A Parent’s Guide to Cold Medicines

When your child’s under the weather, you probably head to the drugstore to pick up a remedy. But with shelf after shelf filled with over-the-counter medications, the vast selection may be enough to give you a headache. How do you know which one is the right one? We asked the experts for a guide to cold medicine that helps clear up the confusion.

1. First, consider your child’s age. “It’s recommended that you avoid giving oral cold medications to children under the age of 6, unless otherwise directed by a pediatrician,” says Maria Marzella Mantione, an associate clinical professor at St. John’s University College of Pharmacy and Allied Health Professions and a national spokeswoman for the American Pharmacists Association. Some topical medications are OK for use in children 2 years and older, but always check the label for age restrictions and be sure to follow the directions for proper application -- they should not be ingested or applied where they can accidentally enter the nose, mouth or eyes.

For younger kids, soothe their cold symptoms with non-medicinal methods: Encourage plenty of fluids and rest, and run a humidifier to relieve congestion and to moisten dry nasal passages. Mantione also advises using saline drops and an aspirator for a stuffy nose, and a spoonful of honey for cough (but only for children over the age of 1).

2. Next, take note of her symptoms. Don’t automatically reach for that all-in-one remedy. “You should only treat the symptoms that your child is experiencing,” says Mantione. “Giving her unnecessary medication may lead to unpleasant side effects, like nausea or dizziness.” If your little one is suffering from more than one complaint, however, using the appropriate multi-symptom formula is a smart move.

3. Check the active ingredients. Once you’ve pinpointed your child’s symptoms, read the label to ensure that you’re buying the correct medication. This cheat sheet can help you make the right choice; make sure that you follow the age and dosing requirements on the package.

· Your child has a: Fever

The box should say: Fever and pain reliever (acetaminophen, ibuprofen). “Acetaminophen and ibuprofen are safe to use for fever or pain, such as an earache or sore throat, in children who are at least 6 months old,” says Mantione, who also advises checking in with a pediatrician. Steer clear of aspirin, which has been shown to cause Reye syndrome -- a rare but dangerous complication -- in children with the flu or chickenpox.

· Your child has a: Dry cough

The box should say: Cough suppressant or antitussive (dextromethorphan) or topical cough relief (camphor, menthol and eucalyptus oil). These types of medications reduce your cough sensitivity by suppressing receptors in the respiratory tract or, for dextromethorphan, in the brain's “cough center.”

· Your child has a: Productive cough or chest congestion

The box should say: Expectorant (guaifenesin). Expectorants thin mucus, which makes it easier to cough up. “A productive cough is good for you, so you don’t want to quiet it with a suppressant,” says Mantione.

· Your child has a: Stuffy nose

The box should say: Decongestant (pseudoephedrine, phenylephrine). This medication works by reducing swelling in the nose. But don’t use it for more than three days in a row, since decongestants can make stuffiness worse with repeated use. You can find pseudoephedrine-based products behind the pharmacy counter; Mantione believes they have fewer side effects.

· Your child has a: Runny nose

The box should say: Antihistamine (brompheniramine, chlorpheniramine, diphenhydramine). Antihistamines work by blocking histamine, compounds that attach to cells and cause fluid leakage. Most of these are sedating and can cause sleepiness, so they’re best used before bedtime.

4. Consult the pharmacist. If you have any questions or want a little guidance, find the in-store pharmacist, says Mantione. “She can also help you figure out the right dose for your child.”