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Cold medications are often taken by patients of all ages – including children – to help relieve symptoms such as a runny or stuffed-up nose, coughing and sneezing. In adults, the medications may provide relief from some symptoms, despite the fact that they cannot stop or shorten a cold. However, the use of these drugs in children is a source of controversy. Though many parents maintain that these drugs help their children to better endure cold symptoms, some experts contend that there is little or no proof that cold medications are effective when used by children.

Colds are a regular part of a child’s life, with the average child experiencing six to 10 colds each year that typically last for 10 days to two weeks. There is no cure for the common cold, but these infections typically are relatively harmless and resolve on their own over time.

A child with a cold may experience symptoms such as runny nose (rhinorrhea) and cough that generate major discomfort. As a result, parents often turn to cold medications to relieve these symptoms. There are scores of these medications available in various combinations that include substances such as decongestants, cough suppressants, antihistamines, antipyretics (which reduce fever) and analgesics (which reduce pain).

According to the American Academy of Pediatrics (AAP), studies have failed to show any proof that cold medications help young children. In particular, these drugs should not be used in children 2 years of age or younger. In this population, these medications can be harmful and sometimes even life-threatening, according to new research. Cold medications may be more effective in treating symptoms related to adolescents and adults.

Although most cold medications are generally considered to be safe, they may present health risks – some of which can be fatal – when they are taken by children at excessively high dosage levels or when taken at correct dosage levels over long periods of time. Parents may not consider over-the-counter cold remedies to be medications when a physician asks if the child has taken any medications. In addition, dosage guidelines for children have traditionally been based on information gathered about adult usage and therefore are not considered to be especially precise. Parents may initially give a child a recommended dosage, but increase the dosage, expecting that a higher dosage may provide additional relief. In some cases, this may worsen symptoms.

In recent years, the Food and Drug Administration (FDA) has asked all drug manufacturers to remove the ingredient phenylpropanolamine (PPA) from over-the-counter decongestants. It is suspected that this ingredient may lead to an increased risk of hemorrhagic stroke (bleeding in the brain that damages brain tissue). Most drug manufacturers have worked to either remove medications that contain PPA or replace PPA with other ingredients.

Many experts urge parents to avoid using cold medications in children if possible. Cold medications cannot prevent or reduce the length of a cold. At best, they can control symptoms, and whether they are effective at all in children remains a topic of debate. Studies have shown that the sedative quality of many of these medications often fools parents into thinking the drugs are working, when in fact they have little or no impact on a child’s symptoms.