When my close friend called me at work to say that my 17 month old son was congested, with a runny nose and slight fever, I knew she was calling to find out what she should do.  She loves Rufus like her own and realized that although I was at work, I’d want to know what was going.  Rufus had recently spent time at daycare several days earlier and he most likely picked up a virus. 

A viral illness may cause fever— even a high fever, cough, a sore throat, runny nose and congestion but it’s self-limited and doesn’t require much, if any medication. 

So I wouldn’t go for the overkill.  He needed something….he was getting fussy and irritable and wasn’t feeling well at all.  He had taken liquid Tylenol on occasion  since the age of 6 months at his pediatrician’s suggestion after getting his routine immunizations so I knew Rufus could tolerate a dose of acetaminophen if needed.  Tylenol would be a good and safe option.  So I recommended that she buy infant’s Tylenol and give him one dropper full—a single dose. 

With the virus spreading throughout the house from Rufus to me and on to my husband, I headed to the pharmacy several days later to pick up some over-the-counter cold medication for myself.  As I walked down the cold remedies aisle, I was struck by the overwhelming number of choices for children and adults from acetaminophen and ibuprofen-based products for fever and pain relief, dextromethophan or guaifenesin-based medications for cough relief to pseudoephedrine for decongestion. 

I spent over fifteen minutes searching the aisle looking for the exact combination of components that would control my symptoms without adding extra medications that I didn’t need like chlorpheniramine or diphenhydramine/Benadryl which causes drowsiness.  I finally settled on a cough syrup containing a decongestant.  After getting my medication, I wandered over to the children’s section just to see what was available. 

Even as a physician, I found it difficult to sort through all the medication combinations and became brutally aware of how easy it would be to get confused or unintentionally give more than the recommended dose of medication to your child…especially if your child has multiple caregivers.  Say for example, your babysitter gives your child a dose of cold medication right before you pick him up.  You forget to ask her when your child last received his medication and then within two hours you give him another dose…virtually giving him a double dose of medication within a short period of time. 

Most of the time a single extra dose of medication won’t kill him but in some instances it might.  If your child has continued to receive multiple extra doses over a course of several days, one additional dose may be toxic and lead to serious complications and even death. 

The Food and Drug Administration has received numerous reports of serious events and death related to cold medicine preparations in children and in response to these reports issued a public advisory regarding over-the-counter cough and cold medications for young children. 

These guidelines are useful for parents and caregivers and especially for physicians who often advise their patients on how to treat the common cold in children: 
 

1. Cough and cold medications should not be used in children under the age of 2 unless directed by your doctor.  Rufus had been advised to use Tylenol as needed after receiving his vaccinations to his prevent a post-immunization fever and help relieve any discomfort at the vaccine site.
2. Cold and cough medications intended for use by adults should not be used by children.  In other words, if you don’t have Children’s Tylenol in your medicine cabinet but you have adult cough syrup, DO NOT try to substitute this for medication designed especially for children.  Even in smaller quantities, the adult formulation may still be too potent and too strong for your child.
3. Use the packaged measuring device to administer the liquid medication.  DO NOT use a household teaspoon or tablespoon to estimate the dose.  You may inadvertently given significantly more than the intended dose.  And if you don’t have a measuring device, BUY ONE before you leave the store.
4. If your child’s condition doesn’t improve or worsens, stop using the medication and contact a doctor immediately.  
5. And the fifth guideline is from me, Dr. Traci, the Health and Wellness Queen:  Keep a running log of when your child has received his last and is due for his next dose of medication.  Make sure you alert all of your caregivers concerning your child’s medications, either prescription or over-the-counter.  This log will avoid over dosing or missing doses.  Good communication between caregivers is the key to keeping your child safe when fighting a cold.

To safely treat the common cold, be smart and use over-the-counter medication only as directed.

To your wellness,
Dr. Traci Ferguson, The Health and Wellness Queen.

This entry was posted on Saturday, September 15th, 2007 at 10:53 pm and is filed under Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.