Help! My child has caught the flu,
what can I do about it?
OR A PARENT, it can be miserable to watch your child suffer through a cold. She or he can’t sleep, won’t eat and may be burning up with fever. We just want to do something to make our children comfortable. Here is information to guide you through the treatment options.
Most parents now know that antibiotics do not help treat the common cold or influenza. Many parents have turned to over-the-counter (OTC) cough and cold preparations to provide relief for their children. Many infant cough and cold preparations, however, are being removed from the market in response to a Food and Drug Administration (FDA) review. On Jan. 17, the FDA advised that OTC cough and cold medications not be given to children younger than two. This advisory applies to medications that include cough suppressants, expectorants, antihistamines and decongestants. The FDA is still reviewing the use of OTC cough and cold medicines for children ages 2 to 11 years.
Why has the FDA taken this action? Mostly because these medicines provide limited benefits with potentially rare, but serious, side effects. Moreover, the common cold will eventually run its course and does not cause permanent damage to the body. Also, the FDA is concerned about overdose when many preparations contain similar ingredients with different names or when parents use both prescription and OTC products.
Multiple studies have shown no benefit to using cough medications. Dextromethorphan is the most common medicine used for cough suppression. Studies show, however, that dextromethorphan is no more effective than sugar water. Sugar water has very few side effects while dextromethorphan can cause sleepiness, dry mouth and thicken the mucous in the throat and chest. Dextromethorphan has been implicated in rare cases of dystonia, a type of unusual muscle contraction in the face and neck, hallucinations and rapid heartbeat.
Antihistamines such as diphenhydramine, better know as Benadryl, are also not effective at providing cough relief. The American Academy of Pediatrics discourages the use of antihistamines as a sleep aid. It is easy and risky to overdose a child on antihistamines, which can lead to over sedation, dry nose and mouth, abdominal pains and hallucinations. Antihistamines are effective in treating acute allergic reactions, this is their proper role.
In January 2007, the FDA warned that overdoses of pseudoephedrine (a common decongestant such as Sudafed) was the cause of at least three infant deaths in 2005. These children were taking multiple products and had drug levels 9 to 14 times the expected levels. Each death was ruled an accident.
So, what is a parent to do? First, pain management is the priority. Many parents tell me that after hearing the FDA warning, they did not know if pain medicine was OK for their children. Unfortunately, some news stories showed products such as Tylenol Plus being removed from the shelves. Pain and fever medicines such as acetaminophen, better know as Tylenol, and ibuprofen, known as Advil or Motrin are not included in the FDA advisory. Pain should absolutely be treated.
Fever management is also important. Fever is the human body’s response to infection. A fever might make us uncomfortable, but it can destroy viruses. When a child has a fever, but is comfortable and active, treating the fever is not always necessary. If a child is acting ill, take the temperature and treat a fever with acetaminophen for infants younger than 6 months or acetaminophen or ibuprofen for older children. Please call your child’s doctor if she or he is younger than 3 months old and has a fever.
Chicken soup is good for the soul and for the common cold, too. Clear warm fluids help to loosen phlegm and soothe a sore throat. Nasal saline, along with nasal suctioning, can help with nose congestion. A study just published in the Archives of Pediatric and Adolescent Medicine showed that buckwheat honey provided significantly more cough relief than dextromethorphan or placebo. Honey, however, has been known to carry the spores of the bacteria that cause infant botulism and should never be given to an infant younger than 12 months. For older children it is worth trying for temporary cough relief. Human touch has also been shown to be beneficial to anyone who is ill.
Dr. Melinda Ragins is a Board Certified Pediatrician who practices at Bay Valley Medical Group, which offers multi-specialty services and has offices in Hayward, Castro Valley, Danville and Pleasanton. Dr. Ragins is located at Bay Valley Medical Group offices at 27212 Calaroga Ave, Hayward, 510-785-5000 and 20126 Stanton Ave #201, Castro Valley, CA, (510) 581-2559.