How Effective are Children's Cough and Cold Medicines?

‘Tis the season for spreading germs, which means your little one could be coming home from school at any moment with a hacking cough and a runny nose. So what should you give them to relieve their cold symptoms?

Well, the first thing you should do is skip all those over-the-counter children’s cough and cold medicines, according to one expert.

“These medicines can do more harm than good,” Dr. Tamara R. Kuittinen, Director of Medical Education at the Department of Emergency Medicine at Lenox Hill Hospital in New York City told “The ingredients in children’s cough and cold medications do not help. They are not effective, especially the decongestant, and part of it is because children’s anatomy is different. The risk margin is high.”

According to the American Academy of Pediatrics (AAP), over-the-counter cough and cold medications should not be given to infants and children younger than 2 years “because of the risk of life-threatening side effects.” The AAP also points to the fact that several studies show that cold and cough products “don't work in children younger than 6 years and can have potentially serious side effects.”

Some of the common active ingredients found in children’s cough and cold medicines include:

Chlorpheniramine: This is in a class of medications called antihistamines, which are commonly used to relieve itchy, watery eyes, sneezing and runny nose caused by allergies, hay fever, and the common cold.

Dextromethorphan: This is used to temporarily relieve cough caused by the common cold or the flu. It will relieve a cough but will not treat the cause of the cough or offer speed recovery, according to the National Institutes of Health. Dextromethorphan is in a class of medications called antitussives.

(NOTE: At high doses, dextromethorphan acts as a dissociative hallucinogen, which is a form of narcotic.)

Acetaminophen (Tylenol): This is a common pain reliever/fever reducer that belongs to a class of medications called analgesics and antipyretics. It’s used to relieve mild to moderate pain, colds and sore throats and to reduce fevers.

Phenylephrine: This is used to relieve nasal discomfort caused by colds, allergies and hay fever. It is also used to relieve sinus congestion and pressure. And while phenylephrine will relieve symptoms, it does not treat the cause of the symptoms or speed recovery. Phenylephrine is in a class of medications called nasal decongestants.

Kuittinen said the only two medicines you should be giving your child, up to the age of 6, are children’s acetaminophen and children’s ibuprofen.

“Ibuprofen and acetaminophen are helpful for dealing with body aches, fever and flu symptoms – especially if taken properly,” she said. “Children’s acetaminophen liquid medication should be taken every four hours and children’s ibuprofen should be taken every six hours. Once kids get rid of these symptoms, they should start to feel better.”

When you’re giving your child these medicines, Kuittinen suggests buying an oral syringe or dropper at your local pharmacy to make sure you get the exact dosage right, which is based on age and weight and, of course, always read the product labels very carefully.

“Also, having a humidifier in their room is very helpful,” said Kuittinen, who’s a mother of three small children. “Make sure you clean it every other day and it’s also important to keep children well hydrated.”

If nothing works, and you’re child is not feeling better in a few days, don’t be afraid to reach out for help.

“If the high fever is not going away seek medical care immediately,” Kuittinen said, “Never hesitate to go to your doctor.”

And once that fever subsides, remember children should stay home, fever-free, for at least 24 hours before returning to school.

“The bottom line – stay away from children’s over-the-counter cough and cold medicines. The American Academy of Pediatrics and the Food and Drug Administration tells us in children younger than 6, these medications could do more harm than good,” Kuittinen added.

In fact, removing cough and cold medicines for very young children from store shelves led to a big decline in emergency room visits for bad reactions to the drugs, according to a recent study that appeared in the journal Pediatrics.

Dr. Jordan S. Josephson, an Ear, Nose and Throat specialist at Lenox Hill Hospital in New York City and author of “Sinus Relief Now,” also suggests some alternative methods, especially when it comes to kids and sinus infections.

“Sinus irrigation is great for kids,” he told “You can use a saline mist or a neti pot, and various other things for kids, such as a Hydro Pulse Sinus irrigation system. These are products that kids can use to decrease amount of infections they get.”

Josephson said if the infection doesn’t clear up in five days, it’s time to make an appointment with a doctor.

But in the meantime, he said kids should use a lot of hand wipes and make sure they wash their hands after blowing their nose. By doing these simple things, both kids and parents can avoid getting sick this season.