Alternatives to infant cold medication

Friday, February 15, 2008 | 5:00 p.m. CST; updated 11:15 a.m. CDT, Tuesday, July 22, 2008

COLUMBIA — Monica Henson has always been wary of giving her young children over-the-counter cold medicines.

Henson, a mother of two who’s expecting her third child later this month, finds home remedies an effective way of treating her children’s colds.

“I was always scared to give the cold medication,” she said.

Henson wasn’t surprised when she heard the U.S. Food and Drug Administration in January began advising against the use of cold medicine for children younger than 2. She said her daughter Destinee began “throwing up non-stop” after taking cold medicine.

Henson relies mostly on home remedies such as honey or lemon tea, a damp towel and a lot of relaxation and down time.

“They say sleep is the best way to cure a cold,” she said.

Only when her own remedies don’t seem to be working will she give her children over-the-counter medicine, but even then she usually limits her use to fever reducers such an infant Tylenol designed for young children. When the colds are severe or show signs of being a different illness, Henson said, she turns to her pediatrician.

The FDA review found that chemicals in the cold medicines marketed for young children — dextrapremorphine, pseudophedrine and phenylephrine — can be dangerous and ineffective. Pseudophedrine and phenylephrine can contribute to high blood pressure, cardiac arrest and, in some cases, death in babies younger than 2. Dextrapremorphine can cause over-sedation and convulsions from overdosing.

No data supported the effectiveness or safety of the medications, the FDA said.

According to the FDA, “many of the over-the-counter cough and cold products have multiple medications in them. If you use two medications that have a similar active ingredient, the child could get too much of the ingredient and that could hurt a child.”

Many cases were reviewed in which infants became ill or died from accidental overdoses or ineffective chemicals. Cold medicines such as Dimetapp, Pediacare, Little Colds, Robitussin, Triaminic and Tylenol Infant products have been voluntarily pulled by the makers of these medications.

Dr. Thomas Selva, a pediatrician at Green Meadows Pediatrics, recommends the use of home remedies before over-the-counter medicine for infants and children.

Parents treating their infants with home remedies will find “they’re just as effective as over-the-counter medications,” Selva said. “Home remedies work just as well.”

The home remedies he recommends might not seem as attractive to some as colorfully packaged medicines, but it’s surprising how well remedies such as cool-mist vaporizers, saline drops and, for children older than 1, a teaspoon of honey can treat colds, Selva said. Since the FDA has not outlawed infant cold medicines, the medicines can be sold, although most have been pulled from the shelves of pharmacies in Columbia. Kilgore’s Medical Pharmacy stopped carrying cold medicine for infants since the advisory, but pharmacist Ann Bromstedt said parents still ask for it.

“I steer them away and tell them to ask their pediatrician before buying the cold medicine,” Bromstedt said.

Dr. Hana Solomon, a private practicing pediatrician in Columbia, has gone as far as patenting her alternative to cold medicines. After researching an ancient concept used by Buddhists, she found nose-washing was a safe and effective alternative to treating sinus congestion. When she first recommended it, some patients were not exactly thrilled.

“You want me to what? Where?,” Solomon said was a common initial reaction.

Since she first began recommending nose-washing, Solomon said she’s seen increased use of this alternative. She credits the media and rising costs of medical care for an increasing reliance on home remedies.

“Complementary and alternative medicine is growing faster than Western medicine,” Solomon said. “People are more aware of the side effects of medicine. The Internet has made people more consumer savvy, and people are more aggressive advocates for themselves.”

Solomon’s Nasopure is patented as a modern take on the neti pot, a small container resembling Aladdin’s genie lamp filled with salt water and used to drain sinus congestion. Users tip the spout into one nostril and let the solution flow out the other, removing pollen, mold, dust and mucus and relieving congestion.

Her commercial version, which sells for $17 to $20, consists of a blue plastic bottle and premixed salt packets that make a pharmaceutical-grade buffered isotonic salt mixture that provides a stronger concentration of salt for more congestion. It’s safe for ages 2 and up, but for younger infants, Solomon recommends a lesser concentration of the saline mixture. She advises keeping the infant upright, using a bulb syringe to suction the mucus out of each nostril and repeating up to two to three times a day.

Whether using a neti pot or Nasopure, Solomon stressed the value of using a nasal wash. “Any washing is better than no washing,” she said.

Selva said that 1/2 teaspoon of traditional table salt can also be mixed with 8 ounces of water and used in the same way.

Dr. Robert Harris, a private practising pediatrician at Boone Clinic Pediatrics and clinical professor at Children’s Hospital at the University of Missouri Medical Center, said he doesn’t want any of his patients to use the cold medicines under scrutiny if possible. For children older than 6, he recommends a cough suppressant only for sleep-disturbing coughs.

“A cough suppressant will help them sleep,” Harris said. “But use it with discretion.”

Not all coughs are bad. They are the body’s way of eliminating the secretions and mucus within the lungs, Harris said. But when children need relief and parents are exhausted, a safe dose of cough medicine is OK, especially for overnight relief.

Also safe to use are acetametiphines, commonly known as fever reducers.

“When used in proper dosage and when used by themselves and not in combination with a decongestant, they make the child feel better,” Harris said.

Although the FDA will not announce another decision on regulating cold medicine for children over 2 until the spring, Harris said the main message is clear: “They’re not effective and possibly dangerous.”

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