02/20/2015 11:12 am ET Updated Apr 22, 2015

Is It Okay to Give My Child Over-the-Counter Cough Medicine?

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Meredith Grossman, MD
Department of Pediatrics
Kravis Children's Hospital at Mount Sinai

Is It Okay to Give My Child Over-the-Counter Cough Medicine?

Even though product labels on most packages of over-the-counter (OTC) cough medicines state, "Do not use in children under 4 years of age," I generally recommend that parents not give cough medicine to children of any age. As a pediatrician, my main concern is the potential for rare but serious neurologic side effects involving the central nervous system, including confusion, irritability, and nervousness. The good news is that there are several safe, supportive measures parents can try to help alleviate their child's cough.

Coughing is our body's way of clearing the airway of mucus and other irritating substances, and it is important to first determine the cause of the child's cough. Most of the time, it's a virus or upper respiratory tract infection, in which case my colleagues and I at the Kravis Children's Hospital at Mount Sinai advise parents to let it run its course -- without cough medicine -- and to try some of the tips below. When cough is caused by another underlying problem, such as asthma, we will treat that disorder accordingly.

Instead of using OTC cough medicine, try these home remedies to help manage your child's cough:

For any child, steam is effective at easing coughing spasms and also may help draw out mucus if a child has a lot of congestion, which can contribute to coughing. Just turn the shower on hot and sit with your child in the bathroom, breathing in the steam for about 15 to 20 minutes, if possible.

Buckwheat honey has shown to be effective in improving both the frequency and severity of cough associated with childhood upper respiratory tract infections. For children one year of age and older, I usually recommend giving between half a teaspoon to a teaspoon, as needed. Never give honey to a child younger than 12 months, as it can cause a rare, life-threatening disease called infantile botulism.

Warm Water
Drinking warm water may help relieve cough.

If a child is congested, staying well hydrated by drinking lots of liquids will help thin the mucus, making it easier to cough out. Some people avoid giving milk to children with cough for fear it will worsen mucus, but if milk is the only thing children want to drink, it's more important they drink that and stay hydrated. (In fact, research has shown that milk consumption does not increase mucus production.)

Nose Suctioning
Because a runny nose or nasal congestion can trigger a cough, suctioning the nose can be helpful, especially for babies who can't blow their noses. First apply saline drops in the nostrils to moisten and loosen the mucus, then suction it out with a nasal aspirator or bulb syringe.

It is important to note that when a child has a cold, an irritating cough may linger for a few weeks, even after other symptoms have resolved. This is normal, as long as the child does not have a high fever or labored breathing, has a normal appetite, and is otherwise healthy. In this case, it is reasonable to just watch and wait for the cough to run its course. However, if a cough persists longer than a few weeks, it's time for a trip to the pediatrician to investigate other causes of cough.