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: Cough and cold syrups should be used carefully
in children
DEAR DR.PAUL: Can I give cough medicine to my 18-month-old
baby? If so, what brand is best? What is the difference between
cough medications that are "DM" and non-DM?
PEDIATRICIAN DR.PAUL ANSWERS: Thanks for
your question. It has reminded me that I wanted to talk about
"over the counter" (OTC) medications. Just because they are
available without prescription, does not mean that these medications
have no potential side effects.
As a matter of fact, recent studies have shown that giving cough/cold
syrups improperly, or in higher-than-recommended doses can actually
be quite dangerous. This applies to all OTC medications of which
cold and cough preparations are among the most commonly used.
But before talking about when and how to use such syrups, let
me address your second and third questions.
Generally, all brands contain the following ingredients: DM
or "Dextromethorphan" a cough suppressant, "D" which represents
a decongestant, and "E", for an expectorant (something that
helps bring up chest secretions).
These are available in different combinations, and in different
forms, ranging from syrup to pill forms:
- Preparations referred to as "DM", only contain a cough
suppressant
- "DM-D" preparations contain both a cough suppressant and
decongestant and
- "DM-D-E" has all three: a cough suppressant, a decongestant
and an expectorant
I usually prefer not to use the combination preparations. Why?
Because it does not make sense to give an expectorant, for example,
at the same time as a cough suppressant. Bringing up secretions
causes a cough reflex allowing us to clear the secretions out.
Giving a cough suppressant as well, makes no sense.
When I recommend a syrup for a child with a cold, I usually recommend
a DM (cough) preparation, and only if the child is made uncomfortable
by the cough - that is, waking up at night or not being able to
sleep. For children less than two years old, these preparations
should not be used unless under the direction of your doctor.
It is also important to note that if a child has fever, the fever
will not respond to these syrups. Only fever medications like
Tylenol or Tempra (acetaminophen) can help bring down a fever.
Conversely, fever medication cannot help with cold symptoms such
as congestion and cough. Another important point to remember is
that, in general, cough or cold medications should not be given
to children with asthma or other chronic lung problems. If your
child is asthmatic, talk to your doctor about what to do during
a cold.
Let's not forget the basic treatment of a cold which should include
a humidifier (I prefer cold air mists), drinking plenty of fluids,
and for younger children, helping wash out the congested nose
with a nose pump and saline (salt-water) drops. In most situations,
these simple techniques can do the trick, without the use of medications.
But if a child requires cough or cold medicines, use them carefully.
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