Parents have been hot recently asking me what they can do for their young children’s colds now that over-the-counter cough and cold medicines are no longer recommended for children under 2 and have not really been found to be that effective in children under 6.  So this week, let me put everyone in the nose as to how to treat your child’s cough and cold symptoms safely.

Before I do that, it is important to recognize the reasons why over-the-counter medicines have been pulled off the market for infants and toddlers.

  • There are no good studies on how to dose these medicines in younger children
  • There are no good studies that suggest they work in this age group
  • There are good studies suggesting that the side effects – if overdosed or taken accidentally – can be quite severe such as hallucinations, irritability, and irregular heartbeats that can be fatal.

So what can we do?  Well, since most common infections that cause cold and cough are due to viruses, and viruses get better with time, my best suggestion is to ride out those cold symptoms with some rest and plenty of fluids.  If you want to clean out a stuffy nose, consider a cool mist humidifier to loosen-up some of the congestion as well as saltwater nose drops for the nostrils which can also help loosen-up the mucus or snot.  You can make the drops by putting a teaspoon of salt in 8 ounces of water. Put a few drops in one nostril at a time, let them sit for 3-4 minutes and then clean out that  nostril with a suction bulb and repeat the sequence for the other nostril before your infant eats or before sleep.

When do we worry that a cold may be more than just a cold? If you find that your child is not getting better with their cold after a few days, has a high fever, persistent cough or wheezing, difficulty breathing, or you are just concerned, then speak to your child’s doctor who will probably want to see your child and make sure they don’t have an infection that might require a prescription antibiotic, or a form of asthma that will require other prescription medications. And if you want to prevent a cold, the name of the game is not over the counter cough and cold medicines, but good hand washing and avoiding exposure to second hand smoke.

Hopefully, tips like this will help tell you what is and is snot recommended when it comes to treating your child’s cold without those over-the-counter decongestants.

Lewis First, M.D., is chief of Pediatrics at The University of Vermont Children’s Hospital at the University of Vermont Medical Center and chair of the Department of Pediatrics at the Larner College of Medicine at UVM. You can also catch “First with Kids” weekly on WOKO 98.9FM and WPTZ Channel 5, or visit the First with Kids video archives.


Lewis First, MD, is chief of Pediatrics at The University of Vermont Children’s Hospital and chair of the Department of Pediatrics at the Robert Larner, M.D. College of Medicine at the University of Vermont.

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