Patient information from BMJ

Treating coughs and colds in children

Last published:Jun 02, 2023

Coughs and colds are common in young children. Although these illnesses usually last only a few days, they can be hard on children and on their parents, who want to help their child feel better. However, parents looking to ease their child’s symptoms with an over-the-counter medication might be surprised to find few options for young children.

Many over-the-counter cough and cold medications are now not recommended for children under age 4. These include:

• Decongestants, to unclog a blocked nose. Examples include ephedrine, phenylephrine, and pseudoephedrine.

• Cough suppressants, to reduce coughing. One example is dextromethorphan.

• Cough expectorants, to help thin mucus so it can be coughed up. One example is guaifenesin.

• Antihistamines, to reduce sneezing and a runny nose. One example is diphenhydramine.

These restrictions stem in part from a review of the safety of cough and cold medications for young children by the Food and Drug Administration (FDA). It found several cases where young children taking these medications had been seriously harmed.

This often happened when a child under the age of 2 had been accidentally given a dose of medication that was too high.

As a result of these findings, the FDA recommends that over-the-counter cold and cough medications not be given to children younger than 2. The manufacturers of these medications have gone a step further than the FDA, and changed their labels to say these medications should not be used in children under age 4.

The FDA is currently looking at the safety of cough and cold medications in children through age 11.

Some treatments are suitable for younger children who have coughs and colds. But you still need to take great care to never give more than the recommended dose.

Also, keep in mind that most colds and coughs clear up on their own within a few days. Medications won’t cure the cough or cold. They will only help make the symptoms a little milder.

• To lower a child's temperature, you can use acetaminophen or ibuprofen - as long as you don't give them more than the recommended dose. Always read the labels carefully. You should never give aspirin to children under 16 years old. It can cause a serious problem called Reye syndrome that affects the brain and the liver.

• For treating coughs you can use honey and lemon mixed with some water. However, you should never give honey to babies under 1 year old, as they could develop a rare but serious illness called infant botulism.

• Nasal drops of saline (sterile salt water) can be used to help unblock a child's nose. These drops can be particularly helpful for babies who are having trouble feeding because of a blocked nose.

• You can also help relieve a child's blocked nose using vapor rubs and inhaled decongestants that you put on children's clothing, such as menthol. However, inhaled decongestants used as rubs or on clothing are not usually recommended for very young children, as they can be irritating.

• It’s important to make sure your child drinks plenty of fluids while they are ill, so they don’t become dehydrated. Warm drinks can help soothe the throat.

Whenever giving medications to a child, whatever the child's age, it’s important to take certain precautions.

• Read the label on any medication you give your child. Check the active ingredients section of the label and the correct dose for your child’s age.

• Be very careful if you give more than one medication to a child. If you use two medications with the same active ingredient (such as acetaminophen) your child could get too much.

• Only use the measuring spoons or cups that come with the medication.

• Call a pharmacist, doctor, or other healthcare professional if you have any questions about using cough or cold medications for a child.