New warning about giving kids codeine cough syrups
Last month, a medical advisory group to the Food and Drug Administration (FDA) voted “overwhelmingly” to limit the sale of codeine products without a prescription and advised “drugs containing codeine should not be used to treat children or the majority of teens suffering from pain or a cough.” [my emphasis]
I knew you could buy codeine painkillers and cough syrups in Canada, but apparently you can in 28 US states, as well. The FDA hasn’t acted on the advisory committee’s recommendation yet, so these products are still available over the counter.
Parents—be especially cautious when buying cough or cold medications for small children (under 12). Read the labels!
Codeine is a narcotic and a small amount is converted by the liver into morphine, which depresses or slows down the body’s breathing mechanisms.
Young children are particularly vulnerable. Their bodies may convert codeine into morphine at a higher rate, resulting in higher levels of morphine in their blood.
The American Academy of Pediatrics (AAP) does not recommend using either codeine or the more common cough syrups containing dextromethorphan. Like codeine, dextromethorphan depresses the central nervous system.
Dextromethorphan is in A LOT of over-the-counter cough and cold medicines. Did I mention read the labels? 😉
Related post: Save money on cold medications
So what’s a parent to do when their child has a lingering cough that is keeping everyone awake at night?
Try a spoonful of honey
JAMA Pediatrics published a study in 2007 that looked at different treatments for cough. One group of kids was treated with the recommended dose of dextromethorphan (DM); another with honey; and a third with placebo.
In a comparison of honey, DM, and no treatment, parents rated honey most favorably for symptomatic relief of their child’s nocturnal cough and sleep difficulty due to upper respiratory tract infection.
WebMD suggests giving kids 2 teaspoons of honey (any type) before bedtime. However, honey is not recommended in children under the age of 1 because of a risk of botulism.
Rub on some Vick’s VapoRub
My favorite pediatric blogger, Wendy Sue Swanson, MD, evaluated a study that suggests rubbing Vick’s VapoRub (or a generic version) onto a child’s chest and neck at bedtime helps reduce nighttime coughing.
A new study found that when compared to using Vaseline or nothing at all, Vick’s stood tall. It helped children and their families SLEEP.
So go ahead and use it on their chest at night if you feel it helps.
But she adds:
Most pediatricians (and I) don’t recommend Vicks or any Camphor-containing products for infants or children under age 2.
Dr. Swanson also recommends honey and humidifiers.
The medical journal Pediatrics just last year published a report that said emergency room physicians are prescribing codeine too frequently for children. Treatment guidelines can take a long time to trickle down to every doctor in every health care setting (old habits die hard).
Don’t hesitate to ask for more information about any prescription given to your child.
- Question any prescription containing codeine that is given to your child. Ask about alternatives.
- Read labels at the drugstore and avoid medications containing either codeine or dextromethorphan.
- Be patient. The average cough takes up to three weeks to go away.