Cough and Cold Treatments for Your Child: What Really Helps

By: Zest Pediatrics

During this time of year, it sometimes seems like your children are always sick.  And in fact, this may be true with many children having 4 or more different illnesses during a winter season. Grandmother’s home remedies, childhood memories, and social media are all prominent parent sources for reccomedned treatments coughs and colds. But what is best for your kid? What will help them in their misery?   

This article provides guidance on which remedies and treatments have been proven to be of benefit, those for which science is not quite clear if it helps, and some we know will not be of any benefit (and may be harmful). Before we dive into treatment, remember however cliché as it may sound, the best treatment is prevention. And the best prevention is good hand hygiene and keeping your child home when you know they are sick.   

Colds are caused by viruses. It is important to understand that none of these treatments actually treat the viral cold itself. Rathe, they may help alleviate symptoms and make your child feel more comfortable. Colds often take 7 to 10 days to run their course, with or without treatment (though some remedies may help a child return to normal a day or so earlier, but that is not for certain). 

WE KNOW THESE WILL HELP

Fluids: By far the most important treatment for a cold is adequate fluid intake. What type of fluids? Whatever your child will drink. Fluids keep phlegm and mucous thinner and looser - helping to decrease cough and congestion. Fluids can also soothe the throat – especially warm ones such as chicken soup or tea. Chicken soup may even have some other immune benefits during a cold.   

Antipyretics (pain and fever reducers): Acetaminophen (all ages) and ibuprofen (if over six months) will help address fever and pain in your child. Remember, fever is harmless and actually helps fight the virus. However, fever also can make your child uncomfortable, especially if over 102 F. So use these medications to help your child feel more comfortable due to fever or sore throat.

Honey: For a cough or sore throat, honey can help. It coats the throat to relieve pain and also decrease cough triggers. Serve it on a spoon or add it to warm water or tea to help with hydration and soothing the throat. Just remember, do NOT give honey to children under 12 months old due to the small risk of botulism at that age.

Over the Counter Cough Medicines: This is a tricky subject, as it completely depends on the active ingredients. In general, the only cough medicine ingredients thought to be of benefit are honey and dextromethorphan. So the only ones you should get, if any at all, should have as the only active ingredient dextromethorphan and only for children over 4 years old. Note, this is likely no better than simply giving honey (and honey tastes so much better!). 

Humidifiers: As with giving a child fluids, humidifiers help to keep nasal mucous thinner and also can help soothe a dry and raw throat caused by mouth breathing due to a congested nose.  Cool mist is preferred to warm mist due to the risk of children getting burned if they tip over the device. 

Nasal Saline Drops/Washes: Using saline or salt water drops/sprays definitely can help loosen nasal congestion. Drops are best for small children. Neti-pots or other nasal lavage/rinsing devices can be very beneficial for older children who tolerate this. A bit scary at first, but kids do learn to use it and it can provide great relief.

Nasal Suction: Clearing your child’s nasal passages can greatly increase their comfort. This can be accomplished by using devices that support parents using their own mouth to provide the suction. These seem a bit gross, but work great and are safe to use for parents and children. Electronic suction devices are also available. Use nasal drops before to help loosen the mucous.

Topical Nasal Decongestants: These over-the-counter treatments (oxymetazoline and phenylephrine) will quickly help decrease congestion. They can be used twice a day. For children younger than 6 years, check with your pediatrician if appropriate to use. They can only be used for a few days as there is a risk that they can cause increased congestion if used for too long.

Pseudoephedrine: This medication is only available “behind-the-counter” from the pharmacist. It can be used in older children over 6 years of age and may decrease nasal congestion. However, it has many side effects like increased heart rate, decreased appetite, trouble sleeping, and changes to urination. In general, use sparingly and only in older children as recommended by your pediatrician.

Salt Water Gargles: Older children who can learn to gargle will find warm salt water gargles (with or without honey) will find it very soothing for a sore throat. 

Throat Lozenges: For older children over 4 years, these can be used to help coat the throat when sore or a tickle is prompting the cough. And now they even come as sore throat suckers on a stick to help lessen the concern for these presenting a choking hazard.

Warm Bath or Shower: Who doesn’t like a warm bath or shower when they don’t feel well? It is warm and soothing, and the increased humidity will often help relieve nose congestion. 

THESE MAY HELP

Antihistamines: The main purpose of antihistamines is to treat hives and allergies. For their anti-allergy properties, they will be of no benefit for a cold. However, diphenhydramine (Benadryl ®) does make most children sleepy and may aid in helping a sick child sleep at night. Note, if used, it should only be used for a few nights. Also, some kids have a reaction to the medication and get hyper rather than tired. 

Vitamin C: Vitamin C has various reported results. It is harmless to give, and most of what is given is excreted in the urine. In general, it is not recommended to give to children as a cold treatment. 

Elderberry: This is the hottest new supplement for colds, and it may help. Certainly, there are many preparations available, some mixed with other possible immune boosting and soothing substances such as honey, zinc, and vitamin C.

Zinc: Again, there is no great evidence that zinc will help relieve cold symptoms or shorten the duration of a cold. Zinc can also have side effects for some people. 

Menthol/Eucalyptus Rubs: That medicinal smell of menthol and eucalyptus is soothing to many people. It may help decrease nasal congestion. Some children do find it soothing to have it rubbed on their necks or chests. If it feels good to your child, why not try it. If your child’s skin becomes irritated stop using it. Some people add menthol or eucalyptus oils to the humidifier or a shower/bath.

WE KNOW THESE WILL NOT HELP

Over-the-Counter Cold Medications: These should not be given to children younger than 4 years as they have potential significant side effects. The main ingredient in cold medications, phenylephrine, simply does NOT work. Avoid using cold medications unless recommended by your pediatrician. 

Antibiotics: Remember, the common cold is caused by an infection from a virus. Antibiotics only work on bacteria. So unless your child gets a bacterial infection as a complication to the cold (ear infection, sinus infection, pneumonia) an antibiotic will not help and should be avoided.

As you can see, there are so many choices out there and you can often feel overwhelmed trying to figure out what to use for you child when they are sick. First, if your child is not bothered, do nothing. If they are uncomfortable, what you do for your child will depend on their age and what makes them feel better. And most likely, what will make them most comfortable is your loving, caring and simple presence. And maybe some jello!