Cough Syrup Doesn't Help Kids

I would say no, linkat. My grandmother used to take a teaspoon of whiskey for her cough. It worked, but since she was a hard shelled baptist, she would always proceed it with the statement:

The Bible says a little wine for the stomach's sake.

Kids--especially happy, trusting kids--are very open to the placebo effect. When an authority figure--especially a loving authority figure--says, "Swallow this and you'll feel better," kids obey.

Noddy you don't know my kids. My husband and I have had to work as a team to make my kids swallow their medicine before. One to hold the kid down and avoid scratches and the other to pry open the mouth and force the medicine down. Lots of yelling and hollering. The old this will make you feel better does not work in our household.

The most effective cough suppressant is codeine, obtainable only by prescription.

The FDA requires testing of medicinals on adult patients. To my present knowledge, children and of course infants are NEVER tested for their responses in CONTROL STUDIES.

With 100 participants ( insuficient number ) in the reported study, and not knowing the experimental conditions, I'd take the whole thing with a grain of salt.

Those ingredients, effective in the adult Rx, are probably at a reduced concentration, when added to the pediatric OTC product, primarily to avoid any possible occurrence of a toxicity.

Codeine will quiet the cough for sure because it knocks the child or adult who takes it out like a light. LOL

Should Codeine, Dextromethorphan or Hydrocodone be Prescribed?
AAP Committee on Drugs, Pediatrics June 1997

Introduction: Pediatricians often feel that they need to prescribe something when a patient comes to the office. Of course, the primary cause of cough - if present - needs to be identified and treated: eg allergy, GE Reflux, asthma, irritants such as cigarette smoke, dust and wood heat. Even if one of these etiologies is found, codeine, dextromethorphan, hydrocodone are often prescribed to give symptomatic treatment to children. What will you recommend when you are in private practice?

1. Codeine

Mechanism of action: suppress artificially and disease-related cough through CNS action
Dosage usually used: 1 mg/kg/day in 4 divided doses up to 60 mg/day.
Side Effects: respiratory depression and obtundation; can be addictive.
< 2 mg/kg/day: unlikely to have any side effects
3-5 mg/kg/day: somnolence, ataxia, miosis, vomiting, rash, facial swelling, itching
> 5 mg/kg/day: 3% require mechanical ventilation; 2 deaths.
Interactions with other medications: If given with Acetaminophen, increased toxicity:
Hepatic glucuronidation pathway incompletely developed in infants putting infants at increased risk, more if given with other meds metabolized in the liver.
Evidence of effectiveness: shown to definitely work in the chronic cough of adults; a linear relationship between the dose and the frequency of chronic cough. There is no study that shows that codeine is effective in suppressing cough in children: Ref: Taylor: JPeds 93;122:799-802. Controlled study: same as placebo.
2. Dextromethorphan

Mechanism of action: same as codeine; in adults’ works through CNS action to elevate the threshold for coughing.
Dosage used: also 1 mg/kg/day in 3 to 4 divided doses.
Side Effects: behavioral disturbances including respiratory depression
Evidence of effectiveness: same study of Taylor: no difference from placebo.
3. Hydrocodone and hydromorphone

More addictive than codeine and should not be used. Elixir contains 25% alcohol.
4. Combination Medications: antihistamines, decongestants, expectorants, and antipyretics and codeine or dextromethorphan.

Problem: these medications are potentially harmful particularly in children less than 6 mos of age. Immature hepatic enzyme systems make side effects from decongestants more likely: irritability, restlessness, lethargy, hallucination, hypertension, and dystonia.
Dosage: never worked out well so that dosages extrapolated from adult data.

Conclusions of AAP Committee on Drugs about cough medications in children:

No studies support efficacy and safety of narcotics. No clear-cut indications in children. Cough suppression may be hazardous and contraindicated in some illnesses.
Dosage guidelines for cough and cold mixtures are imprecise for children.
Parents must be educated about lack of proven effect and risks of medications.


Medical College of Georgia
Department of Pediatrics | Medical College of Georgia


http://www.mcg.edu/pediatrics/CCNotebook/chapter2/cough.htm

I've had that cough suppressant with codeine. I don't know whether it made my cough stop or not, but it did knock me out and allow me to sleep. It was actually for my allergy as I was coughing so hard my chest ached. He also prescribed an allergy medicine.

When my baby had a bad cold/cough, my pediatrician said that no cold or cough medicine should ever be given to an infant. They should be at least 1 and a half to 2 years old. All that my pediatrician suggests is use saline drops to help decongestion. My pediatrician rarely gives prescriptions especially for things like the flu or colds. As a matter of fact the only prescriptions I have ever received for my two young children (5 and 1.5 years) since their birth was one for one ear infection and one other one for conjunctivitis,