By Jeanne Roberts

As a recent UK recall of cough medicines emphasizes, children can't be treated like adults when it comes to colds and coughing. Take the case of a Wayne, Indiana infant, who was given some cough medicine and subsequently died in her sleep. Or consider the case of a New Zealand child, who was given an anti-psychotic instead of cough medicine. Cough and cold medicines (including prescriptions) that would not faze an adult can be lethal when used in children under 2. Even prescription medicines must be suspect, since allergic reactions develop quickly and pharmaceutical errors are not uncommon.

The UK recall involves six baby cough remedies because of fears of accidental overdose. The recall sends a clear warning to parents not to administer any cough or cold remedy to the under-2 set without first consulting a doctor. This is good advice in any country.

According to Sara Coakley, of the UK's medical products regulatory agency, the cough remedies, or syrups, contain a number of suspect ingredients which can be harmful to small children. These include: brompheniramine; chlorphenamine; diphenhydramine; dextromethorphan; pholcodine; guaifenesin; ipecacuanha; phenylephrine; pseudoephedrine; ephedrine; oxymetazoline and xylometazoline.

These ingredients, if given in excess, can do serious damage to small, developing bodies. Instead, Coakley and American pediatricians recommend giving children under 2 simple cough syrups made from glycerine, honey or lemon. Or, better yet, water. A 2004 study published in the journal Pediatrics shows that water is fully as effective as an over-the-counter, or OTC, cough medicine, yet cheaper and safer.

Of particular concern to health professionals is the tendency of parents to combine medicines to treat their child's cold. Combinations like cough medicine and cold medicine – containing two or more of the above ingredients – have been known to result in loss of consciousness and even death.

In the UK, more than 90 patented cough remedies will eventually be removed from shelves and relabeled with warnings against administering them to anyone under 2 years of age (with additional precautions for the over-2 set). In August of 2007, the Food and Drug Administration (FDA) warned against giving any cough or cold remedies to children under 2 without a doctor's consent. In January of 2008 , the FDA followed up this warning up with a review and a recall, primarily affecting Tylenol and Pediacare brands of children's cough and cold remedies. To read the entire report, go to: Recall on Children's Cold & Cough Medicine. The FDA further advised parents that administering OTC cough and cold remedies to children under 2 – and up to age 12 – is likely to do little good and equally likely to cause harm.

The serious and potentially life-threatening side effects that can occur from improper administration of cough and cold remedies to children under 2 include, but are not limited to, inability to breathe, rapid heart rate, seizures, choking, loss of consciousness and death. To emphasize these warnings, the FDA reported on 4 infants who had recently died as a result of improper administration of cough and/or cold medicines.

If you must treat your child for a cold (and why would you, since colds go away on their own?), use acetominophen or ibuprofen to relieve pain and fever. Never give your child a “leftover” prescription medication – even if it was originally prescribed for your child – and never use aspirin or anything containing salicylic acid or salicylates, as this can cause Reyes Syndrome, or RS (RS is primarily a childhood disease that generally occurs about 3-5 days after the onset of a viral illness like flu or chicken pox. RS affects all organs of the body, causing particular harm to the brain and liver by increasing cranial pressure and depositing massive amounts of fat in the liver).

RS is often misdiagnosed as encephalitis, meningitis, diabetes, drug overdose, poisoning, sudden infant death syndrome, or psychiatric illness. Its symptoms include persistent or recurrent vomiting, listlessness, personality changes like irritability or combativeness, disorientation or confusion, delirium, convulsions, and loss of consciousness. If you observe any of these symptoms in your child – even if you have not administered salicylates – contact a doctor immediately. RS can develop on its own, does not necessarily produce all the symptoms mentioned above, and can be debilitating or even fatal if not caught and treated early.

Coughing is actually a good thing. It helps relieve chest congestion. Night coughs can deprive children, and their parents, of sleep, but a vaporizer can help by adding needed moisture to the air. Add a little Vicks to the vaporizer if you like. It has no medical value in reducing cold symptoms, but it will help open airways and soothe your child.

Severe or persistent coughing can be a sign of pertussis, or whooping cough, a dreaded childhood disease that – left untreated – can lead to persistent ear infections, pneumonia, convulsions, seizures, brain damage or brain bleeding, mental retardation, cessation of breathing and death. If your child's coughing becomes so persistent and difficult you can hear the classic “whooping” sound at the beginning of each breath, you need to get to a hospital. This whooping may sound like a loon, a boiling teapot, or the blast of a train whistle at a crossing.

Lastly, to protect your child, clean out your medicine cabinet. Throw away all expired prescriptions, and move all prescription and non-prescription medications to a place your child can't reach. Cough and cold medicines, formulated to taste good, are an enticement to explore and experiment. Don't let your child come to harm from the medicines you safely administer under a doctor's supervision, or the medicines you – as a good parent - don't dispense.