Is Cough Medicine Bad for Kids?

Coughing is a natural reflex that helps your little one to protect their lungs. During a cough, the body pushes air out of the lungs and airways to clear out dust, mucus and germs. 

It’s normal for your child to cough every so often, but if they have an ongoing dry cough when they’re otherwise well, this could be a sign of allergies, irritation or another medical problem and it’s a good idea to get them seen by your pediatrician.

A productive cough (where your child is coughing up mucus) can be a sign of infection, especially if it comes with a fever or they feel unwell. 

Most coughs and colds can be managed at home, but according to the FDA it’s best to see a physician if your little one isn’t eating or drinking, has a high fever, if they’re struggling to breathe or if things aren’t getting better after a week or so.

Although it’s natural, it can be hard to see your child coughing and feeling under the weather. You may want to start them on some cough syrup, but let’s talk about why this may not be a good idea.

Why over-the-counter cough medicines may not be recommended for kids

Pediatrician Dr. Akash Sinha advises against the use of cough medicines for kids. “We don’t typically advise cough medications for children because it suppresses the cough,” he explains. Coughing is a natural reflex and stopping children coughing can interfere with the body’s natural defenses. 

Cough medicines can also come with side effects that are dangerous to kids, such as:

• Nausea and vomiting
• Hallucinations
• Dizziness
• Tiredness and lethargy
• Increased heart rate
• Agitation 
• Confusion, seizures and even comas

Health Canada advises that non-prescription cough and cold medicines should not be given to children under the age of six. They also emphasize the importance of reading the label before giving any medication to your child.

The FDA doesn’t recommend giving over-the-counter cough medication to children aged two years old or under. In a two-year-old, cough medicine can cause serious issues and even lead to life-threatening side effects. In the US, it’s possible to buy cough syrup for four-year-old children and above. 

How to read and understand cough medicine labels

Always read the label to check what ingredients are in cough medicine before giving it to your child. Certain antihistamines, decongestants and anti-cough ingredients are not suitable for kids. Health Canada provides a helpful list of ingredients that are unsafe for children under six.

Take a look at the list so you know what to avoid when you’re reading the label. Canadian cough syrups containing these ingredients should be labelled with the warning: “Do not use this product in children under six years of age.” 

Make sure to check any age restrictions on the label and follow them. If a medication does not say it’s safe for kids your child’s age, you should not give them that medication. Adult formulation cough medication shouldn’t be given to children as they may contain the wrong dose for kids or may not be safe at all. 

Medication labels can be confusing. If you’re unsure about anything written on the packaging, speak to a pharmacist for advice. 

Natural cough medicine alternatives 

No homeopathic cough and cold remedies are approved by the FDA because they often don’t include what they say they do and may even contain harmful ingredients. These medications should never be given to kids under four.

Some natural remedies may help with a cough as long as they’re safe for kids your child’s age. 

“Honey use in children over the age of one may provide symptomatic relief,” Dr Sinha reveals. Studies show that honey may help with kids’ cough symptoms and soothe sore throats, but should only be used in kids older than one due to the risk of a type of food poisoning called botulism. 

Other FDA-recommended natural cough and cold treatments include:

• Drinking plenty of fluids to stay hydrated—hot drinks can be particularly good for sore throats
• Using a cool-mist humidifier to help your little one breathe more easily—cool is better than warm as heat can cause the nasal passages to swell
• Saline nose sprays or drops to help avoid stuffiness

Gargling salt water and drinking cold liquids or eating ice pops can provide relief from a sore throat. Kids over four years old may also be able to take throat lozenges (as long as the packaging says they’re suitable).

If you’re not sure whether a particular home remedy is safe to give your kids, it’s always best to ask your healthcare provider.

When to see your child’s doctor or pediatrician

Many coughs and colds can be managed at home, but certain symptoms can be a sign something more serious is wrong with your child.

According to the FDA, it’s best to call your pediatrician or family doctor if your child has:

• A fever of 100.4 degrees Fahrenheit or higher (if they’re two months or younger) OR a fever of 102 degrees Fahrenheit (if they’re older than two months)
• Blue lips
• Difficulty breathing—you may notice wheezing, shortness of breathing, quick breathing, nostrils widening or the ribs showing with each breath
• A severe headache
• Signs of dehydration—such as dark urine, urinating less often, sunken eyes, dry mouth
• Been overly cranky or sleepy
• Ongoing ear pain
• Been getting worse

If you’re worried at any point, it’s always best to seek help from a doctor. Keeping a record of your child’s symptoms leading up to the appointment can help the consultation go more smoothly. 

Your child may be prescribed antibiotics if your pediatrician thinks that they have an infection that’s caused by bacteria. Antibiotics will not help an infection that’s caused by a virus. According to Medline, a high fever or coughing up thick, yellowy-green phlegm may be a sign of a bacterial infection. 

Why it’s important to drink enough and eat the right foods

Hydration helps keep your child’s body healthy and is an important part of recovery. HealthLink BC recommends honey or lemon juice in warm water to help keep your child hydrated and soothe their throat at the same time (remember, honey is not suitable for children under one year). Plain water is great but try to avoid soda which can irritate the throat.

Ice cream or popsicles can help soothe a sore throat. Warm soup is another easy-to-eat food for kids. Try to choose a fresh soup that’s packed full of nutrient-rich vegetables to support their immune system.

It’s important to give your child time to rest and recover. It takes a lot of energy for a kid’s immune system to fight off infection, so let him or her rest.

What to know about dosage 

If you do choose to use cough medicine, it’s important to use the correct dosage for your child’s age. Information about the correct dose should be provided in the medication packaging. 

Usually, a syringe or cup is also included in the box. This can be used to measure the dose. To avoid accidental overdosing, use the tool provided rather than a spoon or tool from another medication. 

Do not give more than the recommended number of doses within 24 hours, as this can also lead to an accidental overdose. If you’re using cough medication along with other types of medication, make sure they don’t interact or contain the same ingredient.

For personalized advice on dosing and medication interactions, contact your healthcare provider.

How to monitor your child's response to cough medicine

When giving cough medicine, try to observe your child's reaction. This will help you pick up on any side effects. 

Keeping a symptom diary will also help you see if symptoms are improving. If they're not improving, make an appointment with your physician. 

If at any point during your child’s illness, you’re worried about how they’re doing (including how they respond to any medication), contact a healthcare professional straight away. 

Experts

• Dr Akash Sinha, pediatrician