How Good Are Children’s Cold Medicines?

Americans spend billions each year on cough and cold remedies. Much of that money is wasted. Many products on drug store shelves are ineffective, but don’t tell Dr. Mom that. It will just make her mad.
When a child comes down with a runny nose because of a cold or has a nasty cough that is keeping her awake at night, parents want to do something–anything–to make the child better. Many adults remember their mothers giving them honey and lemon to ease a cough or spreading Vicks VapoRub on their chests when they had congestion. Those old simple remedies communicated love and concern as much as anything.
Today parents are just as committed to helping a sick child. Instead of considering simple approaches, though, we are seduced by commercials encouraging us to buy a variety of multi-symptom cold and cough preparations. But are they any better than mom’s old-fashioned solutions?
A study published in Pediatrics last summer (July 2004) found that the two main ingredients in OTC cough medicine, dextromethorphan and diphenhydramine, were no better at easing children’s coughs than a placebo syrup.
According to the lead author, Ian Paul, MD, assistant professor of pediatrics at Penn State Hershey Medical Center, “one of the conclusions you could come to from the results of our study is that these medicines don’t work [for kids]. And in fact this is what evidence-based reviews of the medical literature have found before, that the existing evidence doesn’t support the use of these medicines for acute cough due to a cold.”
Such medicines are not without risk, however. According to Dr. Paul, the children who received the standard ingredient in most cough medicine, dextromethorphan (DM), had a harder time falling asleep. That’s the last thing an anxious parent wants for a sick kid.
Conventional cough syrups are not the only cold remedies that have come up short in studies on children. The herb Echinacea has also been found ineffective in children, despite some studies showing benefit in adults.
Doctors are also rethinking the old recommendation to give a sick child plenty of fluids. Some parents may overdo this advice, believing that the more juice or soda a child drinks, the better. But a review in the British Medical Journal (Feb. 28, 2004) cautions that the practice of giving extra fluids to patients with respiratory infections is not backed up by research, and might have undesirable effects in some cases. The researchers recommend allowing a child’s own sense of thirst to guide how much fluid they are given while they are ill.
What recommendation holds up for colds? It is hard to go wrong with chicken soup, recommended by grandmothers around the world. It can make the sufferer feel better and communicate comfort and love.
For readers of this column, we have prepared a Guide to Cold Remedies with other approaches to relieving cold symptoms, including our favorite recipe for chicken soup and herbs to boost the immune system. Anyone who would like a copy, please send $2 in check or money order with a long (no. 10) stamped (60 cents), self-addressed envelope: Graedons’ People’s Pharmacy, No. Q-20, P. O. Box 52027, Durham, NC 27717-2027.