Jump to:  A   |   B   |   C   |   D   |   E   |   F   |   G   |   H   |   I   |   J   |   K   |   L   |   M   |   N   |   O   |   P   |   Q   |   R   |   S   |   T   |   U   |   V   |   W   |   X   |   Y

Fewer ER Visits for Kids After Cold Medicine Restrictions

MONDAY, Nov. 11 (HealthDay News) -- Restrictions placed on cough and cold medicines may be working, with fewer young children ending up in the ER because of bad side effects tied to the drugs, new research shows.

The drop in kids' illnesses came about after drug manufacturers voluntarily withdrew cough and cold medications for this age group from the market in 2007, and after drug labeling changes put in place in 2008. The labeling changes advised that the products were not for use in children under 4.

"The change [in ER admissions] was associated with those two events," said study author Dr. Lee Hamilton, a medical officer in the division of healthcare quality promotion at the U.S. Centers for Disease Control and Prevention.

"We saw that in children under 2 years old, adverse events from cough and cold medicines dropped from one in 25 of all emergency department visits for adverse drug events to about one in 40 [such visits]," Hamilton said. "In the 2- to 3-year-olds, adverse events from cough and cold medicines dropped from one in 10 of all emergency department visits for adverse drug events to about one in 15."

Results of the study were released online Nov. 11 in the journal Pediatrics.

Manufacturers of over-the-counter oral infant cough and cold medications voluntarily withdrew these products from the market in 2007 amid concerns that the drugs were causing significant numbers of emergency department visits -- and in rare cases, infant deaths. The following year, manufacturers changed the labeling on over-the-counter cough and cold medications to state that they should not be given to children under 4.

To see what effect these changes had on related emergency department visits, Hamilton and his colleagues reviewed information from a nationally representative injury surveillance project.

The researchers looked for any emergency department visit related to the use of a drug that didn't result in the patient's death. They collected information from January 2004 through December 2011 so they could see if the labeling changes and the withdrawal of the infant formulations of cough and cold medications had made an impact.

In children under 2, adverse events related to cough and cold medications made up 4.1 percent of all adverse drug event admissions before the changes took effect. After the changes, that rate dropped to 2.4 percent, according to the study.

In those aged 2 to 3, emergency room visits due to cough and cold medications made up 9.5 percent of all adverse drug event admissions before the change. After the changes, that proportion dropped to 6.5 percent.

The researchers also looked to see if rates of adverse drug events rose for other medications or alternative therapies, which might have indicated that parents were substituting another treatment for cough and cold medications. But, Hamilton said, they saw no shifts to other drugs or therapies.

They also wanted to understand how these young children who ended up in the emergency room were still getting the drugs, and found overwhelmingly that it was through unsupervised ingestion. In the under-2 group, 64 percent took these medications unsupervised. And, in the 2- to 3-year-old age group, 89 percent took the drugs without parental knowledge.

"The vast majority of emergency department visits in recent years was due to kids getting into them without supervision," Hampton said. He said that packaging changes, such as putting a low-flow filter on bottles to limit how much someone can consume could help, and he said parents have to remember to put the child-resistant cap back on the bottle every time and turn it till it clicks, and then put the bottle on a high shelf, out of sight.

Another expert explained why toddlers are at risk for accidental ingestion.

"Over-the-counter medications may seem benign to the average person, but they can be dangerous, especially in small children. The highest number of unsupervised ingestions was in 2- to 3-year-olds. These are kids that are beginning to be mobile and may start climbing and getting into more. And, these medications are sweet and good-tasting. This is the age group that parents really need to be monitoring," said Dr. Bradley Berg, medical director of Round Rock Pediatrics at Scott and White Healthcare, in Texas.

As for the parents who still choose to give their young children cough and cold medications, Dr. Allison Bartlett, a pediatric infectious disease specialist at La Rabida Children's Hospital in Chicago, said many people think these medications are safe because they're sold over the counter, and many parents may have taken these drugs when they were young, or they may have older children that to whom they gave the medications.

"Kids get so many colds; it's a frustrating problem. The temptation is there to give them over-the-counter medications that promise to make your kid feel better. But, under the age of 4, these medications are no better than giving a placebo and they carry a number of additional risks," Bartlett said.

"The discussion would be different if there was a benefit to these medications," she said. "But, they don't actually make kids better, and they expose children to unnecessary risks."

While these medications can ease symptoms in adults and older children, Bartlett said the nasal passages and airways in young children are so small that the slightest bit of inflammation from a cold or respiratory illness makes it harder to breath, and it also makes it harder to make an impact with any treatment.

Texas pediatrician Berg said that for children over 1 year of age, a teaspoon of honey several times a day can help quell a cough. You can give put it in tea or in water with lemon juice, he advised. The reason that children under 1 year old can't have honey is a risk of botulism in infants, he added.

More information

Learn more about keeping medicines safely from the PROTECT initiative.

SOURCES: Lee Hamilton, M.D., M.Sc., medical officer, division of healthcare quality promotion, U.S. Centers for Disease Control and Prevention; Allison Bartlett, M.D., infectious disease specialist, La Rabida Children's Hospital, Chicago; Bradley Berg, M.D., Ph.D., pediatrician and medical director, Round Rock Pediatrics, Scott and White Healthcare, Round Rock, Texas; December 2013 Pediatrics

Reviewed Date: --

Find a pediatrician
Charles Bullaboy, MD
Alexander Ellis, MD
Jonathan Fleenor, MD
Lopa Hartke, MD
John Reed, MD
Bertrand Ross, MD
Elliot Tucker, MD
Michael Vance, MD
Children's Cardiac Surgery
Benjamin B Peeler, MD
Felix Tsai, MD
Infectious Diseases
Kenji Cunnion, MD
Randall Fisher, MD
Laura Sass, MD
Health Tips
5 Ways to Avoid Colds and the Flu
A Parent’s Guide to Choosing Child Care
Boost Your Teen Daughter’s Body Image
Cool Tools to Keep Your Kids From Smoking
Could Your Child Have a Drug Problem?
Do Parents Influence Their Kids’ Health Behaviors?
Growing Up Short or Heavy Can Be Difficult
Guidelines for Raising Smoke-Free Kids
Help for a Child with a Cold
Help Your Babysitter Prepare for Anything
Helping Children Conquer Fear
How Old Is 'Old Enough' for Contacts?
How to Prevent Childhood Obesity
How to Talk About Drugs With Your Kids
Keeping Your Cool When Parenting Teens
Kids' Health Concerns Ease with Age
Making Rules for Children Reinforces Love
Making This School Year Your Child's Best Ever
New Parents...Sore Backs
Over-The-Counter Medicines for Infants and Children
Paging Dr. Mom
Parents-to-Be Must Communicate
Paying for Attention: Abuse of Prescription ADHD Drugs Rising on College Campuses
Preparing Your Daughter for Changes
Reading to Kids Helps Their Development
Solving Battles at Mealtime
Talk With Your Kids About These Issues
Talking Sex with Your Teen
Teens and Talk: What's a Parent to Do?
The Do's and Don’ts for Children's Meds
Treat Children's OTC Drugs With Care
Treating Minor Childhood Injuries
We Can Head Off Teen Tragedies
What Kids Drink Is Important, Too
When Children Say 'No' to New Foods
When to Call the Doctor for Childhood Illnesses
When Your Child Says, 'I'm Sick'
Diseases & Conditions
AIDS/HIV in Children
Anatomy of a Child's Brain
Anatomy of the Endocrine System in Children
Anxiety Disorders in Children
Asthma and Children
Asthma in Children Index
Bicycle, In-Line Skating, Skateboarding Safety--Injury Statistics and Incidence Rates
Bipolar Disorder in Children
Bites and Stings
Bone Marrow Transplantation in Children
Brain Tumors in Children
Chemotherapy for Children: Side Effects
Child Care
Diphtheria in Children
During an Asthma Attack
Ewing Sarcoma
Eye Safety and First Aid
First Aid for Poisonings
First-Aid for the Eyes
Hepatitis B (HBV) in Children
Home Page - Burns
Inflammatory and Infectious Musculoskeletal Disorders
Inflammatory and Infectious Neurological Disorders
Inguinal Hernia in Children
Insect Bites and Children
Insect Stings
Kidney Transplantation in Children
Meningitis in Children
Minor Injuries Overview
Mood Disorders in Children and Adolescents
Muscular Dystrophy
Myasthenia Gravis in Children
Osteosarcoma in Children
Pediatric Blood Disorders
Poliomyelitis (Polio) in Children
Post-Traumatic Stress Disorder in Children
Preparing the School-Aged Child for Surgery
Schizophrenia in Children
School-Aged Child Nutrition
Slipped Capital Femoral Epiphysis
Sports Safety for Children
Superficial Injuries Overview
Television and Children
The Growing Child: 2-Year-Olds
The Heart
The Kidneys
Tick Bite Diseases
Treatment for Human Bites
Upper Respiratory Disorders
Upper Respiratory Infection (URI or Common Cold)
Vision Overview
Whooping Cough (Pertussis)

Disclaimer: This information is not intended to substitute or replace the professional medical advice you receive from your child's physician. The content provided on this page is for informational purposes only, and was not designed to diagnose or treat a health problem or disease. Please consult your child's physician with any questions or concerns you may have regarding a medical condition.