Cold Medicines For Kids: Safety, Risks & Best Alternatives

It’s that time of year, when kids come home from school with artwork, half-eaten sammies, and coughs and colds. And for some inexplicable reason, the coughing seems to crank up at night, right when everyone really needs the rest and go to sleep already. That’s when you might be tempted to check your bathroom cabinet to see about over-the-counter cold and cough medicines for kids so that the sniffling and sneezing can stop. Before you start spooning out that syrup, though, you’d better back away from that dropper, because cold and cough medicines for kids aren’t safe — or even effective — for all ages. In fact, many over-the-counter cough and cold medicines for kids aren’t proven to be effective at all.

Is it safe to give babies and toddlers cold or cough medicines?

Your kid has a bad cold and they’re miserable. So, it makes sense that you want to help reduce the ickiness that your kid feels as a result of having the common cold or from the coughing that can result from it. Thing is, giving your child an over-the-counter (OTC) cold or cough medicine is not safe, according to Dr. Cherilyn Cecchini, a pediatrician in New York City. “The ingredients in over the counter (OTC) cold/cough medicines can cause serious side effects in babies and toddlers,” Cecchini explains. “Given this, the U.S. Food and Drug Administration (FDA) does not recommend using them in children ages 2 or younger and most products include a label that states something along the lines of ‘do not use in children 4 years or younger.’”

The American Academy of Pediatrics has also weighed in on the safety of giving young children cough and cold medicines, and advises against prescribing or using them for children younger than 6 years old. One reason for this is because of pediatric fatalities that have been associated with OTC cough and cold medicines. Researchers found that, while uncommon, some young children have died because of an unintentional overdose of cough and cold medicine.

What should you look for when picking out a cough and cold medicine?

For the most part, home remedies — like plenty of fluids and rest — are all that’s needed to treat a cold or cough at home. In general, most over-the-counter cough and cold medicines are not proven to be effective at treating the common cold and can present some risks. “Talk to your pediatrician before starting any over-the-counter cough or cold medicine,” Dr. Steph Lee, a pediatrician and preventive medicine specialist, explains. If you’re really dead-set on trying one, though, be sure to “check the age range and start at the lowest dose possible to minimize any unwanted side effects.” Lee suggests taking a photo of the product and label to show your child’s doctor exactly what brand (and its ingredients) you’re considering. Don’t use the medicine until your doctor has confirmed a safe dosage.

It's often the ingredients in OTC cough and cold medicines for kids that can pose a problem. “Some products combine acetaminophen or ibuprofen, so you want to make sure you're staying within recommended dosing intervals,” says Lee. To do this, you’ll want to find medication with fewer ingredients “and one with an easy way to measure the dose like a cup or marked syringe,” says Cecchini.

As for homeopathic cough and cold medicines for kids, Cecchini advises parents to against them as they are not safe. “These are not approved by the FDA and can sometimes contain harmful ingredients as well,” she explains. “The FDA urges against using them in children 4 years old or younger.”

What are some other ways to treat colds and coughs in kids?

So, you’re staying away from OTC cold medicine for kids. But, thankfully, there are plenty of safe ways to keep your kid comfortable while their body works fight off that virus. There are other alternatives to treat your child’s cough or cold. “They may not kill the virus causing the cold, but it will make your child more comfortable,” explains Lee. “The more comfortable they are, the easier they will sleep, and the better they are able to fight off the illness.”

In lieu of OTC cough and cold medicine for kids, try these options that can alleviate some discomfort:

• Nasal aspirators with bulb syringe or other nasal suction devices, like a Nose Frida
• Nasal saline spray
• Humidifiers
• Warm steamy bath
• Pain relief medications, like Tylenol
• Warm fluids (water, small amounts of apple juice, broth or tea)
• Tea and honey (only offer honey in children over 1 year old)
• Cold or frozen foods (popsicles)

What are some of the best syrups for cold and cough for kids?

If you’re looking for the best cold medicine for kids, you should speak with your child’s pediatrician first to find their recommendations. And you should know that it’s likely they will point you towards your own pantry rather than the cold medicines or kids cough syrups that line the aisles of your closest pharmacy.

“There is no definitive evidence that [OTC cold medicines for kids] are effective and some may even be harmful,” says Lee. “Many over the counter medicines have honey in them and these are safe only for children 1 year old and up.” Babies younger than 12 months old can’t digest honey because it can put them at risk for becoming severely sick with infant botulism, another study found.

Once your child is 1-year-old or older, though, you might want to give your little honey some, well, honey. “Honey for children 1 year and up is a great natural remedy for cough and colds because it helps soothe the throat and suppress coughing,” she continues. “For example, if your little one is having trouble sleeping, you can give 1-2 teaspoons about 30 minutes before bedtime. Studies have shown it can be as effective, if not more, than over the counter cough suppressants.”

What are some good cough drops for kids?

Much like cough and cold medicines, cough drops can be given to sick kids depending on their age, but are not necessary and can even be dangerous. “Cough drops can be choking hazards, so to be safe, I recommend not giving them to children less than 6 years old,” adds Lee. “Older children should be warned about the risk of choking and advised not to sleep with cough drops either, since many of them contain sugar and when left in the mouth overnight, could increase the risk of dental cavities.” If your child is older than 6, cough drops can help with throat pain or cough, and are considered fairly safe, explains Cecchini. “Pectin is an ingredient used in cough drops that is also found in some jams and jellies and many fruits like oranges and apples,” she says. “It is uncommon for there to be any side effects (unless a child is allergic to pectin), so this type is often recommended in kids.”

But most of the potentially unsafe ingredients (menthol, benzocaine, dextromethorphan) are found in very small amounts in cough drops, making side effects rare for any type.

What’s the best cold medicine for a 3-year-old?

The best cold medicine for a 3-year-old is rest, fluids and plenty of snuggles. In other words — skip the OTC stuff. If your doctor prescribes them an antibiotic, of course, use that as prescribed. If your 3-year-old comes home with a cold, you’ll want to take the same approach to helping them get well again. “Encourage them to stay hydrated by drinking water or warm fluids like apple juice or broth,” says Cecchini. “You can try offering tea with honey if they have a cough and if they have a sore throat, you can give them over the counter pain medicine like Tylenol or Advil — just avoid aspirin.” Warm baths can help open their airways, and a humidifier can add moisture in the air to help soothe symptoms. As always, ask your pediatrician for advice if your child is sick and follow that advice.

What’s the best cold medicine for a 2-year-old with a runny nose?

When your 2-year-old is running around with a runny nose, you can banish the boogers with a nasal saline spray for starters. Not only will this help thin the snot coming out of their nose, but it will allow more of the green stuff to drain. “If your child needs help blowing their nose, try using gentle bulb suction,” adds Cecchini. You can also try running a hot shower and sitting in the steamy bathroom with your babe to help clear their sinuses.

What are some good baby cold medicines?

When you have a crying kid on your hip, you’ll do almost anything to make them better fast. Unfortunately, you won’t be able to find meds that will safely work for your little one. Babies with mild colds that your pediatrician has said can be treated at home are best off just riding it out. Rest and fluids are the best medicine for mild colds in babies. “There are no baby cold medicines that are proven to be 100% effective,” says Lee.

Timing is everything when it comes to cough and cold medicine for kids. Until they’re old enough to safely take meds, you can treat their symptoms, which should provide some relief and much-needed rest until they’re well enough to be back to their rambunctious selves again.

Studies referenced:

Dart, R., Paul, I., Bond, G., Winston, D., Manoguerra, A., Palmer, R., Kauffman, R., Banner, W., Green, J., Rumack, B. (2009) Pediatric fatalities associated with over the counter (nonprescription) cough and cold medications, Ann Emerg Med, https://pubmed.ncbi.nlm.nih.gov/19101060/

Goldman, R. (2014) Honey for treatment of cough in children. Can Fam Physician, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4264806/

Tanzi, M., Gabay, M. (2002) Association between honey consumption and infant botulism. Pharmacotherapy, https://pubmed.ncbi.nlm.nih.gov/12432974/

Experts:

Dr. Cherilyn Cecchini, M.D., a pediatrician in New York City

Dr. Steph Lee, M.D., MPH, FAAP, a pediatrician and preventive medicine specialist