Are cough and cold medicines safe for kids?

What the evidence says

Most cough and cold medicines you can buy without a prescription are not recommended for young children. Health Canada requires labels on these products to say they should not be used in children under 6 years old. This rule was put in place in 2009 after reports of children being harmed by these medicines.

The main problem is that these medicines usually do not work very well in kids, and they can cause side effects. Ingredients like decongestants can cause a fast heartbeat or trouble sleeping. Antihistamines can make a child sleepy or, in rare cases, cause dangerous reactions. Cough medicine ingredients like dextromethorphan have not been shown to clearly help children cough less.

There are also safety risks from giving too much medicine. Many cough and cold products combine several drugs together, including acetaminophen. If a parent also gives a separate dose of acetaminophen for fever, a child could accidentally get too much. Health Canada has also said that cough medicines containing opioids, like codeine, should not be given to anyone under 18, because there is not enough proof they help and they carry a risk of harm.

The good news is coughing itself is often helpful. It is the body's way of clearing mucus from the airway. For comfort, Canadian pediatric guidance suggests fluids, rest, saline nose drops, and a bulb syringe to clear a stuffy nose in babies. For children over age 1, a small amount of honey may ease cough better than no treatment at all. Acetaminophen or ibuprofen can still be used for fever or pain, following the label carefully and never combining with aspirin, which is never safe for children due to the risk of a rare but serious illness called Reye syndrome.

If you are unsure what is safe for your child's age, or symptoms seem to be getting worse, check with a pharmacist or doctor before giving any cough or cold product.