Q. When my 4-year-old is sick, is it best to treat his cold symptoms with over-the-counter medicines? Do they really work?
A. As a parent, there are two questions you should ask about over-the-counter (OTC) cold medicines: Do they work, and are they safe? In my family and pediatric practice, we operate on the principle of "show us the science." Children are too precious to be given any medication that has been proven neither safe nor effective, despite advertising claims. I believe that the best OTC treatments can be found at your local health food store. Fruits, vegetables, and seafood are optimal foods for building up the immune system, and are the best prevention of illness. That said, here are a few safe and effective ways to treat colds in children.
Try home remedies. You might be surprised that the great majority of OTC cold remedies don't work any better than home remedies: a good nose blow, "steam cleaning" the air passages, eating immune-boosting foods, and plain old tender loving care. In fact, I'm convinced that taking a decongestant to dry up a runny nose may actually prolong a cold. Secretions in air passages need to be thin and moving so that you can cough and sneeze them -- and the germs -- out. Consult your doctor for effective home remedies.
Ask yourself how much the cold is bothering your child. If your child is sleeping well, doesn't seem especially sick, and the cold is just a runny-nose nuisance, then home remedies are enough. But if a stuffy nose keeps your child awake at night because clogged air passages are making breathing difficult, you'll want to treat the cold with something stronger. Being sleep-deprived not only makes a cranky child crankier, but weakens the immune system further. Your best bet is to use decongestant nose drops or nasal spray. Flush out the nose first, then use the drops or spray as directed. Try not to use nasal decongestants more than two or three nights in a row; otherwise a rebound effect can occur and actually increase your child's stuffiness.
What about coughs? There's no need to treat a daytime cough unless it's interfering with your child's ability to play and learn. If the cough wakens, your child at night, try a medicine that contains these two essential ingredients: guaifenesin (a cough loosener; also called an expectorant) and dextromethorphan (a cough suppressant). Carefully follow the directions on the package.
A warning: Do not give cough and cold drugs to an infant under one year of age without your doctor's recommendation. Do not allow your child's daycare center or caregiver to give any medication to your child without your permission.
Develop the pills/skills mindset. It is of great concern to many doctors, especially pediatricians, that so many patients expect a pill for every ailment. While medications for colds are sometimes necessary (especially prescription meds), it's equally important to go the self-help route. Put your home-remedy skills to work and administer OTC medication, when necessary. Instill this pills/skills mindset in your children, practice it yourself, and your family will live healthier ever after.