How to help young kids when they have a cold

Q: My 5-year-old daughter has a bad cold, but her pediatrician doesn't want me to give her over-the-counter cold medication. What can I do to help her feel better?

A: When your child is coughing and congested, it's tempting to reach for cold medicine. But as your doctor advised (based on guidelines from the American Academy of Pediatrics), you shouldn't give over-the-counter cold medicines to children younger than 6 years.

These products have caused complications in young children, and even some deaths. The main problem is that the benefits and side effects (risks) of most cold medicines have not been well-studied in kids — only in adults.

This is true for the decongestants phenylephrine and pseudoephedrine; the cough medicines dextromethorphan and guaifenesin; and antihistamines such as chlorpheniramine and diphenhydramine.

You may not recognize these names, but I'll bet you find at least one of them listed on the bottle of cold medicine you might have given to your daughter.

So what's a parent to do? There are many other ways you can help your child feel better without using medication:

• Clear out the mucus. Use a bulb syringe in the nose (with a couple of drops of saline first) to clear out mucus. This can make a huge difference when it comes to breathing better.

• Keep a humidifier running. This keeps the mucus thinner, which makes it easier to cough, blow or syringe out. Use a cool-mist humidifier, and be sure to clean it regularly. (You don't want to fill the air with mold and bacteria.) Some folks swear by adding a bit of menthol to the water. Menthol can help nasal passages feel more open and sometimes helps calm a cough.

• Elevate your child's head. This helps the mucus run down, so it doesn't get stuck at the back of the throat and cause coughing. An extra pillow can do the trick.

• Give lots of fluids. Your child needs to drink to keep mucus running more freely. Give lots of water, 100 percent juices and soup. Dairy is fine, too: There's no clear evidence that dairy increases mucus and should be avoided.

• Encourage rest. Many sick kids spend their days playing video games and watching television — both of which tend to keep a sleepy child awake. That isn't to say that children can't do those or other quiet activities. But you do want to make sure that when your daughter is sick, she gets enough sleep.

• TLC. A good snuggle always makes a kid feel better — and it may actually support the immune system. Also, it's still OK to give acetaminophen or ibuprofen (but not aspirin) for fever, and for aches and pains.

Call your doctor if your child has a bad cough, trouble breathing, or isn't better within five to seven days.

I don't want to be alarmist: Unless a child gets hold of a bottle of cold medicine and drinks more than is recommended, the chance of serious problems is relatively small.

Still, better safe than sorry..

• Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.

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