Cough medicine and children « Healthy Children

Dr. P’s Pediatric Journal Club

The study

The parents of 100 children with common colds were asked to rate the frequency, severity, and ‘bothersome nature’ of their child’s nighttime cough for two nights.

On night #1:

–> no cough medicine was given.

On night #2 :

–>1/3 were given dextromethorphan (“DM”),

–>1/3 were given diphenhydramine (“Benadryl”),

–> 1/3 were given sugar water.

(Parents were not aware of which they gave.)

What the study found
- Most kids’ coughs improved on day #2.

- There was no difference in the frequency, severity, or discomfort of the cough, whether or not the child had received either cough medicine or sugar water.

- Kids who took DM tended to sleep worse; those who took diphenhydramine tended to be drowsier.

What the study suggests

Two popular over-the-counter cough medicines were no more effective than sugar water in reducing the nighttime cough of children with a common cold.

In response to the scientific evidence of this and other studies, the American College of Chest physicians issued guidelines for treating coughs this week which also spoke to the general uselessness of OTC cough syrups (in part, they believe, because they are given in too small doses to be of benefit).

Dr. P comments

Considering the unbelievable amount of money spent on cough syrups, you’d think they actually would work. This study, as well as others, just confirms what I have seen for a long time: they rarely (if ever) do. Perhaps their only benefit is the (false) sense of security parents feel that at least they are at least doing something for their miserable child!

In a way, it’s not all bad that OTC cough syrups are ineffective. When the back of the throat and lungs are full of mucus, coughing is nature’s way of bringing it up and out of the irritated areas. Imagine what would happen if your child were not to cough at all: all that gunk would pool in the back of the throat, making breathing even more difficult.

The sad truth is that giving your little one cough medicine will probably be an exercise in futility, not to mention a waste of money. Remember, in this study, most kids’ coughs got better on their own. Sure, go ahead and try cough medicine if you must, but 1) don’t get your hopes up and 2) don’t continue giving it if it clearly is of no benefit.

A vaporizer or humidifier may help to keep the mucus moist and thin, and therefore easier to cough up. Elevating the head of the bed helps a bit. Occasionally a decongestant affords some relief.

Your TLC is always the best medicine for soothing your miserable child and, alas, tincture of time is the only sure cure for the cough of a common cold!

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Article cited:

“Effects of dextromethorphan, diphenhydramine, and placebo on nocturnal cough and sleep quality for coughing children and their parents.”

Paul M, et al. Pediatrics. July, 2004.