When a child has a drippy nose or a nasty cough, parents are caught in a bind. They want to do something to ease cold symptoms, but pediatricians and now the FDA warn against giving kids cold medicines.

Research shows the drugs in such formulations are not effective for kids. There is also concern that some children may suffer side effects. In fact, although it’s rare, there have been serious reactions and even deaths reported to the FDA.

Pseudoephedrine, a decongestant that used to be popular in cold medicines, is available behind the counter. Adults rarely have problems with this drug, but children may experience visual hallucinations of spiders, insects or snakes.

The oral decongestant phenylephrine has now replaced pseudoephedrine in many cold medicines. It may be less likely to produce hallucinations in children, but there isn’t any convincing data that it is very helpful.

An expert panel for the FDA has recommended that the agency not allow such products to be sold for children under the age of six. Pediatricians and lung experts have been telling parents for years that OTC cough medicines don’t work for children and do pose hazards. The FDA has been slow to act.

Millions of kids have been treated with ineffective and potentially harmful cold medicines for decades. It’s hard to imagine a more vulnerable population than little children. And yet the watchdog agency has let them down.

Another question remains unanswered. How effective are cold and cough remedies for children over the age of six, teenagers or adults? We asked Dr. Ian Paul, a pediatrician at Penn State College of Medicine who has conducted research on cough and cold medicines, if these medicines are effective for anybody. He replied that there is very limited evidence that some of these medicines are effective even for adults with colds.

Most cold and cough medicines contain a conglomeration of ingredients, including pain relievers like acetaminophen or ibuprofen. As far as we can tell, there is no justification for including a pain reliever in cold medicine. Most colds do not cause pain and fevers are generally mild.

There are studies showing that medicines such as aspirin, acetaminophen and ibuprofen may actually increase viral shedding. That means a person might spread cold viruses to others more readily.

So what can you do if you catch a cold? Chicken soup remains a time-honored cold remedy supported by science, and it has no side effects. A dab of Vicks VapoRub on the soles of the feet may help a nighttime cough. (Socks help keep sheets clean.)

Although most home and herbal remedies have not been tested any better than some drugstore products, many readers report success with Chinese botanical medicines such as astragalus or andrographis.

We have collected a number of alternative approaches (and our favorite chicken soup recipe) in our Guide to Cold Remedies.

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  1. AA

    I like astragalus and andrographis for myself and my wife, but I hesitated to use them on our 2-year-old daughter.
    Instead, I used probiotics and cod liver oil–they shorten illness considerably and are proven safe if used as directed.

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