The other day a mother with a well 6-month old child came in to the clinic and reported that she was using a ‘natural’ medication to treat a cough. She left unhappy when I tried to dissuade her from using any medication, and suggested simple methods of support. Since, I have been wondering how to get the message across in a clearer fashion, and have decided to write this article.
As most parents know, the use of any cough suppressants in children under 6 years of age is a concern. The US Food and Drug Administration, with the support of most pediatricians and pediatric associations has stated that these medications should be avoided in children in general and absolutely in those less than 6 years of age.
Unfortunately, we are seeing an increase in the number of parents who are using homeopathic medicines for cough in children. Among the more popular is KIDS 0-9 Cough and Cold Syrup. This syrup is very well marketed as a ‘natural product’. However, most folks do not recognize that on the list of the ingredients for this ‘natural medication’ is BELLADONNA or ‘beautiful lady’. Belladona is poisonous and is riskier than any of the over the counter medications prohibited in children < 6 years of age. Indeed, drugs derived from belladonna are rarely used in children and even then in a controlled fashion.
Natural Does Not Mean Good!
Marketing medications as ‘natural’ is troubling. My explanation that ‘natural is not necessarily better’ often falls on deaf ears. Belladonna is just one of the active ingredients folks will find in a number of the concoctions in the ‘natural products’ section. The entire area is poorly regulated. Most consumers do not realize that the majority of the drugs physicians use (aspirin, morphine, digoxin) is derived from plants. Thus, they too are ‘natural’.
My biggest concern is that many of the ‘natural’ syrups available have so many ingredients, that it is really hard to understand what you are taking. Please appreciate I have the same concerns with Tylenol or Advil or Motrin Cold and Sinus etc. Using many different medicines together is not good. If anything, it is worrying.
I always encourage parents to stay within the FDA guidelines, and to use non-medicinal support for the children with coughs and seek help when they are concerned. Natural products and their use are becoming more and more a ‘belief centered’ therapy. Please appreciate regardless of your beliefs, there is enough evidence for just time and patience in treating our children with coughs and colds.
So what should a parent do for a child with a cough?
Before considering the question of what to do, lets ask whether you need to treat. Many parents are concerned with coughs in their children, especially in the very young. Many children, especially in their first year in daycare, school or in any new environment will have frequent coughs and colds. The younger the child, the more likely the cough will ‘sound like it is in the chest’. The mucus form the nose drains down the child’s throat triggering a cough, which often sounds like it starts from the chest. Consequently, people often come in concerned about the child’s chest.
There is also a misconception that a child with a persistent cough has or will develop pneumonia if the cough is not suppressed or ‘treated’. With the advent of improved immunizations, the incidence of bacterial pneumonias is small. Most coughs in immunized children are caused by viral respiratory tract infections. They may be associated with fever, chills, aches and pains just like a pneumonia.
However, in children who have received at least 3 rounds of the pneumococcus vaccine, the chances of having a bacterial infection, even with x-rays consistent with pneumonia is less than 1%. The need for chest x-rays in children under 5 years of age is increasingly debatable.Practitioners will not consider an x-ray or treat for pneumonia in the absence of fever for 5 days.
I realize that many parents want to fix a cough. However, time is often the only thing available. Frustrating as it may seem, it is likely a better option than giving your child a medication that not only is unlikely to work, but has dangerous side effects.
- Image referenced from oxfordcounty.ca