The common cold and cough are common ailments that afflict individuals across all ages and backgrounds. A cough can be triggered by external agents such as dust. It is an intrinsic mechanism that enables clearance of mucus accumulated in the airways.

The traditional approach to cough treatment involves monitoring the cough for a few weeks to see if it gets worse and natural home made remedies including warm fluids and rest. However, in recent decades, it is increasingly common for parents, especially to seek a doctor’s consultation when their children present with coughs and they often leave the clinics with cough syrups and other medication.

Pricey medications also come with risk of side effects

A recent poll conducted in the Royal Children’s Hospital in Melbourne has revealed that excessive use of “over-the-counter” medicines may in fact do more harm than good. A staggering estimate suggested that approximately AUS$67 million was being spent each year on cough and cold medication. In the sample of parents the poll surveyed, the researchers discovered that these medicines were incessantly being given to children without observation of any apparent benefit.

An article published in 2009 discussed the need to ban cough medicines due to manifestation of unexpected side effects such as allergic reactions and hallucinations.

Dr. Adam Jaffe, director of respiratory medicine at the Sydney Childrens Hospital stated, “There is no scientific evidence to support their use in the under twos. There was concern those children were suffering side effects because they were being overdosed.”

The Health Sciences Authority (HSA) in Singapore quoted possible dangerous side effects for the use of cough medicines for children under the age of two, such as seizures and reduced consciousness. These medications can be particularly pernicious if the child is simultaneously suffering from other illnesses, the medications are given in excess or the frequency of dosage given is higher than recommended.

The HSA suggests discussing the use of cough medicines with a qualified healthcare professional especially for children “between 2 to 12 years old.” Simple precautionary measures such as scanning the ingredients present in the medication and measuring out precise amounts of the medicine may be helpful as well.

Such medicines were found to be largely ineffective in excess years ago

Even more worrying is that the fact that cough medicines may have no scientific basis for their effectiveness had already been established several years ago. Yet to this day, parents continue to purchase these medications for their children.

This apparent indifference towards scientific evidence stems from several causes such as the widespread availability of these medicines, and even more worryingly, recommendations from professionals such as pharmacists and doctors.

Parents are also interested in alleviating the discomfort that their child experiences from a common cold or cough, without realising the complete extent to which these medicines exert their insidious effects in the body. However, the onus cannot be placed entirely on healthcare professionals as often times, their decisions can be governed by parental expectations.

The manner in which these medications are metabolised in adults and children is radically different. After considerable research of the effects of cough medicines conducted primarily in adults, some positive effects have been noted as a result of taking these medications.

However, it may not be prudent to simply extrapolate these results and expect similarly positive benefits in children. The Asian Parent, a popular website based in Singapore, recommends natural remedies to treat cough such as honey, warm soup and steam, which has long been used as a technique to relieve congestion. It may be useful for paediatricians to remind parents of such natural alternative for minor bouts of cough and flu.

A statistic from the KK Women’s and Children’s Hospital in Singapore suggests that the average child suffers from a cold or cough six to 12 times a year. With such frequent occurrence of the common cold and cough, particular attention must be paid to using these medications in moderation. Whilst it may be idealistic to expect complete cessation of usage of these medications, efforts must be made to educate parents and guardians about the occasionally unexpected harm that these medications can cause. MIMS


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