‘Tis the season when mothers everywhere are faced with crusty, dripping noses and hacking coughs. When faced with a sick, miserable child, what’s a caregiver to do?

“The best treatment for colds is the most old-fashioned – get rest, drink plenty of fluids and use a humidifier,” said Dr. Carla Giannoni, otolaryngologist with Texas Children’s Hospital. “Fluids help mucus drain more quickly, and heated, moist air makes breathing easier, may ease a dry throat, and improves secretions.”

Colds are caused by viruses and are not cured by antibiotics. In fact, doctors are steering patients away from unnecessary antibiotic use since overuse leads to the development of bacteria resistant to the usual antibiotic treatments. Still, parents want to help relieve cold symptoms and to help their child be more comfortable, particularly at night. When rest, fluids and the humidifier don’t seem to bring enough relief, do over-the-counter (OTC) cold medicines work?

“Most children are not helped significantly by OTC preparations, but if you find one that is helpful for your child then it is safe to use,” said Dr. Giannoni. Texas Children’s offers these tips for smart use of OTC cold and allergy medicines:  

If You Want to Do This: Choose Medicine With This: Unclog a stuffy nose Nasal decongestant Loosen mucus to cough it up Expectorant Stop runny nose and sneezing Antihistamine Ease fever, headaches, minor aches and pains Pain Reliever (Analgesic)

 

Decongestants: Decongestants are most effective for the common cold if used for no more than two to three days to relieve symptoms. Decongestants should not be used in conjunction with antihistamines. Common side effects of decongestants include hyperactivity or sleeplessness, so avoid giving your child these medicines just before bedtime. A common brand is Sudafed^®.

Antihistamines: Over-the-counter versions are very effective for easing the symptoms of true allergies such as hay fever, and are less expensive than prescription formulas. Antihistamines are best used when symptoms are seasonal or intermittent. Because antihistamines often cause sleepiness, these drugs may affect school performance or a teen’s ability to drive. A common brand is Benadryl^®.

Cough expectorants: Look for one that contains the drug guaifenesin only. Ask your doctor for the amount you should give your child to equal the dose found in prescription drugs. Be sure that your child drinks plenty of fluids while taking an expectorant or it won’t work. A common brand name is Robitussin^®. 

Cough suppressants: Humidity and fluids are recommended to relieve a child’s cough rather than cough suppressants. 

Other suggestions for the use of OTC cold medicines include:

Buy “plain” drugs. Don’t buy OTC drugs that contain multiple medicines that will work at cross-purposes.  For instance, avoid expectorant/antihistamine and cough expectorant/cough suppressant combinations. 

Avoid double-dosing. Read labels so that you know whether an OTC drugs contains acetaminophen. If the drug you’ve chosen already contains acetaminophen, you don’t need to give your child an additional dose for fever or aches. Do not give aspirin or other salicylates to children or teen-agers. 

Buy generic. Generic drugs are more likely to contain only one ingredient and include exactly the same dose of medicine as branded OTCs.

Avoid misuse. Consult your pediatrician before giving any OTC drug to children under 2. In addition, educate yourself about which OTC medicines currently are popular with teens looking to get high. Ephedrine or dextromethorphan are two such drugs.

While OTCs cause few major side effects in children, time-honored home remedies such as hot water mixed with lemon and honey actually may be more effective.

“Fluids actually work better than some OTC medicines since the doses are so low,” said Dr. George Mallory, associate professor of pediatric pulmonology at Baylor College of Medicine, the training institution for many of Texas Children’s physicians. “In addition, OTC medications can be expensive, and there’s growing evidence that immunity in childhood is built by exposure to mild illnesses like colds.”

So, use OTC medications judiciously, then help your child get comfortable, stock up on some favorite (non-caffeinated) drinks, watch a video, read some stories, and let the cold run its course.