Pediatrician Dr. Sheref Unal checks
Emilie King of New Berlin during a clinic visit

November 27, 2007

SIU Pediatrician Gives Advice for Treating Children’s Colds

Even children want a speedy recovery when suffering from the dreaded cough, runny nose and fever.  But with warnings from the U.S. Food and Drug Administration (FDA) about cold medications, parents are questioning what they can do to help their sick children.

“Most children will get better only with time as the body builds a defense against the infection,” says Dr. Sheref Unal, assistant professor of pediatrics at Southern Illinois University School of Medicine in Springfield.  The average child will have eight colds a year with symptoms disappearing gradually after seven days, according to the American Academy of Pediatrics (AAP).  That means one week out of nearly every month in a year, your child may have a cold, explains Unal.

Medicines have been marketed for children for decades but there is little proof these medications work.  “When your child is sick, you feel vulnerable and marketers have played on those feelings,” explains Unal.  “Unfortunately the medications have not shown to be any more effective than a placebo or ‘dummy pill’ in medical studies.”

Instead of studies in children, most dosing recommendations for these medicines have been based on studies conducted in adults.  These medications need to be thoroughly studied in children, but many drug manufacturers have never done that.  Children are not small adults and have completely different bodies and immune systems, explains Unal, who is also on staff at St. John’s Children’s Hospital (SJCH) in Springfield, a joint endeavor of SIU and St. John’s Hospital.

The recent cold medication debate was sparked by an FDA advisory panel that voted in late October to ban over-the-counter cold products intended for children under the age of six.  Prior to the meeting, most manufacturers voluntarily removed from store shelves those products intended for children under the age of two.

The FDA concerns originated from a 350-page study of more than 800 over-the-counter cough and cold medications.  The advisory panel found no proof medications ease cold symptoms in children and in rare cases they have caused serious harm, even when used at the approved dosing instructions.  The AAP has questioned the safety and efficacy of the medications since 1997.

“The actions of the FDA reaffirm what many pediatricians have always believed,” says Unal.  “However, determining the future of these products is going to be a very long process.”

Unal says there is no cure for the common cold but there are remedies that can provide relief.  Suggestions for treatment from the AAP include –

• Saline drops given with a rubber-bulb syringe clear a baby’s nasal passages.
• Cool mist humidifiers aid in relieving congestion and soothing sore throats.
• Pediatric electrolyte maintenance beverages designed to re-hydrate and restore water and minerals.

For more information, visit the AAP’s Web site at www.aap.org/new/kidcolds.htm.

Colds can become more severe.  Seeing a pediatrician is important if a child has a persistent cough, difficulty breathing, persistent fever, irritability or loss of appetite.  These symptoms could be signs of an accompanying bacterial infection.

“Always trust your intuition.  If you are unsure, call your child’s physician.  This way we can do what is the most effective and safe for your child,” suggests Unal.

The best way to prevent colds is to keep children away from people who are already ill.  Because infants’ immune systems are not as developed, cold viruses can cause more serious illness.  Teaching children to cover their mouths when they cough and to use a tissue to sneeze into are good measures.  Also, washing hands regularly will cut down on the spread of viruses.

Here is some additional advice for parents, as suggested by the FDA --

• Do not use cough and cold products in children under two years of age unless given specific directions to do so by a health care provider.
• Do not give children medicine that is made for adults.
• Have health care providers review and approve combined use of medications.
• Follow the directions for dosing amounts; too much medicine can lead to serious and life-threatening side affects.
• If you do not understand instructions on a product, do not use the medicine.

“This is a difficult issue.  For so long parents have trusted these products to aid in making their child better and now an FDA panel has said otherwise,” says Unal.  “At this point pediatricians are helping re-educate parents.”

Unal joined SIU’s faculty in 2007.  He is a diplomate of the American Board of Pediatrics.  He completed an internship in pediatrics at St. Louis Children’s Hospital (2003) and his pediatric residency at Medical University of South Carolina (2005) and earned his medical degree at SIU (2002).

St. John’s Children’s Hospital in Springfield combines the faculty resources of SIU with the pediatric facilities and services of St. John’s Hospital and is accredited by the National Association of Children’s Hospitals and Related Institutions.  Its Web site is www.sjchildrens.org.

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