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Cold and Flu Medications for Kids

When a child is sick, many parents turn to over-the-counter (OTC) medications to help reduce cold or flu symptoms. OTC medications may help make your child feel better, but they will not make the illness go away faster. A cold or flu will usually resolve on its own within one or two weeks. The following explains how to choose and administer an OTC cold or flu medication for your child.

When should you not give your child an OTC medication?
According to the FDA, children younger than 2 years old should not receive OTC cold, cough, or flu medications unless a parent has talked to a doctor. OTC medications have different minimum ages, so always check the Drug Facts label to see if a product is recommended for your child’s age. In general, OTC treatment should not be used without consulting your pediatrician if your child experiences symptoms lasting longer than a week, has a fever for greater than two or three days, or has severe ear pain.

How do you select the right product for your child?
Many OTC products contain multiple active ingredients that may not all be necessary for your child’s current symptoms. It is best to choose a product with a single active ingredient that targets your child’s most bothersome symptom(s). Look at the medication’s Drug Facts label to find specific information about the product’s ingredients and uses. Check out “How to Read an Over-the-Counter Medication Label” for additional details. The most common cold and flu symptoms include the following:

  • Stuffy nose: Decongestant products made specifically for children are available. Pseudoephedrine (Sudafed), which is stored behind the pharmacy counter, and phenylephrine (Sudafed PE) may be given to children at least 4 years old. Oxymetazoline (Afrin) is a nasal spray for children at least 6 years old. Nasal formulations should not be used for more than three days. Saline (saltwater) drops/spray do not contain medication and are safe for all ages, including newborns and infants.
  • Fever: Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) may be given to reduce fever. These medications are dosed by weight. Parents should check with a doctor before giving these medications to children under 2 years old. Aspirin should not be given to any child younger than 18 years old because it has been linked to a potentially fatal illness called Reye’s syndrome.
  • Cough: Dextromethorphan (Robitussin, Delsym) and guaifenesin (Mucinex) may be given to children who are at least 4 years old. Honey is a home remedy that may be given to children at least 1 year old.
  • Sore throat: Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) are effective for reducing throat pain.

Herbal and alternative cold products such as vitamin C (Emergen-C, Airborne) or zinc (Zicam) are not recommended for use in children. If your child is younger than 2 years old, talk to your doctor before giving them an OTC product.

What is the correct dose of an OTC medication for your child?
Check the Directions section on the Drug Facts label for the proper dose and administration instructions. Give only the amount specified on the label.

Most liquid versions of OTC medications are packaged with a measuring device such as a medication cup or syringe. Ask your pharmacist for a suitable device if one is not provided. If the medication dose depends on your child’s weight, ask your pharmacist to calculate the correct dose and mark it on the measuring device.

Do OTC medications have any risks?
The biggest risk with OTC children’s medications is accidental overdose. If your child accidentally takes too much medication, call your local poison control center immediately. OTC medications may also cause side effects. If your child experiences new symptoms or symptoms do not improve in a week, stop the medication and call your pediatrician.

Are there non-medication therapies for treating a cold or the flu?
There are many things that you can do to make your child more comfortable, including the following:

  • Make sure your child gets plenty of rest.
  • Encourage your child to drink lots of fluids, especially warm liquids such as soup or tea.
  • Use a cool mist humidifier to help soothe a dry nose or throat.
  • Use nasal saline drops or spray to moisten the nose and thin out mucus.

Where can you find more information?
Ask your pharmacist if you are unsure about which product to give your child. Your pharmacist can recommend an appropriate product and advise you on how to give it.

By Clara Ting, Pharm.D. — PGY1 Pharmacy Resident, Brigham and Women’s Hospital, Boston