Children's cough and cold medications: FAQ

Health Canada recently finished its review of the effectiveness and safety of cough and cold medications for children under the age of 12. Their conclusion? These popular products for the cold season should not be used by children under 6 years of age. So what does this mean? Here are answers to some frequently asked questions.

Why has Health Canada decided that children under 6 should not use cough and cold medications?

Non-prescription, or over-the-counter, cough and cold medications have been used by children for a long time, but there is limited evidence supporting the effectiveness of these medications in children. Health Canada made its decision based on many factors:

• For many years, it was assumed that cough and cold medications worked the same way in children as they do in adults, but now there is an understanding that these products work differently and may not be effective in children.
• There have also been reports of misuse, overdose, and side effects in children under 6 years of age who use cough and cold medications. The side effects are rare but serious, and include seizures, decreased levels of consciousness, hallucinations, increased heart rate, and abnormal heart rhythms.
• Canadian and international health professionals and experts recommend not to use these products in children under 6.
• Children under 6 years generally have more colds than older children, so they are more likely to be exposed to whatever health risks these medications may bring.
• Children under 6 years may not be able to communicate side effects they are feeling or ask their parents or caregivers for help as well as an older child can.

What is Health Canada doing to ensure the safety of our children?

In 2008, Health Canada mandated manufacturers to re-label non-prescription cough and cold medications that have dosing information for children to include the statement "Do not give to children under 6." These medications also require better labelling for children 6 to 12 years, childproof packaging, and inclusion of a dosing device (such as a measuring cup or spoon) for all liquid forms. Manufacturers had until fall 2009 to comply with the re-labelling requirements. Now, all cough and cold products comply with the standards set out by Health Canada and those that do not have been removed from the market.

What about children over 6 years old?

Children older than 6 years old can try over-the-counter cough and cold medications, keeping a few things in mind:

• Always follow the instructions on the package carefully, including dosing information and how long to use the medication.
• Do not give your child more than one kind of cough and cold medication, as this can lead to problems such as overdose.
• Ask a health care provider such as your doctor or pharmacist which cough and cold medication would be most appropriate for your child's symptoms.

My child has taken cough and cold products in the past. Are they at risk?

No. There is no evidence to show that children who have taken these medications in the past are at risk. The risk to children is only at the time of use.

What can I do if I have already purchased a children's cough and cold product?

People may have some cough and cold products with the old labelling in their home already. Parents and caregivers should talk to a health care provider such as a pharmacist or doctor before using these products. These medications can still be used by adults and children 6 and over but not for children under 6. If you will not be using the medication, dispose of the product by returning it to your pharmacy if they have a disposal program in place.

What can I give my child if they have a cough or cold?

The common cold does not have a cure. The cough and cold medications available are for treating the symptoms only. For children under 6 (and for anyone who has a cold), here are a few ways to get some relief from symptoms:

• Get plenty of rest.
• Drink lots of fluids, such as water, unsweetened juice, or clear soup.
• Clear nasal passage by blowing the nose or using nasal saline drops or solution, which can be purchased over the counter or made at home by mixing ¼ to ½ teaspoon of table salt and a pinch of baking soda into 8 ounces of tap water (use within 24 hours).
• Use a cool-mist humidifier or vapourizer to keep the air moist to relieve cough and congestion.
• Help ease nasal congestion with a warm bath or hot shower.
• Soothe a sore throat by gargling with warm salt water

Keep in mind that symptoms will usually go away in about 6 to 10 days. If they don't, if symptoms worsen, or if your child appears sick and you are worried, consult a health care provider.