Sue Brenan: Hello! I’m Sue Brenan, pharmacist with RxCo. Pharmacy and I am here to give you a pharmacy update of OTC cough and cold products for infants and children. On January 17th of 2008 the FDA issued a public health advisory for parents and caregivers and they recommended that over the counter which are the OTC cough and cold products should not be use to treat infants and children who are less than two years of age. And this is because of serious and potentially life threatening side effects that can occur from such use. The American Academy of Pediatrics and the CDC which is the center for disease control and prevention have also issued statement cautioning parents and caregivers. And this follows the FDA recommendation from last fall, were we have the voluntary removal of the OTC cough and cold products from the market, the products with pictures of infants and any leveling for use in children less than age 2.
And this recommendation was base on finding that are was not evidence that the pediatric cold medicines really provided and a relief to children suffering from colds and they’re were growing reports of rapid heart rates, loss of consciousness, convulsions and even death associated with there used. And all the pharmacist got mailing from our wholesalers and we have lists of products that had to be taken off. Most medicines have not been specifically tested for safety in children and it was only until recently we trusted that the OTC medicines will basically safe for children as long as we will careful to give them in small doses. But when the expert review the evidence for antihistamines, nasal decongestants and cold serves they did not give them a very good report card. The cough and cold preparations are good examples of how medication that millions of people can use without worry maybe come unexpectedly lethal.
A strong reaction to antihistamine is could include any of the following reactions; confusion, behavior problems and this is particularly important in children less than two of behavior problem might be the first sign that you would see that something is off. Often children less than two don’t have the ability to communicate very well about what’s wrong. Other system issues could be constipation, blurred vision, inability to urinate, dry skin and over heating. Decongestants on the other hand can be the heart rate, raise blood pressure cause sleep and behavior problems. I agree with this guidelines, if from medication is not very effective and its not work any risks however small especially with our infants and side effects can be unpredictable and more severe than in older kids. As we say in the trade, first do no harm. As this is now cough and colds season the FDA again is cautioning parents and caregivers against the use of OTC cough and cold products in children less than two years of age.
There was some concern that parents may have not heard the initial warning may still have some other products in there homes even other no longer on the pharmacy shelves and may continue to give infants the OTC remedies. So, what’s the parent do? How is anybody going to get some sleep in this house tonight? Do we close the medicine cabinet and let your child’s cold run it curse. First of all infants who have cough and cold symptoms should be evaluated by there pediatrician or other health care provider. A persistent or productive cough in any age should require evaluation by physician or other primary care provider. Secondly, I know as parent you always want to find a way to make your kids feel better. In this case it maybe better to stick to TLC instead of OTC. There are many none pharmacologic measures that can be use, keeping an infant in an upright position can enhance nasal drainage. So positioning your child especially at night so that his or her head is lifted higher than usual, this can be particularly helpful for a baby who is breastfeeding.
Also maintaining adequate fluid intake, have your child drink plenty of fluids. Increasing the humidity of the inspired air, try a humidifier in your child room or help your child to take a hot steamy shower. Irrigating the nose with saline drops and clearing mucus from the nasal passage ways gently with the bulb syringe can also help. There are some products now coming out helping sinus relievers and I haven’t seen some infant atomizer type products coming out so look for those. If a child has an ear ache Acetaminophen or a plain Tylenol can help, please check with your caregiver for the appropriate dose. Trying a heating pad for a short period of time or a warm compress against the ear, this could be surprisingly suiting. Do not let the child by on the heating pad however that could be dangerous. Again, Acetaminophen for a sore throat, a little Tylenol checking with your caregiver for appropriate dose, throat lozenges are not safe for children under three as they could choke on them.
Of course hugging and holding your children can comfort them. Often they really want to become to provide there parent, caregiver when they’re not feeling well. Of course be sure to wash your child’s hands and your own hands often and this will avoid passing the cold onto others. Interesting to lend up there was a new study publish in the archives of pediatric and adolescent medicine, it suggest that honey maybe a safe alternative for easing a child’s cough and improving sleep difficulties that are cause by upper respiratory infection. Honey does have antimicrobial and antioxidant properties as well as demulcent which mean soothing activity. And this soothing activity can help irritated mucus membranes. Although does not harm older children and adults, honey can contain bacteria can cause botulism in infants. So, babies under 12 months should not be given honey and therefore only consider honey as an option for treating cough and cold symptoms in children over the age of one year.
With respect to children age two and older the FDA is currently still considering the proceeding of a recent pediatric cough and cold advisory committee and further guidance on this matter will be fourth coming probably by the spring. In the enter room parents and caregivers who wish to use OTC cough and cold products for children age 2 to 11 years are advice to do the following. Carefully follow the directions on the product level and use only on the measuring spoons or cups that are provided or specifically made for the administration. I have an example, he will be to see now on the number of products that are coming out that children age two years of age or under it says asks the doctor and then I will give specific dose and directions for the other age groups and I caution you not use households spoons. They are not useful in measuring the exactly you need when it comes to measuring medicines, please use a dosing device a medicine drop or spoon that is available either at your grocery or local pharmacy.
Again, check the active ingredients on each product. Multiple products can have the similar ingredients and if you are using more than one product you could get duplicate ingredients among the preparation and combining them can increase the risks for an overdose. Select the OTC cough and cold products with child for safety capsule when they’re available and of course keep them out of the reach of your children. And also understand that OTC cough and cold medicines do not treat the cause of the symptoms or really shorten the duration of the illness very much. They can only relieve some associated symptoms. This product should never be use to sedate the child or make them sleepy. Now, finally remember that TLC is the greatest bump for discomfort, love, tenderness, some back rubs and kind of words it can be a great comfort. TLC is surely the greatest I’ve know to mankind and that’s a good thing. It has no side effects and it doesn’t cause of penny and has plenty of emotional and physical benefit.
For more information on product safety, both for consumers and health professionals it’s available at www.otcsafety.org.
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