Children's Health

Better ways to help sick infants

Love, liquids?

R. Harkness

QUESTION: What are parents supposed to do for a sick infant now that over-the-counter cold and cough products have been taken off the market?

ANSWER: The recent widely publicized shelf pull involved OTC cold and cough products labeled for use in those younger than 2 years old. Product ingredients were antihistamines, decongestants and the cough suppressant dextromethorphan.

The withdrawal was spurred by reports of product misuse that led to cases of accidental overdose and death. Additionally, there was no proof of efficacy in this age group.

Products that remain available include single-ingredient acetaminophen or ibuprofen oral infant drops for pain and fever, nasal spray/drops and rubs labeled for use in infants. (With oral infant drops, be sure to measure doses accurately.)

To answer your question: One FDA panelist, a pediatrician, recommended “love” and “liquids.”

Though parents will fret, the common cold runs its course in a few days, so that fills the bill in most cases.

There are, however, other things you can do to safely soothe and comfort your infant. Here are tips from the Handbook of Nonprescription Drugs (American Pharmacists Association):

• >Keep infants in an upright position to enhance nasal drainage.
• Increase humidity (moisture in the air).
• Use saline nose drops/spray to irrigate the nose.
• Use a bulb syringe to clear mucus from the nose.
• Give adequate liquids to prevent dehydration.

It's time to seek medical care when there is persistent fever, a persistent or phlegm-producing cough, severe sore throat, ear pain or other symptoms that fail to get better in a few days. When in doubt, call the doctor, especially for infants under 9 months.

The following 14 products are included in the withdrawal:

• Concentrated Tylenol Infants' Drops Plus Cold
• Concentrated Tylenol Infants' Drops Plus Cold & Cough
• Dimetapp Decongestant Plus Cough Infant Drops
• Dimetapp Decongestant Infant Drops
• Little Colds Decongestant Plus Cough
• Little Colds Multi-Symptom Cold Formula
• PediaCare Infant Drops Decongestant
• PediaCare Infant Drops Decongestant and Cough
• PediaCare Infant Dropper Decongestant
• PediaCare Infant Dropper Long-Acting Cough
• PediaCare Infant Dropper Decongestant & Cough
• Robitussin Infant Cough DM Drops
• Triaminic Infant & Toddler Thin Strips Decongestant
• Triaminic Infant & Toddler Thin Strips Decongestant and Cough

Pediatricians and FDA panelists further recommended that cough and cold products not be used in children younger than 6 years.

Advisers stopped short of a thumbs-down for use in older children (6 years and up). The concern was that many parents might give adult products to these children, heightening the risks.

Expect to see an onslaught of promo ads for OTC homeopathic remedies in the wake of safety concerns about OTC cold and cough products.

Keep in mind that safety and efficacy studies are not required for homeopathic remedies. Claims that products are free of side effects appear to be based on the fact that they contain little or no active ingredients. For the same reason, products also would be free of pharmacologic medicinal effects.

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