Drugstore cold meds unlikely to help kids

Stick with fluids, pain relievers; research shows over-the-counter meds don't benefit kids under 6.

Posted: January 22, 2013

When a young child gets a cold - congestion, a sore throat, and runny nose, maybe with greenish goo - many parents head to the drugstore for a bottle of children's cold medicine.

Don't bother.

It's worth it to give children lots of fluid and acetaminophen or ibuprofen if they are uncomfortable. But research has repeatedly shown that cold medicines do not work for children younger than 6, and give only a negligible benefit for children 6 to 12.

Parents in my pediatric practice typically express surprise - because these medications appear to work, though that's really just cold symptoms naturally waxing and waning throughout the day - and frustration that there isn't a medicine to just make the cold go away.

A common cold is the most frequent infection people get. Older children and adults tend to come down with a cold two to four times a year; young children get them six to 10 times a year. This is normal and not a sign that something is wrong with a child's immune system.

A 2012 review by the Cochrane Collaboration, which looked at many studies done on the effectiveness of over-the-counter cold medication, reported that while antihistamine-analgesic-decongestant combinations provide some relief to adults and teenagers, "there is no evidence of effectiveness in young children." Even for teens and adults, the review found that "adverse effects" from cold medicine, such as heart racing, drowsiness, dizziness, and nausea, had to be weighed against any benefit.

A cold has a predictable life span, and not much can be done to change it.

Given the recent surge in flu cases, it's worth noting that, like a cold, influenza is a viral infection that also resists over-the-counter cold medications.     

  So what's a parent to do? Research published last summer found that honey may reduce the coughing that comes with a cold. (Never give honey to a child under 12 months of age because it could cause infantile botulism.)

Zinc slows replication of some cold viruses, so it can limit a cold's course and severity. Studies have shown that zinc is effective in adults, but the data are insufficient to recommend its use in children.

Vaporizers and cool-mist humidifiers moisturize the air in a room. They have no direct effect on cold symptoms, but dry air can make a sore throat feel worse. Hot-air vaporizers that create steam should never be used around children because they boil water and could result in a serious burn if knocked over.

No one has shown that drinking lots of fluids makes a cold resolve faster. But keeping a child hydrated will make him feel better.

A study years ago showed that chicken soup is among the best fluids, because it loosened nasal mucus in adults. It has never been studied in children, but generations of grandmothers (mine too) have believed in its medicinal value. So the next time your child has a cold, walk past a supermarket's cold-medicine aisle and pick up some soup instead.

Howard Bennett is a Washington pediatrician. At www.howardjbennett.com, he writes about common pediatric problems.

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