Recommendations for the Use of OTC Cough and Cold Medications in Children

Ann McMahon Wicker, PharmD, BCPS; Brice A. Labruzzo, PharmD


US Pharmacist. 2009;34(3):33-36. 

In This Article

Complementary and Alternative Therapies

Alternative cough and cold therapies such as increased fluid intake, room humidifiers, nasal dilator strips, nasal aspiration or irrigation, and vitamin C can be used alone or in combination with an OTC cough and cold medication. Increased fluid intake helps prevent dehydration in a child suffering from a cough or cold. Room humidifiers provide relief from congestion by moistening the air.[16] Warm-mist humidifiers work by boiling water in a reservoir, thereby posing a potential burn risk; for that reason, cool-mist humidifiers are generally recommended. Because bacteria thrive in moist settings, parents should be encouraged to empty water from the humidifier and wipe all surfaces dry on a daily basis.[17]

Nasal dilator strips are adhesive bands placed on the nose that dilate the nasal air passages or stiffen the nasal wall, leading to increased airflow and thus relieving nasal congestion.[18,19] Nasal dilator strips with or without added menthol are FDA-approved for use in children aged 5 years or older. Latex allergy is a potential concern with this product.[18]

Cleansing of the nasal passages with a bulb syringe and nasal irrigation with saline drops are two options for treating small children with congestion. Aspiration with a bulb syringe clears mucus from the nasal passages; 0.65% sodium chloride drops and sprays soothe irritated mucus membranes and rehydrate dried secretions for easier removal from the nasal passages.[7,18]

Supplementation with vitamin C may decrease the duration of the common cold in children. A 2004 Cochrane systematic review suggests that, in children, doses of 0.2 g to 2 g vitamin C are beneficial for reducing a cold's duration. Studies have shown that children have a greater decrease in cold duration than adults, and that higher doses confer a greater benefit than lower doses. Studies evaluating 0.2 to 0.75 g/day vitamin C reported a 7% reduction in cold duration compared with an 18% reduction in studies evaluating 1 g/day.[20] Children given 2 g/day demonstrated a median decrease in cold duration of 26%, versus a 6% median decrease in adults receiving 1 g/day.[21] At doses greater than 1 g, side effects including nausea, vomiting, increased iron absorption, and diarrhea may occur.[5]