Parents agree just how miserable cold and flu season can be when their child is sick. And, when the cough kicks in, parents logically look for ways to help. Grocery store shelves have several choices of cold medicine for children. But, what is the right choice? Can a doctor prescribe something stronger?
Well, doctors can prescribe something stronger. In fact, cough medicines and syrups with codeine have long been prescribed to adults to relieve serious coughs. However, according to Food and Drug Administration guidelines, they should not be given to children under the age of 18 after the members of the Pediatric Advisory Committee determined the side effects outweighed the benefits.
The dangers of some cold medicines
To be clear, the issue does not focus solely on cold medicines containing opioids but all opioid-based medications. Opioids are a class of drugs that reduce pain by affecting the nervous system and include morphine, oxycodone, codeine and others.
If your child’s doctor prescribes a cough medicine, the FDA recommends you ask the doctor if it has an opioid in it for your own peace of mind. If the medicine does include an opioid, the FDA also recommends asking the doctor to prescribe a different option.
So, what can a parent do for a child with a horrible cough?
Cold medicine for children
Gina Montion, MD, is a pediatrician with Banner Children's. She provided answers to why opioids are dangerous for children.
“The main risk is respiratory suppression and, frankly, stopping breathing,” said Dr. Montion. “Opioids also cause significant constipation, sometimes nausea or itchy reactions.”
Because of these issues, cough suppressants and syrups with codeine are not typically prescribed to children with the rare exception being for an older teenager. This leaves over-the-counter medicines.
“Generally, the cough medicine part of cough and cold medications tastes terrible,” Dr. Montion said. “I tend to avoid it because of that; however, it’s generally regarded as safe, if one desires to use it.”
For children 2 and over with bad coughs, Dr. Montion recommended 1 to 2 teaspoons of honey at bed time and again every 2 hours, if needed. To help with a sore throat associated with a cough, Dr. Montion suggested Tylenol, ibuprofen or sore-throat suckers. A nightly shower and a cool-mist vaporizer placed about a foot away from the head of the bed can also help.
Dr. Montion said, in cases where there is a lot of thin nasal drainage, a dose of Zyrtec can help. For infants, a NoseFrida, or nose aspirator, can be used to gently remove congested mucus from the nostrils.
The good news is, if you feel your child needs an over-the-counter cough syrup or cold medicine, you won’t have to worry about making sure it doesn’t have codeine in it – especially if it’s labeled specifically as a cold medicine or cough syrup “for kids” or “for children.” Those with opioids are available only by prescription.
And, as always, be sure to talk to your child’s doctor if you have concerns or if the cough doesn’t clear up in a few days.
A version of this post originally appeared on September 7, 2017.