Cough Medicine For Kids: Safety, Side Effects & Precautions

check_icon Research-backed

Image: Shutterstock

IN THIS ARTICLE

There is an ongoing debate about whether or not cough medicines for kids are safe. The over-the-counter medications prescribed for cough in children provide symptomatic relief against its symptoms. Cough is a symptom of the common cold caused by rhinoviruses. A few other causes of cough include parainfluenza virus infection (barking cough or croup), asthma, and allergies. Cough helps in expelling the excess mucus produced by the body in response to an infection and protecting the lungs. The cough can be productive, chesty, and with phlegm, or dry and without any phlegm (1) (2). However, antibiotics are meant to treat bacterial diseases and are ineffective against cough caused due to viral infections (1).

The below post discusses the types of cough medicines for kids, their use, side effects, and alternative medicines to manage the cough.

Safety Of Cough Medicines In Children

Coughs due to common cold may not need medicines, and children get better after one or two weeks. Keeping in mind the adverse effects of cough and cold medications, various countries’ governments and medical bodies have laid down instructions for their safe use among children.

  • The US Food and Drug Administration (FDA) disapproves of the use of OTC or prescription medicines for cough and cold in children younger than two years. FDA restricts the use of products containing codeine or pholcodine for those younger than 18 years (1).
  • The American Academy of Pediatrics (AAP) does not recommend OTC cough medications for children younger than four years. The academy advises consulting a registered medical practitioner for the administration of cough medicines for children between four and six years.
  • The Consumer Healthcare Products Association (CHPA) mandates labeling instructions saying not to use cough and cold medications in children younger than four years (3) (4).
  • The Government of the UK approves the use of OTC cough and cold medicines only in children older than six years (5).

Cough Medications For Children

Cough often follows the common cold in children who have a sore throat, congestion, fever, runny nose, and body aches as well. Most of the medications for cough are available OTC and contain more than one ingredient to address multiple symptoms.

The table below may help you identify appropriate cough medicines for children (2) (6) (7)

Class of medicationActive IngredientsFunctionBrand namesRemarks
Cough SuppressantDextromethorphanReduces severity of dry coughDelsymUsed for dry cough
ExpectorantGuaifenesinHelps loosen phlegm or mucus so that it comes out easilyLittle Remedies, Mucinex, RobitussinFor productive cough
AntihistamineChlorpheniramine, Brompheniramine, Diphenhydramine, CetirizinRelief from allergiesBenadryl, Dimetapp
Zyrtec
May cause drowsiness

Other medications available only on prescription from a registered medical practitioner include:

  • Corticosteroids and nebulized adrenaline (administered via a mask) if your child is diagnosed with croup (8)
  • Bronchodilators, inhalant corticosteroids, and leukotriene modifiers if cough is due to asthma (9)

Side Effects Of Cough Medicines In Children

Most side effects of cough medicines in children are due to overdosing caused by using more than one OTC product that may contain overlapping ingredients. These adverse effects include (10):

  • Drowsiness
  • Restlessness
  • Increased or altered heart rate
  • Allergic reactions
  • Shallow breathing
  • Seizures
  • Hallucination
  • Nausea
  • Headache

Drowsiness or sleepiness is the most common side effect of OTC cough and cold medications. However, you should consult a pediatrician if it is very severe or any of the other side effects appear.

Precautions To Be Taken

It is best to consult a healthcare provider before treating your child with any OTC cough preparation, especially when they are already on any other medication. Below are some precautions you must follow when administering a cough remedy to the child (11) (12).

  • Make sure you buy a cough preparation meant for children and not for adults. Adult medications may contain a higher dose of the medicine.
  • Aspirin should not be given to children. It increases the risk of Reye’s syndrome, which causes inflammation in the liver and brain.
  • Read all the instructions in the packet insert and go through the list of active ingredients in the product.
  • Give the correct dose as mentioned in the packet insert or as directed by the physician. Use the calibrated dropper or graduated cup provided with the product instead of regular spoons.
  • Avoid using more than one OTC cough remedy for your child. These often contain mixtures of ingredients, which may result in double-dosing.
  • Consult a doctor if symptoms do not improve, become severe, or persist after two weeks.
  • Keep all medications out of your child’s reach to avoid accidental overdosing.

Alternative Ways To Relieve Cough In Children

OTC medications should not be the first approach if your child has a cough and cold. These medications are incapable of altering the course of the viral infection, which gets resolved on their own in a week or two. Therefore, you may use several home remedies to ease the discomfort of your child (13).

  • Ensure proper rest for the child. It helps in the healing process.
  • Give your child plenty of fluids such as warm soups or juices, or plain water. Staying hydrated keeps the body fluids from thickening, making it easier to cough out.
  • Honey can be given to children older than one year to loosen the mucus (a spoonful of honey in warm water). It eases nighttime coughing.
  • Use saline (salt water) drops or sprays if the child has a stuffy nose.
  • Use a cool-mist humidifier in your child’s room. It helps in reducing swelling in the nasal passages and keeping the mucus thin. Make sure to clean out and dry the humidifier to avoid any bacterial or fungal growth.
  • A mix of menthol, camphor, and eucalyptus oil, such as found Vicks VapoRub, applied topically on chest and throat, soothes cough temporarily and may help children sleep well (14).
  • Cough drops (throat lozenges or hard candy) may be given to reduce itchiness in the throat. It should be avoided in children under six years due to the risk of accidental choking.
  • Do not expose your child to secondhand smoke.

If your child is not much bothered with the cough and can play and sleep, then cough medicines are not required. They should be used when the discomfort is keeping your child awake at night or hampering normal activities. OTC cough medications should be used carefully and preferably with a doctor’s consultation to avoid any complications and side effects.

Key Pointers

  • According to FDA, OTC medicines for cough and cold should not be used in children younger than two.
  • Overdosing or overlapping cough drugs can cause drowsiness, restlessness, allergic reactions, seizures, and hallucinations, among other side effects.
  • Home remedies such as humidifiers, adequate hydration, nasal saline sprays, and proper rest may help alleviate cough symptoms.

References:

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
  1. When to Give Kids Medicine for Coughs and Colds.
    https://www.fda.gov/consumers/consumer-updates/when-give-kids-medicine-coughs-and-colds
  2. Cough, Cold & Flu.
    https://www.knowyourotcs.org/symptom/cough-cold-and-flu/
  3. Leslie A. Briars, The Latest Update on Over-the-Counter Cough and Cold Product Use in Children.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3461939/
  4. Program on OTC Oral Pediatric Cough and Cold Medicines.
    https://www.chpa.org/public-policy-regulatory/voluntary-codes-guidelines/program-otc-oral-pediatric-cough-and-cold
  5. Over-the-counter cough and cold medicines for children.
    https://www.gov.uk/drug-safety-update/over-the-counter-cough-and-cold-medicines-for-children
  6. Medicines for Cough and Common Cold in Children.
    https://www.drugoffice.gov.hk/eps/do/en/consumer/news_informations/dm_36.html#a
  7. Cough And Cold Medicine Over-The-Counter (OTC).
    https://www.nationwidechildrens.org/family-resources-education/health-wellness-and-safety-resources/helping-hands/cough-and-cold-medicine-over-the-counter-otc
  8. Candice L. Bjornson and David W. Johnson, Croup in children.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3796596/
  9. Rebecca Chu and Puneet Bajaj, Asthma Medication in Children.
    https://www.ncbi.nlm.nih.gov/books/NBK441823/
  10. Cough and cold medicines for children – changes.
    https://www.tga.gov.au/behind-news/cough-and-cold-medicines-children-changes
  11. Use Caution When Giving Cough and Cold Products to Kids.
    https://www.fda.gov/drugs/special-features/use-caution-when-giving-cough-and-cold-products-kids
  12. Part 341 – cold, cough, allergy, bronchodilator, and antiasthmatic drug products for over-the-counter human use.
    https://www.ecfr.gov/current/title-21/chapter-I/subchapter-D/part-341
  13. Coughs: Meds or home remedies?
    https://www.seattlechildrens.org/conditions/a-z/coughs-meds-or-home-remedies/
  14. Vicks Vaporub childrens (camphor- synthetic, eucalyptus oil, and menthol ointment.
    https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=52a235a6-5065-663f-e054-00144ff88e88
The following two tabs change content below.

Dr. Dur Afshar Agha

(MS)
Dr. Dur Afshar Agha is a consultant pediatrician with decades of experience in various medical facilities both in Pakistan and Saudi Arabia. She has headed the Department of Preventive Pediatrics at the prestigious, Children’s Hospital and Institute of Child Health in Pakistan and is a life member of the Pakistan Paediatric Association. She has also completed her Post Graduate Program... more

Dr. Joyani Das

Dr. Joyani Das is a PhD in Pharmacology with over two years of experience in academics. Previously, she worked as an associate professor, faculty of Pharmacology. With her research background in preclinical studies and a zeal for scientific writing, she joined MomJunction as a health writer. Her research work was published in international journals and publications, such as Elsevier, Current... more