Gan Pou Wee
M.Pharm, MBBS, BCPS, R.Ph
Anti-histamines in most cough and cold preparations
Most cough and cold preparations on the market contain anti-histamines as an active ingredient. Anti-histamines are medications that control allergies and mucus production in the body, hence they are able to relieve most cough and cold conditions. However, these medications may cause severe, life-threatening side effects to your child under 2 years of age.
Life-threatening side effects
Because of the relative immaturity of children under 2 year of age to excrete excess anti-histamines and sensitivity to its’ side effects, they are at higher risks of experiencing life threatening adverse reactions. Common benign side effects include drowsiness, dizziness and difficulty in coordination. More sinister side effects such as tremors and seizures, though less likely, may occur. Lastly, excessive doses of anti-histamines may cause life-threatening side effects such as respiratory depression (where the child loses the ability to breathe), coma or even death.
May still be used under specialist guidance
With that said, anti-histamines may still be used in children under 2 years of age under the close supervision of a specialist (pediatrician) or inpatient settings. The role of anti-histamines in the treatment of severe allergies is indispensable and doctors may recommend their use after weighing the pros and cons.
Alternatives to anti-histamines for cough and cold in young children
There are several treatments that are considered useful alternatives to anti-histamines against cough and cold symptoms particularly in young children
- Saline nose drops or sprays that help in keeping nasal passages moist, clearing up mucus and reducing stuffiness.
- Cool mist humidifiers are suggested as they shrink nasal passages thus making breathing easier. Note that warm mist humidifiers do the opposite and cause nasal passages to swell and worsen breathing difficulty.
- Suctioning of the nasal cavity with a bulb syringe, usually in conjunction with the use of saline nose drops. This works very well for infants less than one year of age, while older children tend to resist the use of bulb syringes due to discomfort.
- Paracetamol or Ibuprofen may be used to reduce aches, pains and fever. Make sure you consult a pharmacist or doctor for the correct dosage to be administered in children.
- Drinking plenty of water and ample rest will help children stay hydrated and recover faster.
When in doubt, always speak to your pharmacist or doctor.
- Use Caution When Giving Cough and Cold Products to Kids [Internet]. US Food and Drug Administration. 2016 [cited 25 August 2017]. Available from: https://www.fda.gov/drugs/resourcesforyou/specialfeatures/ucm263948.htm
- Children and Sedating Antihistamines [Internet]. Medsafe.govt.nz. 2013 [cited 25 August 2017]. Available from: http://www.medsafe.govt.nz/profs/PUArticles/Mar2013ChildrenAndSedatingAntihistamines.htm
- Ten Eick A, Blumer J, Reed M. Safety of Antihistamines in Children. Drug Safety. 2001;24(2):119-147.
- Do cough & cold preparations work in children? [Internet]. Bpac.org.nz. 2010 [cited 25 August 2017]. Available from: http://www.bpac.org.nz/BPJ/2010/July/coldmeds.aspx#4