Rest and care urged for ill kids
Your child is coughing and has a runny nose, but the U.S. Food and Drug Administration says not to use over-the-counter cold medicine for children under 2.
So, what can you do?
"If a cough or nasal condition is due to a cold, there's not much you can do," said Dr. Loren Yamamoto, pediatrician at Kapiolani Medical Center for Women & Children.
The types of medicine in question do not work much anyway in children under 5, he added.
"Although a lot of doctors prescribe them, and a lot of parents buy them on their own, it has been known for a long time that they don't do very much, compared with placebos (in clinical trials)," he said.
FDA advisers determined last October that the drugs do not work in small children and should not be used in preschoolers.
Viruses that cause cold symptoms usually run their course, said retired pediatrician Dr. Calvin C.J. Sia, a part-time University of Hawaii professor of pediatrics who is active in early child development and primary care.
He prescribes "careful watching, rest and nurturing," propping the child up for sleep to ease congestion and maybe a little sugar water. Honey is not recommended for babies because of concern about botulism, he said.
Cough-suppressing medicine is a bad idea because "you don't want to prevent the body coughing up secretions," Yamamoto said. "You want those to come up."
The desire to cough also is so strong that a higher dose of cough-suppressing medicine would have to be taken than recommended, he said. "Then you start dealing with toxicity."
Runny-nose medicines also do not work in children because their airways are small, Yamamoto said.
What is commonly recommended is to suck out the child's nose with a bulb suction device, which is equivalent to older people blowing their nose with a tissue, he said.
But that is "too much of a nasal trauma," and parents are unable to do it as often as they would blow their nose, he said.
"You can do it once in a while if you want to, but you're kidding yourself if you think you're providing substantial relief," he added.
Keeping children with a cold in an upright position, either by carrying them or putting them to sleep in a car seat, stroller or something to keep them tilted up a little, is the best solution, Yamamoto said.
"If you put them down in a crib or on a bed, they'll be more congested."
Many times, parents of his patients in the emergency room say they never thought of that, Yamamoto said.
He said breast-feeding "is really good because you're passing antibodies against the virus into the baby through breast milk."
If a child is coughing a lot and has a high fever, these could be symptoms of something more severe, possibly pneumonia, he said. "Clearly you need to see somebody for that."