Parents should be careful, this is when cough syrup can be fatal for children under 6 years old

2023-05-19 08:10:00, Shëndeti CNA

Parents should be careful, this is when cough syrup can be fatal for children

Illustrative photo

As winter approaches, many parents will be preparing for cold and flu season. Usually young children get sick about 6 times a year. In generations past, parents might look to cough syrup to relieve a dry or chest-blocking cough.

But now we know that cough syrups are not very effective in treating children's coughs. And amid mounting evidence of poisoning harm and deaths, many countries including Australia have restricted cough medicines. Therefore, they cannot be given to children under the age of 6.

But what does cough medicine contain? The active ingredients in cough syrups vary depending on their claimed benefit. They may contain cough suppressants (soothing the body's cough reflex), expectorants, and mucolytics (both of which help clear phlegm).

Other cold and flu medications often contain decongestants (to relieve a stuffy nose) and soothing antihistamines to reduce sneezing, stop runny noses, and aid sleep.

The most dangerous drugs are those with a sedative effect, such as sedative antihistamines or opioid-based cough suppressants. While sedation may be a desired effect for parents with a child who does not sleep, young children are especially at risk of serious harm or even death in extreme cases.

Also, sedatives can also cause agitation and hyperactivity. While cough syrups that do not contain sedatives are safer, there are very few studies on the safety and efficacy of these products in children. Adverse events, including agitation and psychosis, have been reported infrequently, especially with excessive use.

Overuse can result from parents misreading the label, overdosing in the hope it will work better, inadvertently giving extra doses, and using inaccurate measuring devices such as tablespoons.

Young children under the age of 2 are most at risk of a fatal overdose from cough syrups. But Australia's medicines regulator recommends against using cough syrups for any child under the age of 6. Therefore, there are no dosage instructions for children under 6 years old on the labels of these products.

Our study, published today in the Medical Journal of Australia, shows that limiting the use of cough and cold medicines in children results in a significant and sustained reduction in poisonings.

Our study looked at dosing errors, side effects at appropriate doses, and accidental "exploratory ingestions" by children. In 2020, warnings were placed on sedating antihistamines saying they should not be used for any reason in children under 2 years of age.

This resulted in a halving of emergency room calls and a halving of hospitalization rates. Despite this, hundreds of calls are still made to Australian poison centers each year about these products in young children.

Cough syrups can be used for children aged 6-11 years, however caution should still be exercised. These products should only be given in consultation with a doctor, pharmacist or nurse. Several herbal products are available and marketed for children such as Hedera helix.

But unfortunately there is no convincing evidence that these drugs significantly improve cough symptoms. But the risk of poisoning is low. Simple syrups that do not contain drugs can also be effective: up to 85 percent of the effectiveness of cough medicines is due to the "placebo effect".

The best thing you can do for your child is to give him rest and security. Antibiotics will only be needed if your doctor diagnoses you with acute bacterial pneumonia or a chronic cough due to a bacterial infection, such as prolonged bacterial bronchitis, whooping cough, or a lung abscess.

Paracetamol or ibuprofen can be used if they have fever and pain along with the cough. Check the correct dosage on the package for your child's weight and age. If your child is older than 12 months and has a wet cough (producing phlegm in the throat), consider giving them honey. There is growing evidence that honey can reduce mucus production and therefore the frequency of coughing.

Note: Rose Cairns, lecturer in pharmacy at the University of Sydney. Nial Wheate, associate professor of the School of Pharmacy at the University of Sydney./ Adapted from CNA.al