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Going to the pharmacy to find an over-the-counter medication to help your child’s cough and cold symptoms can be overwhelming. There are so many choices and combinations! It can be confusing to decide which medication to choose because there are many available for the symptomatic treatment of discomfort, pain, cough, colds, and congestion. We would like to help you wade through the confusion!
The two most commonly used medications used for pain, discomfort, and irritability are acetaminophen (ex. Tylenol, Tempra) and ibuprofen (ex. Advil, Motrin). This group of medications provides relief from common aches and pains that may be associated with situations such as viral illnesses, teething, muscle stress or strain, headache, and menstrual cramping. Medication doses for these groups of medications are based primarily on your child’s weight. Acetaminophen can be given every 4 to 6 hours with no more than 5 doses in a 24-hour period. Ibuprofen can be given every 6 to 8 hours with no more than 4 doses in a 24-hour period.
Acetaminophen and ibuprofen come in infant drops, children’s’ suspension, chewable tabs, junior caplets, and adult tablets. It is very important to pay attention to what form and concentration of the medication you are using in order to avoid giving your child too much medication. The most common side effect of these medications is an upset stomach. Although aspirin was used in the past for pain and discomfort, it is not recommend for use in children because of the potential of the child to get a severe liver condition called Reye’s Syndrome.
Acetaminophen and ibuprofen will also reduce your child’s fever. However, remember that fever serves several useful functions. Fever usually indicates that your child has an infection. Also, it is the body’s natural defense mechanism and helps to fight infection because bacteria and viruses do not reproduce as well in a warmer environment. Therefore, if your child is happy and playful but is running a fever, you do not have to give them medication to treat the fever. However, if your child is uncomfortable at any time during the febrile illness, then giving the acetaminophen or ibuprofen for discomfort is appropriate. Do not hesitate to contact your primary care physician who will be glad to see your child to help determine the source of the febrile illness.
Runny noses are common in children and may be caused by upper respiratory tract infections or allergies. Post-nasal drip is a common cause of childhood cough. It is particularly worse at night. Antihistamines such as diphenhydramine (ex. Children’s Benadryl Allergy) and chlorpheniramine (ex. Triaminic Cold and Allergy Softchews) dry up nasal secretions and stop cough associated with post-nasal drip. They also are helpful with temporary relief of sneezing, itching of the nose or throat, and itchy, watery eyes. The main side effect of antihistamines is sleepiness, so they are effective medications to use for nighttime cough. Antihistamine doses are also based on weight, and may be given every 4 to 6 hours as needed. Do not exceed 5 doses in 24 hours.
Nasal congestion is a common problem for children resulting in thick nasal secretions. Weather changes, colds, or allergies can cause nasal congestion. Babies will often have problems with congestion because they are nasal breathers and do not breathe out of their mouths except when crying. Helping to clear the nasal secretions of newborns and infants can be done with saline nasal spray and a bulb suction.
The saline nasal spray is easy to use. First, turn the saline nasal spray bottle upside down and place two drops of saline into each of your child’s nostrils. Your baby will probably cry at doing this, but will be happy afterward! Wait one minute. The saline helps to loosen thick nasal mucous. Then use the bulb suction to aspirate out any secretions. Do not use the bulb more than 4 times in one day because overuse may irritate the inside of the nose and cause increased nasal drainage. Use the saline drops as much as needed, especially for nasal congestion deep in the back of the nose that is difficult to suction. Leaving in the drops will help to loosen secretions at the back of the nose and allow the baby to swallow them. This will be more effective than anything to relieve congestion in newborns and infants.
Pseudoephedrine (ex. Pediacare, Sudafed) is a common decongestant taken by mouth that is used alone or in combination with an antihistamine to help to decrease congestion. Side effects of pseudoephedrine include nervousness, dizziness, or sleepiness. It should not be used in children with heart disease, high blood pressure, or thyroid disease. It may also worsen symptoms of impulsivity and hyperactivity in children with Attention Deficit Hyperactivity Disorder. Medications containing pseudoephedrine may be given every 4 to 6 hours, but do not exceed 4 doses in 24 hours.
There are many different reasons for children to cough. Several common reasons include runny nose with post-nasal drip, wheezing, and respiratory irritation from viral respiratory illness. Runny nose and post-nasal drip are treated with antihistamines. Children who are wheezing will often have persistent cough often worse at night. They may have audible wheezing, increased breathing rate, poor feeding, and/or vomiting after coughing episodes. If your child has these symptoms or continues to have cough despite over the counter medications for several days, then contact your primary care physician.
Dextromethorphan is a common cough suppressant medication used in children. It may be found alone in some cough preparations or in combination with other medications. It may be combined with guaifenesin, an expectorant that will loosen chest secretions, a antihistamine, or a decongestant. These medications may be given every 4 to 6 hours with no more than 6 doses in a 24-hour period.
There are many over the counter medications from which to choose. Using a combination preparation is good if your child has multiple symptoms. However, if your child has only one symptom, try to find a preparation that contains only the medication needed to treat your child’s symptom. Generic preparations are the same as the brand name preparations. However, there is often a taste difference with the brand names having the better taste. Tables for dosing for the some commonly used over-the-counter medications are available. Just ask your primary care physician or pharmacist. You can overcome this over-the-counter confusion!
