None of us want to see children feel miserable – for their sakes or for ours. We want remedies when they feel sick. In light of this, I am pleased with the decision of major pharmaceutical companies to withdraw their cough and cold medicines for children under 2 – it’s a good start. Even though these medicines have been given to millions of children, carefully controlled studies have not been able to show any benefit in typical children under age 6 – and in a small number of children they can have serious side effects.
Yes, many children do get better when they take decongestants, antihistamines, and chemical cough suppressants for coughs and colds, but on average they get the same amount of relief from taking a placebo.
Here are three take home lessons from this evolving story:
1. Don’t worry if your child has already taken some of these medications. The concerning side effects would have already happened if they were going to occur.
2. It’s better to prevent colds than to treat them. Colds are more common in early childhood than at any other time. Children average about 3 to 8 colds a year. Getting a few colds is probably good for the developing immune system, but clean hands and several other steps can help reduce extra colds.
3. Young children can’t get pregnant. Before puberty, the hormonal environment within children’s bodies is vastly different than the hormonal environment in ours. Children’s bodies are set in the rapid growth and development mode. Young adults are in the maintain and reproduce mode. Medicines that work well, or are harmful, for one group may not be for the other. Nevertheless, the doses for many common cough and cold medicines were set by just starting with adult doses and reducing them according to children’s smaller size. It turns out, this often does not work.
Children deserve treatments where their benefit and safety has been carefully considered. I am hopeful that the gap on store shelves will spur innovation and good science on children’s behalf. In the meantime, stay tuned for the latest on how to help when your child does have a cold.