Runny Nose and Cough
. Allergy or Cold
NOTICE: The AAP and FDA have made a recommendation that cold medications
are not to be given to Children below 4 years old. Deaths have
occurred mainly from over doses and usually with the concentrated form of
cold medications. If dosed correctly and used sparingly, I think the
risk is very rare so I will allow these medications past 2 years old. You need to be warned however and the advice on
this page should be used if you know the risks. I frequently talk
parents out of giving medicine but if you are going to give something to
your child, then here is the advice I have given for many years.
AMERICAN ACADEMY OF PEDIATRICS: Use of Cough Remedies in Children
The difference between a viral cold and an allergy is length of time. A cold is a runny
nose &/or cough that lasts for a few weeks, and an allergy lasts for a month or more.
Give a cough/cold medication for the symptoms. These
medications do not cure the problem, nor prevent complications like ear infections,
bronchitis, pneumonia. All these medications do is slow down the symptoms "so you can
rest medicine". They decrease cough, congestion, and mucus for the 4, 6, or 12 hours
but if you are going to have a cold/allergy for a month, then you will have it for a
month. The medicine does not make it go away quicker. So there are a series of questions
you have to ask when talking about treating the cold/allergy. Is it bothering the child or
the parent? If the runny nose or cough is not bothering the child, we would just as soon
not treat the symptoms and just wipe their nose. (How do you make a Kleenex dance? You put
a little boogy in it.:) I would rather they be alert and learning, instead of drowsy on
the antihistamines. If the cold is bothering the child, then the next question is
which medication. A certain medication may help this child but not that one. And that
medication may make this child drowsy and that child hyper and not sleep. So everyone is
different in how they react. We cannot tell you the best one for any certain child or
adult. It is a trial and error. If the mother down the street brags about her medication
and how it helps her child, borrow a teaspoon and see if it helps your child. Treat only
when the child has the symptoms. You may only have to treat it at night. You also can
sleep the child with the head elevated; especially the infants can sleep in their
carriers, swings, or car seats all night. Another old fashion way is to put
Vicks Vapor Rub on their feet (yes feet) and put socks on them. That
helps the cough.
Lets talk about the ingredients of medications. There is only one decongestant over the
counter and that is "Sudafed". Sudaphedrine or Ephedrine is "Sudafed".
This is the decongestant in all preparations. There is only one cough suppressant and that
is Dextromethorphan (DM). I do not think that expectorants are useful and they taste
terrible. So the only difference in most of the medications is the antihistamine that
dries up the mucus. Look for a medication that is for cough (dextromethorphan), and stuffy
nose (Ephedrine), and runny nose medicine (these other medications will be the
antihistamines). If it covers all the symptoms, then you can use it for most illnesses.
There is Triaminic, Pediacare, Tylenol Cough and Cold, Dimetapp, Claritin, or generic drug store
brand and many others. It still boils down as to which one will help your child. Then
there are prescription ones that are different but are not stronger. Claritin
was prescription and now over the counter but it only helped 50% of the
children. Prescription ones tend to be newer on the market and the
company has a "copy right". Then after so many years the product goes
over the counter and generics come out. There is Zyrtec and Allegra and others that are
meds. These are long acting
antihistamines that last 12 to 24 hours. You can give a decongestant Sudafed with them (
or get Claritin-D which has the Sudafed in it). But these will not help the cough most of
the time and they are for allergies and not colds. You can try Vicks
vapor rub on your child's feet and put a sock on it. This helps better
than on the chest and can be used starting around 6-9 months of age. If the cough is severe at night and
none of the cough medications like Nyquil or Vicks 44 are helping, then call for
prescription cough medication that has Hydrocodone and it will help
decrease the cough so everyone can sleep. This stronger cough
medication should be used sparingly and only for the night cough and for
children school age and older.
Most of the over the counter cough meds are dosed the same. Get the cough/cold medicines that are liquid for children
(not concentrated eye dropper form) and dose it:
for 22-33 lb., give 1/2 the dose listed for the 6 yr old.
for 33-44 lb., give 3/4 the dose listed for the 6 yr old.
for over 44 lb. give the dose listed for the 6 yr old.
The AAP does not recommend cold meds below 4 years old.
Definitely not use them below 2 yr old. The main problem is the
decongestant like sudafed.
Decongestants like sudafed should not be used for children below 2 yr old.
Use a pure cough medication with dextromethorphan like Delsym (use 1ml dose
for 18mo to 4 yr.)
For allergy congestion, there are nose sprays of steroids and they are
safe. You have to use them all the time and not just when you are
symptomatic. Discuss them with the doctor if you are not helped out by the
The cough can sound deep and congested, but if the child is happy, playful, and has no
fever, then treat the cold as above. If the child has fever 101 rectal or more, is lying
on the couch not playing, is screaming several times at night, or has continuous green
mucous runny nose plus irritable all day, then make an appointment. One cannot tell it is
bronchitis by the sound of the cough. If the child gets pneumonia or bronchitis, the cough
will sound the same and the child will start having fever and lay around after
the 5th day of the cold. So watch how the
child acts, not go by the cough.
If the cough makes a seal-bark honk sound, it is
"croup". It is helped by a vaporizer, or take them into the bathroom and steam
it up like the London fog, or actually put them in the car and drive around in the cool
night air. It treats the strider (respiratory distress). If they are in severe respiratory distress, then go to
the ER. If they do OK for the night, then see your doctor for a short course of steroids
to open up the airway and keep them out of the Hospital. See them in the AM even though
they are better for it is more severe on the second and third nights.
Coughs that are
severe and they cough 10 times without breathing, and cause them to gag and even throw up, should be seen by the doctor.
Allergy testing and shots are generally not recommended till 4 yr. or older and then I
am still not crazy about them unless there is asthma. The night only cough is usually
allergy. To see if it is anything in the bedroom causing it, sleep the child out of the
bedroom or out of the entire house at Grandmas or neighbors. The child will be fine that
night and the next morning. Then it is something in the bedroom or house (pillow,
mattress, stuffed animals, cat, dog, smoking, etc.)
Remember to ask yourself: "Who are these symptoms bothering, you or the kid?"