Kids' cough syrups will be available on prescription only for children under two.
-Infant cough and cold syrups will only be available on prescription for children under two after a government committee ruled them potentially dangerous and unproven to work.
-The National Drugs and Poisons Scheduling Committee (NDPSC) decided to reschedule the drugs in the wake of reports of rare life-threatening sideeffects, like convulsions and rapid heart rates and even death, in the US and UK.
- The committee said there was little evidence of increased illness and death among young Australian children because very little data was collected. But experts were persuaded to make the change when combining this possible risk with the lack of evidence that the medicines actually work.
- There were also fears parents may be using the drugs incorrectly. The committee said: "It might be for some parents that sedation per se was the reason they sought to use these drugs, rather than the conditions which the products are actually indicated for."
Kids and Cough Medicine
When a child coughs it does so for a reason - whether to expel mucous, a foreign body or because the airway is irritated. The nature of a cough can also be an important indicator of what the likely cause of the cough is: e.g. the whoop of pertussis the barking cough of croup, the cough with wheeze associated with asthma.
Certainly when this reaction is prolonged it affects sleep of both the child and parent and a way to stop it is sought. There are numerous over the counter medicines for such situations and very few have been found to be more effective than placebo. Often they contain substances untested in those under two and which if given in a high enough dose can cause drowsiness, heart rate increases, hyperactivity and in several documented cases overseas, death. For this reason they are going to be only available via prescription in the near future.
Coughs and Medicines
Coughs and colds are common, but luckily most are viral infections and go away by themselves. In fact, a cough is a natural mechanism that helps clear the lungs of infection. Usually most acute coughs settle after one to two weeks, often sooner.
As a general rule, medicines should not be given unless they do more good than harm, but unfortunately most over-the-counter cough mixtures don’t follow this rule.
There is no evidence from clinical tests that cough suppressants (that aim to reduce cough), expectorants (that are meant to help get rid of mucous in the lungs) and mucolytics (that are supposed to thin mucous) actually work.
Cough suppressants often contain codeine derivatives which can sedate children – while they may sleep more it does not help the cough go away. Many cough mixtures contain complicated mixtures of different medications in doses that are less than what would be recommended to be effective that can increase the risk of side effects. For example, the addition of an antihistamine increases the sedative effect, and by making the mucous thicker, can make it more difficult to cough up, causing a second infection.
Decongestants may help clear the nose but again can make children “hyped up” and irritable. So, although many children seem to be OK when given cough mixtures, they are not harmless and probably don’t do much good either.
So what can you do?
If you're concerned that it is not your usual cough and cold (for example they may be more unwell or coughing for longer than expected, or have a very high fever, or breathing difficulties), then you should have your child checked by your doctor; there could be asthma or a bacterial lung infection that needs specific treatment.
If it seems to be your usual cough, then encourage your child to drink more fluids and give paracetamol if needed for fever or discomfort. Saline nasal sprays can help clear mucous if needed. Cough lozenges or demulcents (non-medicated preparations that soothe the throat) can be used in older children, and are relatively harmless and inexpensive.
Remember, most coughs will settle in days and cough mixtures will not make this happen any faster. Interestingly two recent studies showed a spoon of honey and a glass of water more effective in treating a common cough than over the counter medication.
