Feed a Cold, because Cough & Cold Infant Meds are Gone

Posted by Mariano DiFabio
October 19, 2007

Earlier this week, my sister-in-law (the one who’s pregnant) and my mother-in-law told my wife and me about a large voluntary recall by drug companies of their over-the-counter cold and cough medications. For today’s blog, I decided to research the issue further, because we regularly give our son Tylenol on those days when his teeth seem to be bothering him because they’re erupting through the gums in his mouth. Having battled RSV, Croup, Pneumonia, Rotavirus and a number of other bad colds and sickness, we didn’t want something we were doing to cause him any more distress than what he’s already been through.

According to warnings from federal regulators and doctors, the issue is that there are potential health risks with cough and cold medications for kids under 6 years old. Statistics gathered by researchers from the Food and Drug Administration (FDA) show that 54 children had died from 1969 to 2006 after taking medication specifically for children with the ingredients ephedrine, pseudoephedrine and phenylephrine. They also found that 69 deaths in the same period resulted from use of antihistamines that contained diphenhydramine, brompheniramine and chlorpheniramine. Most of these children were under 2 years old, and the FDA added that the medicine didn’t even seem to provide any benefit to children in this age group. (1)

The Consumer Healthcare Products Association (CHPA) represents the collective public voice of drugmakers in the US. Its president, Linda Suydam, acknowledged that there could be issues with “rare patters of misuse leading to overdose,” particularly in infants. But drugmakers insist that the medicines are safe and effective when used as directed, especially given that “the vast majority of parents and caregivers” use them properly. (2)

Still, as a result of the warnings issued by the FDA and private doctors, over-the-counter cold medicines such as Tylenol, Dimetapp, Robitussin, Triaminic and Little Colds were voluntarily recalled by the drug companies that make them for children under 2. They are suggesting to the FDA that labels in these products be changed from “ask a doctor” before using to “do not use” in children under 2 years. The complete list of products is as follows:

USA Today interviewed a group of doctors when this story was released, who offered some advice to parents trying to treat a cold (read the full interview here). Household treatment methods, such as extra humidity in the air, extra fluids to drink, and Tylenol, Motrin or Advil for fever, are all suggested as alternatives to the cold medicines. Since there is no proven benefit from the use of these medicines and studies show that there is risk, one Atlanta pediatrician Jennifer Shu said, “Why chance it?” Indeed, our pediatrician has never recommended the use of these medicines in my son, although I can distinctly remember a couple of instances where we were very tempted to use one of these products. Instead, we ended up buying a humidifier, an aspirator to keep his nose clear (he didn’t love us for that), and a nebulizer for those times when he was really sick. We’re happy to do it to relieve his symptoms, even if it is more work.

In addition, in an article on the New Scientists web site from January 2002 named “‘Feed a cold, starve a fever’ may be right,” Michael Le Page indicates that the adage expressed in its title may be supported by scientific fact. At first, it indicates that saying was regarded as myth by most doctors and nutritionists. But a study by Dutch scientists “found that eating a meal boosts the type of immune response that destroys the viruses responsible for colds, while fasting stimulates the response that tackles the bacterial infections responsible for most fevers.” (4)

The study was started by Gijs van den Brink of the Academic Medical Center in Amsterdam. He wanted to see if alcohol had any effect in the immune system, and after a Christmas dinner with his colleagues, they took blood samples of the guests and examined them for changes. They were surprised to find that it was not alcohol, but food that caused a change in their body chemistry. Extending the study, they invited 6 participants to fast overnight and then come in the next day for tests. On one occasion they were given a liquid, but nutritional meal, on the other just water to distend the stomach.

Six hours after the liquid meal, the participants’ blood samples showed that their level of gamma interferon had quadrupled, an indication that killer T-cells in their body could be readily produced to consume any cells that had been infected by pathogens, the type of response expected in a viral infection, as in a cold, for example. When they drank only water, however, the levels of this gamma interferon fell slightly and another chemical messenger, interleukin-4, nearly quadrupled. This chemical is an indicator of the body preparing its defenses for pathogens lurking outside cells, usually indicative of a bacterial infection and the cause of a fever.

So in addition to any home remedies you use to attack the symptoms of a cold or fever, keep your child fed to stave off that cold, even if his or her appetite is not quite where it usually is. Thankfully, our son loves to eat, so this shouldn’t be a problem for us. And, based on the evidence, a little Tylenol for aching gums is okay — but probably not something we should be doing every day.

What do you think? If children’s cold and cough remedies are relegated to containers that warn parents not to use them if their children are under 2, will you follow that guideline? If you’ve given the medicines to your children before, do you feel that they did work, and the recommendations by doctors and the FDA are overly cautious? Would a combined risk of 123 deaths over the 37 years between 1969 and 2006 be enough to convince you that there is a risk to your own child? Please, share your thoughts!

(1) See “Kids’ cough, cold medicines pulled“, Edward Iwata, USA Today, October 12, 2007.

(2) See (1)

(3) See “Makers of OTC Cough and Cold Medicines Announce Voluntary Withdrawal of Oral Infant Medications“, News Release for the Consumer Healthcare Products Association (CHPA), October 11, 2007.

(4) See “‘Feed a cold, starve a fever’ may be right“, Michael Le Page, New Scientist, January 11, 2002.

Pediatric Medicine, Research

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Pingback by Stress Management » Feed a Cold, because Cough & Cold Infant Meds are Gone on October 19, 2007 @ 2:13 pm

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Pingback by Avelient BioPharm Blog | Sea-ing is Believing: New Way to Treat Cold Symptoms in Children on January 23, 2008 @ 12:22 am

[...] ineffective in any children under 12. We’ve explored the news items here in 2 posts, “Feed a Cold, Because Cough & Cold Meds are Gone,” which was published when the news first broke and the cough and cold medications were [...]

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