Cough And Cold Medicines

There are many cough and cold medicines you can buy without a prescription. This is called over-the-counter (OTC). OTC pediatric cough and cold medicines will not help symptoms get better faster, and they may also cause side effects. Use OTC medicines with caution based on your child’s symptoms, age, and weight.

FDA and American Academy of Pediatrics (AAP) Recommendations for OTC Cough and Cold Medicines

• Less than 4 years - DO NOT GIVE cough and cold medicines.
• Ages 4 to 6 - Ask your child’s doctor. Do not give OTC’s unless you have checked with your child’s doctor or health care provider.
• 7 years and older -Cough and cold OTC’s can be used if given correctly. 
• These medicines are not safe if they are given too often.
• These medicines are not safe if you give a dose that is too high for your child's age and weight.
• Use a pediatric measuring device or the measuring cup that comes with the medicine (Picture 1). Do not use a regular kitchen spoon.

Active Ingredients

Many cold and cough medicines have more than one active ingredient. An active ingredient is the actual medicine in the product you buy. Some medicines have more than one active ingredient, and many ingredients are in many different OTC medicines. Too much of one ingredient can cause serious harm a child.

How to Treat Cold or Cough

There are safer ways to treat your child's cough and cold than using OTC cough and cold medicines:

• Have your child drink plenty of fluids, mainly water, chicken soup, or broths.  Limit fruit juice and sports drinks to avoid sugar.  
• For cough, you can mix 1 to 2 teaspoons of honey in warm lemon water. Do NOT give honey to children younger than 1 year old.
• Make sure your child gets plenty of sleep.
• Use saline nasal spray and a bulb syringe to clear congestion before eating or sleeping.
• Use a cool mist humidifier in your child’s room.  Do not use a warm humidifier. It can cause burns.
• To soothe a sore throat, older children can suck non-medicated lozenges or gargle with warm salt water. To make salt water, mix 1/4 to 1/2 teaspoon of table salt in 8 ounces (1 cup) or warm water.
• You may use these medicines to help bring down a fever or help with aches and pains. Be sure to read the label and give the correct dose.
  • Acetaminophen (Children's/Infant's Tylenol®)
  • Ibuprofen (Children's or Infant's Motrin® or Advil®)
• Do not give your child aspirin or products that contain aspirin (Picture 2).
• Do not give your child medicine labeled for use by adults.
• Always read drug facts on the label for active ingredients. This will help you understand what the medicine is for. It will also help you make sure you are not giving too much of the same type of medicine if you are using more than one product.

When to Call the Doctor

Call your child's doctor or health care provider if your child:

• Has a scratchy throat (hoarse), cannot talk, or complains of a sore throat.
• Has a cough that is high-pitched or has a barking sound.
• Has problems breathing or is wheezing or grunting with breathing.
• Turns a blue color or very pale.
• Complains of ear pain, pulls their ears, or rolls their head from side to side.
• Has problems swallowing or refuses to take liquids for 4 or more hours.
• Does not feel like playing or does not “act right.”
• Has a fever that does not come down or go away after treatment.

Please follow these guidelines for fever:

• Under 2 months of age: fever is over 100.4° Fahrenheit (F) or 38° Celsius (C) by rectum (baby’s bottom).
• Under age 2 years: after 1 day, fever is over 102° F (38.9° C) by rectum or over 103° F (39.4° C) under the arm, on the forehead or by ear.
• Age 2 years or older: after 3 days, fever is over 102° F (38.9° C) by mouth or by rectum or over 103° F (39.4° C) under the arm, on the forehead, or by ear. Oral temperatures are not recommended for children younger than 4.

Cough and Cold Medicines (PDF), Arabic (PDF), Nepali (PDF), Somali (PDF), Spanish (PDF)

HH-V-225 12/07 Revised 5/22, Copyright 2007, Nationwide Children's Hospital