Stronger measures needed to deter use of cough and cold medicine in young children

Following the introduction of Health Canada's 2009 labelling requirement, there has been a small decrease in over-the-counter cough and cold medication use in children -- down from 22 per cent before the change.

The study, published today in the Canadian Journal of Public Health, was led by St. Michael's Hospital pediatrician and researcher Dr. Jonathon Maguire. The research included approximately 3,500 children from 2008 to 2011, measuring cough and cold medication use before and after the mandated labelling requirement.

"We found that a large number of young children continue to receive over-the-counter cough and cold medications even with evidence of harm, public health advisories from government agencies and mandated labelling requirements for manufacturers," said Dr. Maguire. "In addition, evidence suggests these medications are not effective in young children. With no real benefit and documented risks, stronger measures may be needed to curtail their use."

In 2009, Health Canada mandated warnings on cough and cold medications advising against use in children under six, based on lack of evidence in their effectiveness and reports of harm and risk of adverse events. Researchers said although this labelling standard had a small effect on lowering their use in young children, the proportion of children regularly receiving them is still quite high.

"I think a lot of parents would be surprised to learn that these medications can be harmful to children," said Dr. Maguire. "Better public awareness as well as making these readily available medications harder to purchase may help to reduce their use."

Studies have shown that discouraging use of potentially harmful substances -- such as tobacco products -- has been helped by placing them behind-the-counter and adding packaging with prominent warning labels. Dr. Maguire believes that similar strategies may be needed to further reduce cough and cold medication use in children.

The study also found that children with younger parents and older siblings were more likely to receive cough and cold medications, suggesting a need for education within this group.

"Young parents and those who used these medications with older children prior to the Health Canada warning may not be aware of the change, so it's important for health professionals to raise awareness," said Dr. Maguire. "When a child has a cough or cold, it's extremely challenging for families and parents are looking for some relief."

He prescribes patience with a lot of hugs and kisses, saying coughs and colds get better with time.

The researchers asked parents of 3,500 children under the age of six about their use of cough and cold medications who were participating in TARGet Kids!, a unique collaboration between children's doctors and researchers from St. Michael's Hospital and The Hospital for Sick Children in Toronto. The program follows children from birth with the aim of understanding and preventing common problems in the early years to minimize their impact on health and disease later in life.