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Cold Medicine and Children Under 2
Newsday
By Dr. Marc Siegel
January 24, 2008
When my infant son is sick and crying with the fever, cough and runny nose of a cold, I, as a frantic parent, will do almost anything I can to make him (and therefore myself) feel better.
I'm not alone. The Food and Drug Administration, which issued a stern warning last week that infant cold medications should not be used for children younger than 2, is right to be more concerned about the frantic parent than it is about the medications themselves.
What am I supposed to do when my son wakes up in the middle of the night because his nose is too clogged to breathe? Cold medicines contain antihistamines, decongestants and cough suppressants, which haven't been proven to work for children this young but are difficult to study since infants can't say if they are feeling better. I, as a doctor and as a dad, believe they thin nasal secretions and make kids and babies more comfortable.
Still, before I reach for these active chemicals, I should make sure that my son is drinking fluids, that his temperature is normal and that I suction the mucus directly from his nose. Medically, these are the most important measures a parent can take. I should also call my son's pediatrician at the first sign of trouble, before I reach sleepily for a remedy that, even if it works, can't cure a cold.
Approximately 3.8 billion doses of cold medicines are given to kids in the United States every year. From 2004 to 2005, 1,500 infants were brought to emergency rooms as a result, and three died. That's a very small percentage of those kids who received these treatments - except when you consider that the cold isn't curable, so no treatment is essential. And almost all of the 1,500 were in the emergency room because of improper use of the medicine, rather than because of side effects intrinsic to the treatment.
Though I am a practicing physician, I'm no expert at shooting the contents of a medical dropper into a screaming moving target, especially my own child. I can only imagine how this is for a parent who has never handled a syringe - and, in fact, many parents wrongly substitute spoons. Add to that the number of parents who can't calculate a dose properly in the emotions of the moment, or who mix two cold medicines with similar ingredients or misuse a remedy intended for an older child. You can see why the FDA is worried.
Last week's warning follows an FDA advisory committee's report back in the fall, which also cautioned against giving over-the-counter cold medicines to children younger than 2. Nevertheless, a survey released last month by National Public Radio, the Kaiser Family Foundation and the Harvard School of Public Health found that a majority of Americans are still confident in the safety of children's over-the-counter drugs, and 64 percent think they are safe for children younger than 2.
Half of those surveyed still believe that consumers, in consultation with their doctors, should decide for themselves whether over-the-counter treatments are effective, rather than relying on FDA guidelines. Most parents surveyed believed that the drugs had been well tested for safety and effectiveness, which is not the case.
But the real issue isn't whether these medicines help or not. While that remains unproven, the common cold remains incurable regardless. We parents should be reaching for more medically proven methods before groping in the night for oversized spoons so that we ourselves can sleep. The FDA is right to save us from ourselves. |
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