Is it safe to give cough syrups to children?

The recent WHO warning about the dangers of some cough syrups linked to the deaths of children in many countries has frightened parents everywhere.

In October 2022, WHO issued an alert over Promethazine Oral Solution, Kofexmalin Baby Cough Syrup, Makoff Baby Cough Syrup and Magrip N Cold Syrup manufactured by Maiden Pharmaceuticals Limited, Haryana, India.The four “substandard products” were identified in the Gambia and reported to the WHO in September 2022.

In November last year, an alert was issued by the WHO over eight products, including Unibebi Cough Syrup, Unibebi Demam Paracetamol Drops and Unibebi Demam Paracetamol Syrup, identified in Indonesia and manufactured by PT Afi Farma.

Earlier this month, the WHO issued an alert to warn against the use of two “substandard” cough syrups manufactured by Marion Biotech, India that have been linked to the deaths of 18 children in Uzbekistan.

Though India’s drug regulator told the WHO that the global health body drew a premature link between the deaths of children in Gambia and the four India-made cough syrups which adversely impacted the image of the country’s pharmaceutical products across the globe.

But what is worrying is that whether any of cough syrups usually given to children below five years of age is safe or not. According to the experts, Cough syrups are not recommended by WHO for treatment of cough, cold and pneumonia. WHO has classified pneumonia in different categories.

One is No pneumonia (cough and cold), then Pneumonia and severe Pneumonia and or very severe disease in age group 0 to 5 years. The classification is based respiratory rate, chest indrawing and general danger signs.

According to the health experts, it is very important to know that WHO hasn’t recommended cough formula for any classification of above mentioned severity grades of pneumonia.

What they have recommended is 5 days nebulization with levosalbutamol 4 hourly and home-based remedies like honey, mothers’ milk and lukewarm water.

“Cough formulas are actually mixture of more than three drugs and they do more harm than benefit to patient. We recommend people that they should keep nebulizer at their home and whenever their kids develop respiratory symptoms, their knee jerk response should be nebulization instead of purchasing cough formulas,” they said.

It is also important to note that cough syrups are not recommended as the first-line treatment for children’s coughs. The American Academy of Pediatrics recommends that parents should use simple measures to relieve a child’s cough, such as humidifiers to moisten the air and liquids to help loosen secretions. This can help to ease the symptoms of a cough without the need for medication.

Though WHO has issued an alert, but Drugs & Food Control Organisation, J&K had earlier said that these banned cough syrups were not being sold in Kashmir.

But it is important to be aware that some cough syrups contain codeine which can be dangerous for children, and WHO recommends not to use codeine-containing products in children under 12 years of age and to use with caution in children between 12 and 18 years of age, as it can cause serious side effects such as breathing problems, drowsiness, and confusion.

In conclusion, cough syrups can be an effective treatment for children’s coughs, but they should be used with caution and under the guidance of a healthcare professional.

Parents should consult with their pediatrician or a healthcare professional before giving any cough syrup to a child, and they should follow the dosage and usage instructions provided by the manufacturer.

Simple measures such as humidifiers and liquids can also help to relieve a child’s cough symptoms without the need for medication.

DISCLAIMER: The views and opinions expressed in this article are the personal opinions of the author.

The facts, analysis, assumptions and perspective appearing in the article do not reflect the views of GK.