Cough and cold medicines – children

Coughs and colds are common in children, but what medicines can be given?

Cough and cold medicines help reduce the symptoms of the common cold, such as runny nose and cough. They do not cure the infection. These medications can cause serious side effects in young children. To avoid harm follow this advice:

  • over-the-counter cough and cold preparations are not recommended for children under 6 years of age
  • only those labelled as safe for children should be given to children 6 years of age and older.

The information on this page is for cough and cold medicines for children. For information on adults, see cough and cold medicines for adults.

See your doctor if your child has the following symptoms
  • a sore throat
  • is not breathing easily
  • has a cough that has lasted longer than 4 weeks
  • you are worried they are not getting better. 

Can cold and cough medicines be used for children?

Medsafe, a unit of the Ministry of Health, New Zealand, has assessed the safety and effectiveness of cough and cold medicines in children. They have advised the following:

Children aged 6 years or younger

Decongestant nasal sprays: Medsafe recommends that parents and carers should not use decongestant nasal sprays or drops that contain oxymetazoline and xylometazoline in children aged under 2 years. Examples include Otrivin®, Drixine®, Sudafed®, Vicks®. 

Cough and cold medicines: Medsafe recommends that parents and carers should not use over-the-counter cough and cold medicines in children aged under 6 years. This is because there is no evidence that cough and cold medicines work in children. There is also a risk of serious side effects, such as abnormal heart rate, allergic reactions and reduced consciousness in children. Also, there is a greater risk of accidental overdose so cold and cough medicines may cause more harm than good in young children.

Medicines containing the following ingredients should not be used in children under 6 years of age
  • guaifenesin
  • phenylephrine
  • doxylamine
  • ipecacuanha
  • brompheniramine
  • promethazine
  • dextromethorphan
  • chlorpheniramine
  • triprolidine
  • pholcodine
  • diphenhydramine

Note: Paracetamol and ibuprofen are not classed as cough and cold medicines and can still be given to children.

Children between 6 and 12 years of age

For children aged between 6 and 12 years, cough and cold medicines can be used, as there is less risk of serious side effects in older children. However, they are only to be sold in pharmacies, with advice from your pharmacist.

What treatments can be used for coughs and colds in children?

Treatment Description
Paracetamol Is commonly known as Pamol, Panadol or Parapaed.
  • It can be used for the treatment of pain or if your child has a fever (temperature over 38.5°C) and is miserable.
  • Read more about paracetamol in children.
Saline (salt water) nasal spray or nasal drops Can be helpful for clearing blocked noses.
  • Using a few drops of salt water (saline) into the nose just before feeds is a popular option for treating a blocked nose in babies. 
  • Some people feel that this helps to clear the nose to make feeding easier. However, there is little scientific evidence as to how well this works.
  • You can buy saline products from pharmacies.
  • Alternatively, you can make a salt solution at home — make sure you use the correct amount of salt and water. 
  • Read more about saline drops and sprays.
Vapour rubs Vapour rubs are ointments that contain essential oils such as menthol, camphor and eucalyptus.
  • They are usually applied to the chest and back.
  • They are not recommended for use in babies less than three months old.
  • Read more about vapour rubs.
Honey Honey can act to soothe the throat.
  • It can be given on a teaspoon or given as a warm honey and lemon drink.
  • Lozenges are not recommended in children due to the risk of choking.
  • Honey is not recommended in children aged under one year because of the risk of causing infant botulism. Read more about botulism. 

If you child has a cough or cold, encourage rest and give lots to drink. If your child has a sore throat, see your doctor or nurse in case they need antibiotics or a throat swab.

Prevention

Help children to stay healthy and fight off colds and other illnesses by:

  • making sure your house is warm and dry
  • keeping your home smokefree – breathing secondhand cigarette smoke increases the risk of asthma, chest infections, ear infections and many other health problems in children.
  • dressing them warmly
  • feeding them nourishing food.
  • using good hygiene practices, such as washing hands and covering the mouth and nose with a tissue during coughs and sneezes.

Learn more

Use of cough and cold medicines in children — Updated advice Medsafe, NZ, 2013
Coughs and colds in children Patient Info, UK

Additional resources for healthcare professionals

Cough cold preparations NZ Formulary
Reminder – using cough and cold medicines in children is inappropriate Medsafe, NZ, 2016
Table 1 – medicines which should not be used in children under six years of age to treat the symptoms of the common cold Medsafe, NZ, 2013
Cold season – managing without antibiotics BPAC, NZ, 2018
Cold season in primary care BPAC, NZ, 2013

Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 01 Jul 2018