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What is a Safe Cough Medicine for Babies?

Cough is a natural reflex that helps to clear mucus from the airways and protect the lungs. In babies, coughing can be due to many different reasons, ranging from common colds, air pollution, and irritants to potentially dangerous health conditions like pneumonia, foreign object obstruction, and whooping cough. Watching a baby cough can make parents and caregivers feel worried and helpless. If your baby is coughing, should you go to the emergency room, call the pediatrician, or just give the baby some nonprescription cough medicine? Being able to identify the primary cause of the cough can help you to determine the best course of action. Here’s what the experts say.

What causes coughing in babies?

One of the most common causes of cough in babies is a viral respiratory illness affecting the lower airway, which typically causes a wet cough with phlegm accompanied by common cold symptoms such as a runny nose, sneezing, low-grade fever, and decreased appetite. You may have heard the term “bronchitis,” this is always caused by a virus, such as influenza, common cold virus, and even croup. It is important to know that bacteria do not cause bronchitis in healthy children.

Other possible causes of coughing in babies include:

  • A cough can happen during an asthma attack. Though these attacks do not present with cough alone, they often come with wheezing and shortness of breath. 

  • Pollutants, including fumes, air pollution, cigarette smoke, or paint fumes.

  • Serious infections such as pneumonia, bronchiolitis, whooping cough.

  • A foreign object in the airway causing coughing, wheezing, and shortness of breath

Should you give kids cold medicines and cough medicines?

Most coughs and cold symptoms in kids are self-limiting, meaning they will resolve themselves and, most of the time, don’t cause serious health issues. It is absolutely stressful for parents when their baby is not feeling well with a persistent cough, so it can be tempting to give a child cold and cough medicines, but it’s worth remembering that, in most cases, a child’s cold and cough symptoms get better on their own. A cough and cold medicine does not change the natural course of an upper respiratory infection such as the common cold or make it go away any sooner. Rather, some cough and cold medicines can cause serious side effects, especially in babies and young children. 

Is it safe for a baby to take cough syrup?

It is not safe for a baby to take cough syrup. The U.S. Food and Drug Administration (FDA) warns that children under 2 years of age should not be given any kind of over-the-counter cough and cold medication that contains antihistamines or decongestants. 

Cold and cough medications can cause serious, potentially life-threatening side effects in babies and young children, including rapid heart rate, convulsions, and even death. For this reason, drug manufacturers voluntarily label over-the-counter cough and cold products as “do not use in children under 4 years of age.”

Keep in mind that OTC cough and cold medicines are not the same as OTC fever and pain-reducing medications like acetaminophen (Tylenol) and ibuprofen (Advil). It is acceptable to use these medications at the recommended dose to relieve pain and fever for your child as long as these drug products do not contain any other active ingredients except for acetaminophen or ibuprofen.   

Why can older children take over-the-counter medicine if it’s not safe for babies?

In older kids and adults, nonprescription cough and cold medications can help to treat cough, sore throat, runny nose, and congestion in the nasal passages, thereby reducing the discomfort caused by an upper respiratory infection without serious side effects. However, the illness will still run its course (usually about 1-2 weeks), and most children and adults get better on their own even if they don’t take cough and cold medicine. 

Before giving cold and cough medicines to children, parents and caregivers should read the label and package instructions carefully for age recommendations and dosing limits. Never give cough and cold medicines meant for adults to a child. If you are not sure which is an appropriate kids medicine, check with your healthcare professional or pharmacist. 

Even if your child is older than 2 years, talk to a pediatrician first before giving them an OTC cough and cold medicine. Following is the recommendations from the FDA and the American Academy of Pediatric (AAP):

  • Do not give cough and cold medicines to children less than 4 years old

  • Ages 4 to 6: Do not give your child OTC medicines before checking with your child’s doctor.

  • 7 years and older: OTC cold and cough medicine can be given if used correctly.

Is Zarbee's cough syrup safe for babies?

Zarbee’s cough syrup is safe for babies. It does not contain antihistamines or decongestants like other OTC cough and cold products. Rather, Zarbee products contain natural ingredients such as dark honey and agave to soothe coughs and sore throats or zinc to support immunity. Various Zarbee’s products are suitable for babies between 12 and 24 months of age. Zarbee’s also makes a chest rub and saline nasal mist for babies as little as 2 months of age.

What can I give my baby for a cough?

The U.S. Food and Drug Administration (FDA) recommends non-drug remedies to relieve cough and cold symptoms in infants and young children. These include:

  • Hydration (drinking plenty of water) can help a child feel better faster. Babies can be hydrated with ORS (oral rehydration solution), breast milk, or formula.

  • Saline nasal drops or sprays keep the nasal passages moist and clear nasal stuffiness. 

  • Nasal suctioning using a bulb syringe, with or without saline nose drops, can be especially useful in babies younger than 1 year old (older children may resist nasal suctioning). 

  • Cool mist humidifiers help to loosen dried mucus in a child’s nose, decrease nasal congestion, and make breathing easier. Avoid warm mist humidifiers, which can cause swelling in the nasal passages and make breathing harder.

  • An over-the-counter fever and pain reliever, such as acetaminophen or ibuprofen, can reduce fever and aches and pains in children 1 year of age and older. Read the package instructions carefully or talk to your healthcare provider or pharmacist for the correct dose. Do not give aspirin to children as it can cause a serious complication called Reye’s syndrome.

What is the best natural medicine for a baby’s cough? 

For babies under 6 months of age, check with the pediatrician before using any home remedies. 

For babies between 6 months and 1 year of age, you can use saline drops, a cool mist humidifier, and clear fluids (such as lemonade and apple juice) in small doses of 5-10 mL (1-2 teaspoons) up to 4 times a day to relieve coughing. Honey should not be given to children younger than 1 year of age. 

For children older than 1 year of age, 2-5 mL (½ to 1 teaspoon) of honey as needed can help soothe coughs. 

Children older than 6 years of age may be able to take over-the-counter cough suppressants and do salt water gargles to loosen mucus and soothe a sore throat.

When to see the pediatrician for a child’s cough?

You should obtain medical care from a pediatrician if your child’s cough does not go away in a few days or is accompanied by greenish-yellow phlegm, fever, wheezing, or trouble breathing. Call your child’s doctor immediately or go to the nearest emergency room if your child’s cough is accompanied by high fever, fast breathing, difficulty breathing, or labored breathing.

 

References:

  1. https://www.texaschildrens.org/blog/here%E2%80%99s-what-your-baby%E2%80%99s-cough-could-mean#:

  2. https://www.fda.gov/consumers/consumer-updates/should-you-give-kids-medicine-coughs-and-colds

  3. https://www.fda.gov/drugs/information-drug-class/frequently-asked-question-childrens-cough-and-cold-medicines

  4. https://www.zarbees.com/product/baby-cough-syrup-immune

  5. https://www.seattlechildrens.org/conditions/a-z/coughs-meds-or-home-remedies/

  6. https://www.seattlechildrens.org/conditions/a-z/cough-0-12-months/

  7. https://emj.bmj.com/content/20/1/100