Helping Children Deal With a Cold, Cough or the Flu

This page provides general advice about dealing with colds and the flu, including dosage recommendations for some commonly used OTC medicines. Please note that many cold/cough products have been recently taken off the market. Several studies have shown that these products are not effective in children under 6 years old and can have potentially serious side effects. Dosage guidelines are based on adult data and may be inaccurate for children. We also know that adult studies report common side effects including increase in blood pressure, increase in heart rate and restlessness with use of decongestants. For more information on colds, view this video from the American Academy of Pediatrics.

Our favorite cold/cough preparations are listed below. They are no longer recommended for children under four years of age. If you have found something useful for your child in the past, please do not hesitate to call our office for additional information. If you choose to treat a child over the age of four years, please remember they have not been proven to be more effective than humidifying the environment, avoiding airway irritants, and simply waiting it out. In general, upper respiratory infections/colds last 10-14 days from onset of symptoms until completely resolved. As a parent you must weigh the potential benefits and risks, and use these medications only when your child is experiencing significant enough symptoms to warrant TEMPORARY relief.

Mechanical alternatives such as suctioning the nose and throat with a bulb suction syringe, loosening mucus with saline solution (Ocean nasal spray, NaSal nose drops, etc.), and using a cool mist humidifier/vaporizer will help children breathe more easily while congested. Rest is important. Keep your child home from school or daycare until they are fever free for at least 24 hours. The American Academy of Pediatrics offers the following additional suggestions:

  • To relieve chest congestion:  chest physical therapy can loosen mucus and may help infants and young children cough it out. Lay your child across your knees, face down; cup your hand; and gently tap your child’s back. Or sit your child on your lap, lean her body forward about 30 degrees, cup your hand, and gently tap her back.
  • To relieve a cough:  try half a teaspoon of honey for children aged 2 to 5 years, 1 teaspoon for children aged 6 to 11 years, and 2 teaspoons for children 12 years and older. If honey is given at bedtime, make sure you brush your child’s teeth afterward. Remember, it’s not safe to give honey to babies younger than 1 year.
  • For a child aged 4 years and older, cough drops or lozenges may help soothe the throat. Remember not to give cough drops or lozenges to a child younger than 4 years because he could choke on them. Also do not give your child more cough drops than directed on the package.

In general, it is best to give medicines only for the specific symptoms that a child is experiencing. Remember these products treat symptoms only. They will not make your child’s cold resolve faster, but they may help to make him/her more comfortable in the meantime. Do not use a multi-symptom product with a combination of acetaminophen and cold/cough products, because combo products often result in inadequate doses of acetaminophen. Please refer to the Tylenol/Motrin dosage chart for those doses. To ensure the correct dose, make sure you have a working thermometer at home (with fresh batteries).

During the cold/flu season your child may experience back-to-back colds/illnesses. Choose your medicines wisely. You can help your child through an illness by encouraging plenty of fluids and rest; avoiding airway irritants like cigarette smoke, scented candles, fireplaces and potpourri; and by providing extra TLC. Good hand-washing will help keep your child from picking up viruses which can live on surfaces for an extended period of time. You can help prevent the spread of germs in your own home by cleaning commonly handled surfaces such as doorknobs, light switches, and the remote control, with Lysol or another antiseptic cleanser.

Remember, antibiotics will NOT treat a cold or flu. These illnesses are caused by viruses. The more your child uses antibiotics, the more likely he/she is to get sick with an antibiotic-resistant infection in the future. Please feel free to discuss when antibiotics are warranted for an infection with the Palmetto Pediatrics of the Lowcountry physicians and staff.