CR's Take
		Don't give babies and toddlers over-the-counter cough or cold medications, even if the product label suggests that it's safe to do so. The drugs have not been proved to work in children and may cause serious side effects or even death.

Over-the-counter (OTC) cough and cold medications caused three infant deaths in 2005 and sent more than 1,500 babies and toddlers to the emergency room, according to a new report by the Centers for Disease Control and Prevention.

The products are commonly used to relieve stuffy noses and coughs in children under age 2, and many parents assume they're harmless because of their OTC status. But experts have long warned that the drugs, which can raise heart rate and blood pressure, pose significant risks.

Just how much of the drugs can safely be given to babies and toddlers is still unclear, and the Food and Drug Administration has not approved dosing recommendations for children under 2. What's more, cough and cold products often contain multiple ingredients, making it easier for parents to inadvertently overdose their children when they use more than one product.

In all three infant deaths detailed in the CDC's report, the babies had blood levels of the nasal decongestant pseudoephedrine that were 9 to 14 times as high as the recommended dose for children ages 2 to 12. One infant had been given both a prescription drug and an OTC combination drug containing the ingredient.

Product labels aren't always clear about potential dangers, either; while some cough and cold drugs explicitly caution against use in children under 2, others simply say that parents should talk to their doctor about it.


Not worth the risk?

While all drugs pose some risk, there's no evidence that cough and cold remedies provide any benefit to children. Several studies have shown them to be no more effective than a placebo, and some experts have suggested that doctors only continue to recommend them because they're under pressure from parents.

The CDC is urging parents not to give the drugs to young children without first consulting their pediatrician. But given the lack of data to support their use, our consultants believe there is no reason to give them to children at all. Instead, says Wayne Snodgrass, M.D., a spokesman for the American Academy of Pediatrics, parents can use saline nose drops or a cold-air humidifier to loosen mucous in the nose and a rubber suction bulb to clear nasal congestion in infants. Plus, a cold will typically clear up on its own, usually within several days.