Perhaps you heard that in the middle of October 2007, two advisory committees recommended to the FDA that the active ingredients in over-the-counter cough and cold medications be withdrawn from use for children under the age of six. These medications are particularly problematic for children under the age of 2, as it is difficult to dose these medications correctly, and dosages that are too high have actually resulted in the deaths of some infants.
On Oct. 11th, 2007, the Consumer Healthcare Products Association in the States issued a voluntary withdrawal of cough and cold medications for infants, causing these products to be pulled from Canadian shelves as well. (Sorry, I don't know how health bodies in the rest of the world are dealing with this. I realize this newsletter is very North America focused, so to my readers in other parts of the world, I thank you for putting up with the bias.)
See the list of medications involved here, and check your cupboards and throw away any that you may have. I find it interesting how the article goes out of its way to say how safe these products are, and yet studies (see below) consistently show that not only are these medications dangerous, but they also do not work at all. Besides the active ingredients, which are the reason these medications have been pulled, children's medicine (and adult's) is usually full of other lovely stuff like high-fructose corn syrup or artificial sweeteners, colourings, and flavourings and other chemicals, forcing the body to waste energy detoxifying rather than trying to deal with the invading virus.
So, what is a parent with a sick child to do? First of all, it is important to remember that a cold will run its course, and your child will feel better probably within a week. The common cold is not life-threatening, even though it is certainly no fun. To deal with a cough, a recent study showed that buckwheat honey actually works better than over-the-counter cough medications and better than a placebo for relieving coughs due to upper respiratory-tract infections. Raw honey has known antiviral, mucus releasing (expectorant), immunity building and anti-inflammatory properties among others, which would help a cold, and it is thick and goopy, so it coats the throat which also probably helps. Grandma's honey and lemon tea is probably just the ticket, providing the water is not too hot, so as not to destroy those precious enzymes. Obviously, pasteurized honey has been cooked destroying the helpful ingredients leaving not much more than a pot of sugar, so look for raw. Because Clostridium botulinum bacteria may be present in both raw and pasteurized honey, it should not be given to children under the age of one, as children this young do not have an adequately developed immune system to handle it.
Lots of fluids (water) is a good idea, and a saline solution (1/4 teaspoon sea salt in a cup of water) can help keep the nasal membranes moist, as can using steam or a humidifier. Getting lots of rest and washing hands frequently will help. Remember that nose mucus is part of our immune system's response to the virus, so it should not be considered a bad thing even though it is uncomfortable. For this reason, overuse of decongestants may delay recovery. Babies however, can't blow their nose, so when they are congested they can't suck or sleep. Gravity can help, so put your baby in a car seat to sleep. Using a rubber-bulb syringe to gently suction the mucus out of the baby's nose a few seconds after using saline nose drops is another idea. Colds are caused by viruses, so antibiotics will not work. If your child is showing no improvement in a week, see your doctor to rule out anything more serious.
Wingert WE et al. Possible role of pseudoephedrine and other over-the-counter cold medications in the deaths of very young children. J Forensic Sci. 2007 Mar;52(2):487-90.
Centers for Disease Control and Prevention Infant deaths associated with cough and cold medications–two States, 2005. MMWR Morb Mortal Wkly Rep. 2007 Jan 12;56(1):1-4.
Carr BC Efficacy, abuse, and toxicity of over-the-counter cough and cold medicines in the pediatric population Curr Opin Pediatr. 2006 Apr;18(2):184-8.
Paul IM et al. Effect of honey, dextromethorphan, and no treatment on nocturnal cough and sleep quality for coughing children and their parents. Arch Pediatr Adolesc Med. 2007 Dec;161(12):1140-6.
Paul IM et al. Effect of dextromethorphan, diphenhydramine, and placebo on nocturnal cough and sleep quality for coughing children and their parents. Pediatrics. 2004 Jul;114(1):e85-90.
Yoder KE et al. Child assessment of dextromethorphan, diphenhydramine, and placebo for nocturnal cough due to upper respiratory infection. Clin Pediatr (Phila). 2006 Sep;45(7):633-40.
Mitchell JL. Use of cough and cold preparations during breastfeeding. J Hum Lact. 1999 Dec;15(4):347-9.
Schroeder K, Fahey T. Over-the-counter medications for acute cough in children and adults in ambulatory settings. Cochrane Database Syst Rev. 2004 Oct 18;(4):CD001831.
Schroeder K, Fahey T. Should we advise parents to administer over the counter cough medicines for acute cough? Systematic review of randomised controlled trials. Arch Dis Child 2002 Mar;86(3):170-5.
Arroll B. Non-antibiotic treatments for upper-respiratory tract infections (common cold) Respir Med. 2005 Dec;99(12):1477-84.
Simasek M, Blandino DA Treatment of the common cold Am Fam Physician. 2007 Feb 15;75(4):515-20.
Miorin PL et al. Antibacterial activity of honey and propolis from Apis mellifera and Tetragonisca angustula against Staphylococcus aureus J Appl Microbiol. 2003;95(5):913-20.
Postoienko VO et al. Antimicrobial properties of bee preparations in ointment form Mikrobiol Z. 2004 Nov-Dec;66(6):53-7
Lusby PE et al. Honey: a potent agent for wound healing? J Wound Ostomy Continence Nurs. 2002 Nov;29(6):295-300.
Copyright 2007 Vreni Gurd