Choosing Cold Medicine for Your Child

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When your child has a cold, you want to help him feel better as quickly as possible. But figuring out which medication to use can be confusing. Pharmacy shelves are stocked with liquids and pills of all different colors, each promising to ease the discomfort of a cold and cough. Yet the Food and Drug Administration (FDA) has called for caution. Over-the-counter (OTC) cough and cold products are no longer recommended for children under the age of four, and the FDA says that kids between the ages of four and six should only take them if recommended by a doctor.

Children’s still-developing bodies process medication differently than adult bodies. The FDA recommendations (which are also endorsed by the American Academy of Pediatrics) are an attempt to spare children from unnecessary and potentially harmful medication-related side effects. Your child doesn’t have to suffer, though. Here’s a symptom-by-symptom guide to age-appropriate cold medications:

Infant to Age 2

Do not give any OTC cold or cough medication. Manufacturers removed the specially formulated infant cold and cough medications from the shelves years ago, after the FDA’s recommendation, due to the high potential of unintended overdose. (Infant medications were often super-concentrated, so giving a little bit too much could result in an overdose.)

Never give infants and small children small doses of the cough and cold medications currently on the market. The available medications have been tested and approved for use for in older kids and adults; they have not been proven to be safe, even in small doses, in young children.

For a cough

  • Under 3 months:  A minor cough is no big deal, but if your baby is sick and coughing, seek medical care. Your healthcare provider will assess your baby’s condition and give you specific recommendations for care.

  • 3 months to 1 year: Give small, frequent sips of warm, clear fluids. Try water, apple juice or chicken broth.

  • 1 to 2 years: Try honey. Honey soothes the throat, thins secretions and is proven to be more effective than OTC meds when it comes to easing a cough. Give ½ to 1 tsp. as needed, as often as necessary. Never give honey to a child younger than 12 months for risk of developing infant botulism.

For congestion

  • Nasal saline drops may ease congestion. For best results, instill a few drops into each nostril, then gently insert a bulb syringe to suction mucus from your child’s nose. 

  • Keeping your child upright can help. So can exposure to warm steam. Experienced parent tip: Strap your child securely into his car seat and bring him into the bathroom while you shower.

For a fever

You don’t need to treat a fever. But if your child seems uncomfortable, you can use acetaminophen (Tylenol®) or ibuprofen (Motrin ®, Advil®) to bring the fever down. Dosing is based on weight, so check with your child’s physician or pharmacist to determine the appropriate dose.

Ages 4 to 6

Only use OTC cough and cold medication if recommended by a physician Otherwise, try the cough, congestion and fever remedies listed above.

Age 6 and Up

Good news! By age six, most kids can blow their own noses— and that fact alone makes managing colds much easier! You can also now use over-the-counter medication to ease your child’s cough and cold symptoms.

For a cough

Warm liquids and honey work for older kids too! Cough drops (and hard candy) can also be used to ease coughs.

OTC cough medicines can be divided into two main categories: suppressants  and expectorants:

  • Suppressants suppress the urge to cough. Use a cough suppressant if your child’s cough is keeping her from a good night’s sleep or otherwise interfering with her ability to function. Look for the words “anti-tussive” or “dextromethorphan” on the label, sometimes represented in the name as “tuss” or “DM.”

  • Expectorants thin mucus, making it easier for your child to cough it up. The most common expectorant ingredient in OTC cough meds is guaifenesin. Reach for an expectorant if your child seems to have a deep chest cough that doesn’t seem to ease or relieve chest congestion.

For congestion

Two types of medication target stuffy, runny noses:

  • Antihistamines aren’t usually helpful for cold symptoms. Antihistamine medication is most helpful for allergy-related runny noses. The most common side effect of an antihistamine is drowsiness. Antihistamine ID tip: look for “-ine” in the ingredient list. Common antihistamine medications include diphenhydramine, cetirizine and loratadine.

  • Decongestants relieve nasal congestion by decreasing blood flow to swollen nasal tissues. Decongestant medication comes in nasal spray, liquid and pill form. The two most common decongestant ingredients in OTC cough and cold pills are phenylephrine and pseudoephedrine. Meds that include phenylephrine can be found on store shelves. Medications that contain pseudoephedrine are kept behind the pharmacy counter because some criminals have used pseudoephedrine-containing medications to manufacture the illegal drug, meth. Used as directed, however, the medication is safe and effective. The most common side effects of decongestant medication is jitteriness and sleeplessness.

For a fever

You can use acetaminophen (Tylenol®) or ibuprofen (Motrin ®, Advil®) to bring your child’s fever down. Follow the dosing instructions on the package, or follow the instructions given by your healthcare provider.

A word about combination medications

The cold and flu aisle is full of combination medications—medicines that contain more than one active ingredient and are designed to treat a variety of cold symptoms. Combination medicines can be great if you’re trying to treat more than one symptom at once–say, a cough and congestion. If you decide to use a combination medicine, carefully read labels and choose a medication that only contains the ingredients your child needs.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Aug 8
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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