicines that can lower the fever.
- Provide lots of love and care. This is the best medicine of all!
Whatever the age of your child, it is your job to make sure your child does not take a medicine when you are not watching. Accidental overdoses (giving too much medicine by mistake) must also be prevented.
Here's how you can protect your child:
- Always closely follow the directions when giving any medicine. If you have any questions, ask the doctor, nurse or pharmacist.
- Take extra care that you are giving the medicine correctly.
- Keep a close eye on your child's condition when he is taking a medicine.
- Avoid using medicines that are not really needed.
- Use the measuring tool if one comes with the medicine.
- Do not give your child two medicines that contain the same ingredient. This makes it possible to overdose by accident when giving two medicines at once.
- Never give adult medicines to your child. Children are not small adults. It is never safe to assume that an adult medicine is right for a child or teen, even if he or she weighs the same as an adult.
- Keep all medicine out of sight and out of reach.
- Do not take medicine in front of your child.
- Do not tell your child that medicine is candy.
What Can I Expect Looking to the Future?
Children apparently are still taking medicines when no one is watching them. Organizations like the FDA and the American Academy of Pediatrics will keep getting out the word about the dangers of medicines and the need to watch children closely.
The FDA will continue to look thoroughly at the safety and effectiveness of over-the-counter and prescription medicines in children. Steps will be taken to further reduce medical errors and unexpected events from drugs.
Researchers will look for better ways to prevent unexpected health problems when taking medicines. They will continue to study the types of reactions common in different age groups of children.