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USF Professor Offers Advice For Worried Parents

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The Tampa Tribune

Published: January 18, 2008

Updated: 01/18/2008 12:13 am

The Tampa Tribune talked to Bernard Pollara, a University of South Florida professor of pediatrics, about the Food and Drug Administration's public health advisory Thursday against the use of over-the-counter cough and cold products - including decongestants, expectorants, antihistamines and cough suppressants - for children younger than 2.

In October, several drug companies voluntarily removed from the shelves many popular over-the-counter cough and cold remedies that were targeted for infants and toddlers. Are they still available out there?

I don't know the answer to that. I know our parents come in here in our clinics - and they're not apprised. They're always asking, 'Why can't my baby have these medicines?' We've been telling them they're not advised by the government to be safe for infants.

An FDA advisory committee in October voted unanimously to ban these products for infants - and, on a 13-9 vote, also advised banning such products for children under 6 as well. Do parents still have these in their medicine cabinets?

I bet there are a lot of parents who have the stuff in their houses, but it's not advised to use them. It's always been a problem in terms of dosing. We don't know what the correct dose is in young infants. It's unfortunate we use the measure of a teaspoon for prescribing. That's pretty inaccurate. Teaspoons come in all sizes and shapes. Even before the FDA decision, we would never prescribe these to a baby at a young age. Under 1 - never. And very rarely under 2.

What's the danger?

They've had episodes where children have had side effects that have been quite dangerous. Children have succumbed from these medications. It doesn't happen very often, but it does happen.

So what's a parent to do when an infant or toddler gets a cold and is feeling miserable?

What we recommend is humidity - humidifier (Pollara recommends a cold-mist humidifier because he says they're less dangerous than the warm-mist versions.) And if they've got nasal congestion, we recommend using saline nose drops and suction bulbs to clear that out. And then patience is what it takes ... If they have a fever, then we recommend agents like Tylenol or ibuprofen for an elevated temperature.

Back in October, the FDA advisory panel voted to avoid giving these cold and cough remedies to children between 2 and 6 years old as well, although the vote wasn't unanimous. The FDA hasn't put out a public health advisory to that effect yet. What do you think?

They've actually convened a study group on the older children. The same caveats apply. Don't give them unless they're really indicated for kids. There are shelves full of these cough and cold (remedies), decongestants. I don't think we're taking a stance against use in older children.

Karen Branch-Brioso

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