What to Know Before You Buy Children's Cold Medicines - Verywell Health

Children's cold medicines won't help your child get over a cold faster, but they can help ease their symptoms. There are a variety of cold medicines for kids, including cough suppressants, antihistamines, fever reducers, decongestants, and multi-symptom cold formulations that include more than one of these.

While a cold medicine may be labeled "for kids," that doesn't necessarily mean that it's safe for every kid. In addition, just because a child has a cold doesn't mean they need cold medicine.

This article explains when cold medicines for kids are helpful and what their limitations are. It also outlines the active ingredients used in different formulations, including their possible side effects and risks.

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When to Give Kids Cold Medicine

Colds need to "run their course," and children's cold and cough medicines don't make the process go any faster. They also won't keep a cold from turning into an ear infection, a sinus infection, or even a lung infection known as pneumonia.

Children's cold medicines are simply used for symptom relief and increased comfort. For example, you might choose to give your child one if:

• A cough is keeping them up at night
• A sore throat is making it painful to swallow
• A stuffy nose and headache are making it difficult to focus

It's up to you to determine whether more symptom relief could benefit your child or if some rest, patience, and TLC will suffice.

Warnings for Children Under Age 2

The Food and Drug Administration (FDA) does not recommend over-the-counter (OTC) cough or cold medications for kids under 2 years of age as they could cause "serious and potentially life-threatening side effects."

Possible risks of cold medicine use in babies and toddlers include:

Although the risk is dose-dependent, it can be extremely difficult to dose infants accurately. Accidental overdoses of OTC cold medicines have led to death in children under 2.

The Consumer Healthcare Products Association (CHPA), which represents the companies that make most cold medicines, expanded the FDA warning, advising against the use of OTC cough and cold medicines for children under 6.

A Word About Dosing

When using liquid medicines for kids, always measure the dose accurately with a measuring spoon or syringe. So not "eyeball" it.

Moreover, if cold medicine does not seem to be working, giving more will rarely make things better and may only increase the risk of severity of side effects. In general, if a cold medicine isn't helping after a few doses, stop using it.

Decongestants for Kids

Decongestants are medications that help relieve symptoms of a runny or stuffy nose. They include ingredients like phenylephrine and pseudoephedrine, which help open and dry nasal passages.

Decongestants formulated for kids include:

• Children's Mucinex Stuffy Nose & Cold
• Sudafed Children's Nasal Decongestant Liquid
  

When considering a decongestant, keep in mind that oral decongestants with the ingredient phenylephrine are not considered effective at clearing up congestion at recommended doses.

Among possible side effects, decongestants can make some children hyperactive or irritable. Less common side effects can include upset stomach, headache, and dizziness.

Decongestants should not be confused with expectorants used to loosen mucus. Products like these, many of which contain guaifenesin, have not been proven to be helpful in children with colds.

Cough Suppressants for Kids

If a cough is interfering with your child's sleep or daily activities—and there are no signs of breathing difficulties—a cough suppressant may be useful. The active ingredient in most OTC suppressants is dextromethorphan, which provides the temporary relief of dry (non-productive) coughs.

Since cold-related coughs are often triggered by post-nasal drip, a decongestant may be recommended alongside a cough suppressant.

There are several cough suppressants containing dextromethorphan that can be used in adults and children. These include:

• Delsym Extended-Release Suspension 12-Hour Cough Relief
• Mucinex DM
• Robitussin DM
• Triaminic Long-Acting Cough

Common side effects of these OTC drugs include drowsiness, dizziness, and nervousness. Some children may also experience nausea and an upset stomach.

Hydrocodone and codeine are opioid drugs sometimes used in prescription cough suppressants. The FDA advises against their use in children under 12 due to "potentially serious side effects, including slowed or difficult breathing."

Acetaminophen Use in Children

Acetaminophen, the active ingredient in Tylenol, can be extremely effective in relieving fever and pain in infants and children. There are different Tylenol products specifically formulated for children, including:

• Children's Tylenol Easy Dissolve Powder (for children ages 6-11 years)
• Children's Tylenol Fever & Sore Throat Pain Chewables (for children ages 2-11 years)
• Infants' Tylenol Drops (for babies 0-23 months)
• Infants' Tylenol  Fever & Sore Throat Pain (for babies 0-23 months)
• Children's Tylenol  Fever and Pain (for children ages 2-11 years)

Common side effects of acetaminophen in children include nausea, vomiting, and constipation.

Warning About Acetaminophen Overdosing

Acetaminophen can also be found in some OTC cold medicines for children, a fact that many parents are not aware of. In some cases, a parent may inadvertently overdose their child by giving them Children's Tylenol along with a dose of an acetaminophen-containing child's cold medicine, such as:

• Children's Mucinex Multi-Symptom Cold & Fever Liquid
  
• PediaCare Children Cough and Runny Nose Plus Acetaminophen
• PediaCare Children Flu Plus Acetaminophen

The same concerns apply when using an acetaminophen-containing cold medicine formulated for adults and children, such as:

• NyQuil Cold/Flu Relief
• Robitussin Severe Multi-Symptom Cough-Cold + Flu Nighttime
• Theraflu Day & Nighttime Severe Cold & Cough Relief Tea Packets
• Triaminic Cough & Sore Throat
• Triaminic Multi-Symptom Fever

An overdose of acetaminophen can lead to nausea, vomiting, diarrhea, profuse sweating, and stomach pain or cramps.

Antihistamines for Children

Antihistamines are commonly used to treat allergies. These work by blocking a chemical called histamine that triggers allergy symptoms.

Because histamine is not involved with colds, antihistamines will not provide symptom relief but can still be useful. This is because certain types of antihistamines, particularly first-generation antihistamines like diphenhydramine and carbinoxamine, can induce drowsiness and help children with colds sleep at night.

Among the children's medications that contain these antihistamines are:

• Dimetapp Children's Cold & Allergy Liquid
• Dimetapp Children's Nighttime Flu Syrup
• PediaCare NightRest Cough & Cold for Children

There are also antihistamine-containing medications formulated for adults and children, including:

• Benadryl Allergy Relief
• Triaminic Night Time Cold & Cough Syrup

In addition to drowsiness, antihistamines may cause side effects like dry mouth, constipation, nausea, headache, and chest congestion.

Multi-Symptom Cold Remedies

Colds commonly cause more than one symptom, including cough, nasal congestion, mild fever, and post-nasal drip. Because of this, a multi-symptom cough and cold medicine may be a reasonable option for certain kids.

Examples of children's multiple-symptom cold medications include:

• Dimetapp Children's Cold & Cough Elixir
• Little Colds Decongestant Plus Cough (non-drowsy)
• Vicks NyQuil Children's Cold, Cough Relief
• Vicks Pediatric 44M, Cough & Cold Relief

There are also multi-symptom cold medications formulated for adults and children, such as:

• Mucinex Cold & Cough
• Robitussin CF Alcohol-Free Cough Syrup (non-drowsy)
• Triaminic Day Time Cold & Cough (non-drowsy)
  

Choosing Cold Medicine for Kids

The best medicine for a child's cold is one that treats only the symptoms they have. If your child has a cough, use a cough suppressant. If they have a fever, use a fever reducer, and so on. Use these medications for only as long as needed.

This can reduce the risk of side effects that can intensify with each drug a child is exposed to.

If your child has more than one symptom, two medications or a multi-symptom remedy may be appropriate. Your healthcare provider can advise you if you're unsure about what to use.

Read Labels

Don't assume that all medications work for all kids. Read the product label to identify:

• The active ingredient(s) and what they are intended for
• How the drug is dosed
• What ages the medication is intended for

Remember that taking a multi-symptom medication with another medication that has a shared ingredient poses the risk of an overdose. Never do this unless directed by a healthcare professional.

Dosing Confusion

If your child doesn't match up with the dosing recommendations on a product label (for instance, if their age is used for one dose and their weight for another), speak with your child's pediatrician or a pharmacist.

Be Mindful of Health Conditions

Children with certain health conditions should not take certain cold medications as these could worsen their condition and/or increase their risk of side effects.

To be safe, speak with your child's pediatrician before using any OTC cold medication on children with any of the following health conditions:

Homeopathic or All-Natural Cold Remedies

Numerous natural and homeopathic remedies are sold over-the-counter for the treatment of colds. Proponents claim they can help shorten the length of a cold or prevent it entirely.

These include:

• Vitamin C: Some studies show that vitamin C may reduce the duration and severity of a cold, but healthcare providers warn against giving high doses of vitamin C to children as this can cause stomach upset and diarrhea.
• Zinc: Zinc lozenges and syrups are thought by some to shorten a cold, but there isn't much evidence to support their use in children. 
• Echinacea: Studies are mixed as to whether this herbal remedy can help reduce the duration and severity of a cold. It is not recommended for people with autoimmune diseases or those who are allergic to ragweed and certain flowers.

Supplements and homeopathic remedies are not stringently regulated by the FDA. To better ensure purity and safety, only buy those certified by independent certifying bodies like the U.S. Pharmacopeia (USP), ConsumerLab, and NSF International, and never give doses larger than that recommended by the manufacturer.

Most importantly, speak with a pediatrician before giving a child any supplement to ensure that it is safe to use.

Home Care

Medications are not the only way to treat a cold in children. In addition to ensuring your child gets plenty of rest, there are other things you can do to help ease their symptoms.

Here are 10 simple solutions that can help:

• A bulb syringe, available in most drugstores, can help remove mucus from a stuffy nose.
• Elevating the child's head with pillows can ease breathing and reduce throat irritation from post-nasal drip.
• Saline nose drops, which you can buy or make at home, can draw moisture out of swollen nasal passages and help ease congestion.
  
• A neti pot used for nasal irrigation is a simple way to clear mucus in older children, particularly when used with a homemade saline solution. Be sure, however, to only use distilled water or previously boiled water to avoid infection.
• Congestion can be eased by sitting with your children in a bathroom steamed up with hot water.
• A cool mist humidifier can help also decrease congestion, especially while sleeping.
• Rubbing Vicks VapoRub on the child's chest, which contains aromatics like camphor, eucalyptus oil, and menthol, can also help open blocked nasal passages.
• A teaspoon of honey can ease coughing but should only be used in children over one year of age. This is because honey may contain a bacteria called Clostridium that can be harmful to babies with underdeveloped immune systems.
• A sore throat can also be eased by giving your child a popsicle to suck on.
• Gargling with salt water can also help ease throat pain. Fill an 8-ounce glass with warm water and mix in 1/2 teaspoon of salt. 
  

When to Call a Healthcare Provider

Most colds clear up on their own in less than two weeks. In some cases, though, your child may develop symptoms that will need to be evaluated by a healthcare provider.

If your child has a fever that's over 102 degrees, call your pediatrician. Other symptoms that require the evaluation of a healthcare provider include:

• Fast breathing or breathing that seems labored
• A cough that does not go away or seems severe
• Excessive fussiness
• Excessive sleepiness 
• An earache
• A skin rash

Summary

Children's cough and cold medicines are used to ease the symptoms of a cold in children over age 2. They do not shorten the duration of a cold or prevent cold complications like ear infections or pneumonia.

Parents should only use cold medicines that treat the symptoms their child has. Multi-symptom cold medicines may expose a child to drugs they don't need and trigger otherwise avoidable side effects, though these drugs can be useful in some cases.

Acetaminophen, antihistamines, cough suppressants, and decongestants are drug classes that are often considered. If you're unsure of what to use (if anything) or how much to give your child, speak to their pediatrician.

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