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The Honolulu Advertiser
Posted on: Friday, April 6, 2007

Cold medicines can be dangerous for the very young

By Jan Jarvis
McClatchy-Tribune News Service

GIVING MEDICINE TO CHILDREN

Don’t rely on a kitchen spoon to measure. Some can hold nearly twice as much as others.

For dosage cups, pay close attention to the numbers on the side, and measure the medication at eye level on a flat surface.

Cylindrical dosing spoons look like wide straws with a small spoon at the top. Measure at eye level, and have the child sip from the spoon.

For children who can't drink from a cup, put the medicine in a dropper and give it to the child before any drips out.

When using syringes, squirt the medicine into the back of the child's mouth, where it is less likely to spill out.

SOURCE: U.S. Food & Drug Administration

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COMMON SIDE EFFECTS

Antihistamines: These can cause drowsiness or overstimulate a child.

Acetaminophen: Too much acetaminophen has been associated with liver toxicity.

Decongestants: These are stimulants that can raise the heart rate and cause insomnia, loss of appetite or irritability.

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FORT WORTH, Texas — A runny nose or annoying cough is usually not enough to send 5-year-old Huston or his baby brother, Hogan, to the doctor's office.

But they do prompt their mother, Heidi Bryan, to visit the medicine cabinet.

"I'm one of those people who won't call the doctor until we're dying," said Bryan of Fort Worth. "Over-the-counter stuff usually does us pretty well, and I feel safe with what I'm using."

Parents have long relied on fruit-flavored cold medicines to relieve the sniffles. But concerns about the over-the-counter medications marketed for children have led the Food and Drug Administration to study safety and effectiveness of these products.

Pediatricians and others want the government to require labeling that says these medications should not be given to children younger than 6.

"Parents are unaware that many of the medications that they use on their older children have not been tested for their younger children, and that's what dangerous," said Dr. John Podgore, professor of pediatrics at the University of North Texas Health Science Center in Fort Worth. "There are some hazards definitely, especially for children under 2."

The U.S. Centers for Disease Control and Prevention reported in January that over two years, 1,519 children under 2 were treated in emergency rooms for adverse effects and overdoses associated with cough and cold medicines. The medications also were fatal to infants who were found dead in their homes. The babies, all less than 6 months old, had levels of the decongestant pseudoephedrine that were 9 to 14 times the dosage for children 2 to 12.

There is no real "recommended" dosage for children under age 2, said Dr. Vincent Iannelli, UT Southwestern Medical Center associate professor of pediatrics. Many of the drugs have been on the market for decades and were never tested for effectiveness and safety in children under 6, he said.

Labels on all cough and cold medicines for children direct parents to contact a physician before giving them to a child under 2.