While a cold medicine may be labeled “for kids,” that doesn’t necessarily mean that it’s safe for every kid. In addition, just because a child has a cold doesn’t mean they need cold medicine.

This article explains when cold medicines for kids are helpful and what their limitations are. It also outlines the active ingredients used in different formulations, including their possible side effects and risks.

When to Give Kids Cold Medicine

Colds need to “run their course,” and children’s cold and cough medicines don’t make the process go any faster. They also won’t keep a cold from turning into an ear infection, a sinus infection, or even a lung infection known as pneumonia.

Children’s cold medicines are simply used for symptom relief and increased comfort. For example, you might choose to give your child one if:

A cough is keeping them up at night A sore throat is making it painful to swallow A stuffy nose and headache are making it difficult to focus

It’s up to you to determine whether more symptom relief could benefit your child or if some rest, patience, and TLC will suffice.

Warnings for Children Under Age 2

The Food and Drug Administration (FDA) does not recommend over-the-counter (OTC) cough or cold medications for kids under 2 years of age “because they could cause serious and potentially life-threatening side effects.”

Possible risks of cold medicine use in babies and toddlers include:

Abnormally rapid heartbeats Abnormally slow breathing Convulsions, which describe when the body involuntarily moves and spasms due to disrupted activity in the brain

Although the risk is dose-dependent, it can be extremely difficult to dose infants accurately. Accidental overdoses of OTC cold medicines have led to death in children under 2.

The Consumer Healthcare Products Association (CHPA), which represents the companies that make most cold medicines, expanded the FDA warning. The organization currently advises against the use of OTC cough and cold medicines for children under 6.

Decongestants for Kids

Decongestants are medications that help relieve symptoms of a runny or stuffy nose. They include ingredients like phenylephrine and pseudoephedrine, which help open and dry nasal passages.

A bulb syringe can be used to remove mucus from the nose Saline nose drops and gentle sprays help keep the inside of the nose moist A cool mist humidifier can help decrease congestion

These can be helpful for all kids, especially babies and toddlers who are too young to take cold medicines.

Decongestants formulated for kids include:

Children’s Mucinex Stuffy Nose & ColdSudafed Children’s Nasal Decongestant Liquid

Decongestants should not be confused with expectorants used to loosen mucus. Products like these, many of which contain guaifenesin, have not been proven to be helpful in children with colds.

Decongestant Side Effects

Although helpful, decongestants can make some children hyperactive or irritable. Less common side effects can include upset stomach, headache, and dizziness.

Cough Suppressants for Kids

If a cough is interfering with your child’s sleep or daily activities—and there are no signs of breathing difficulties—a cough suppressant may be useful.

The active ingredient in most OTC suppressants is dextromethorphan, which provides the temporary relief of dry coughs (also known as non-productive coughs, or those that don’t produce mucus).

Since cold-related coughs are often triggered by post-nasal drip, a decongestant may be recommended alongside a cough suppressant.

There are several cough suppressants containing dextromethorphan that can be used in adults and children. These include:

Delsym Extended-Release Suspension 12-Hour Cough Relief Mucinex DM Robitussin DM Triaminic Long-Acting Cough

Hydrocodone and codeine are opioid drugs sometimes used in prescription cough suppressants. Both can cause extreme drowsiness and are potentially addictive. Furthermore, the FDA advises against their use in children under 12 due to “the potential for serious side effects, including slowed or difficult breathing.”

Cough Suppressant Side Effects

Common side effects of these drugs include drowsiness, dizziness, and nervousness. Some children may also experience nausea and an upset stomach.

Acetaminophen Use in Children

Acetaminophen is the active ingredient in Tylenol that is used to relieve fever and pain in infants and children.

Acetaminophen can also be found in some OTC cold medicines for children, a fact that many parents are not aware of. In some cases, a parent may inadvertently overdose their child by giving them a Children’s Tylenol along with a dose of an acetaminophen-containing child’s cold medicine, such as:

Children’s Mucinex Multi-Symptom Cold & Fever LiquidPediaCare Children Cough and Runny Nose Plus AcetaminophenPediaCare Children Flu Plus Acetaminophen

The same concerns apply when using an acetaminophen-containing cold medicine formulated for adults and children, such as:

NyQuil Cold/Flu Relief Robitussin Severe Multi-Symptom Cough-Cold + Flu Nighttime Theraflu Day & Nighttime Severe Cold & Cough Relief Tea Packets Triaminic Cough & Sore Throat Triaminic Multi-Symptom Fever

An overdose of acetaminophen can lead to nausea, vomiting, diarrhea, profuse sweating, and stomach pain or cramps.

Antihistamines for Children

Antihistamines are commonly used to treat allergies. While the mechanism of how the common symptoms caused by allergies and colds differ, antihistamines may help some children with colds. Because they cause drowsiness, antihistamines can also help people with colds sleep more soundly.

Older antihistamines like diphenhydramine and carbinoxamine are commonly used for this purpose. They are usually found in night-time allergy and cold medicines. Due to their sedating side effects, second generation antihistamines are preferred. These include Zyrtec, Claritin, and Reactin.

Among the children’s medications that contain antihistamines are:

Dimetapp Children’s Cold & Allergy LiquidDimetapp Children’s Nighttime Flu SyrupPediaCare NightRest Cough & Cold for Children

There are also antihistamine-containing medications formulated for adults and children, including:

Benadryl Allergy ReliefTriaminic Night Time Cold & Cough Syrup

Antihistamine Side Effects

In addition to drowsiness, antihistamines may cause side effects like dry mouth, constipation, nausea, headache, and chest congestion.

Multi-Symptom Medicines

Colds commonly cause more than one symptom, including cough, nasal congestion, mild fever, and post-nasal drip. Because of this, a multi-symptom cough and cold medicine may be a reasonable option for certain kids.

Examples of children’s multiple-symptom cold medications include:

Dimetapp Children’s Cold & Cough ElixirLittle Colds Decongestant Plus Cough (non-drowsy)Vicks NyQuil Children’s Cold, Cough ReliefVicks Pediatric 44M, Cough & Cold Relief

There are also multi-symptom cold medications formulated for adults and children, such as:

Mucinex Cold & CoughRobitussin CF Alcohol-Free Cough Syrup (non-drowsy)Triaminic Day Time Cold & Cough (non-drowsy)

Choosing Cold Medicine for Kids

The best medicine for a child’s cold is one that treats only the symptoms they have. If your child has a cough, use a cough suppressant. If they have a fever, use a fever reducer, and so on. Use these medications for only as long as needed.

In this way, you can protect them from possible side effects of a drug they really didn’t need in the first place. If a multi-symptom cold product was instead used for a child who only has a cough, for example, they could unnecessarily end up experiencing jitteriness (from an antihistamine ingredient) or drowsiness (from a decongestant).

Of course, if your child has more than one symptom, two medications or a multi-symptom remedy may be appropriate.

Your healthcare provider can advise you if you’re unsure about what to purchase.

Read Labels

Don’t assume that all medications work for all kids. Read the product label to identify:

The active ingredient(s) and what they are intended forHow the drug is dosedWhat ages the medication is intended for

Remember that taking a multi-symptom medication with another medication that has a shared ingredient poses the risk of an overdose. Never do this unless directed by a healthcare professional.

Be Mindful of Health Conditions

Children who have some health conditions should not take certain cold medications as these could worsen the condition and/or increase their risk of serious complications.

Some of these conditions include:

Asthma, a disease that impacts the lungs and breathing Thyroid disease, a condition that impacts how much hormone this gland makes Peptic ulcer, or a sore on the lining of the stomach or small intestine Heart disease, or different conditions that impact the heart High blood pressure Diabetes, or a group of long-term conditions that impact how the body manages blood sugar Kidney disease, or kidney damage

Homeopathic or All-Natural Cold Remedies

Natural remedies like zinc and vitamin C supplements are sold over-the-counter for the treatment of colds. Proponents claim they can help shorten the length of a cold or prevent them entirely.

These include:

Vitamin C: Some studies show that vitamin C may reduce the duration and severity of a cold, but healthcare providers warn against giving high doses of vitamin C to children. This is because it may cause stomach upset and diarrhea. Zinc: Zinc lozenges and syrups may help shorten a cold, but there isn’t much evidence to support their use in children.  Echinacea purpurea: A few studies have suggested that this herb can help reduce the length and severity of a cold. It is not recommended for people with autoimmune diseases or those who are allergic to ragweed and certain flowers, however. Honey: Honey can help with coughing, but should only be used in children over one year old. Lozenges: Throat lozenges may help with cough and sore throat for those not at risk of swallowing the lozenge. There are lollipops with the same active ingredients as lozenges for those at risk.

Homeopathic cold remedies are also available over the counter. These products contain heavily diluted ingredients that are thought to provide cold symptom relief.

Supplements and homeopathic remedies aren’t regulated by the FDA. That means the agency has not evaluated them in any way, including for safety, efficacy, and whether or not the ingredients and doses listed on the label actually match what’s in the bottle.

Given this, it’s important to discuss the use of these products with a pediatrician before giving any of them to your child.

When to Call a Doctor

Most colds clear up on their own in less than two weeks. In some cases, though, your child may develop symptoms that will need to be evaluated by a healthcare provider.

If your child has a fever that’s over 102 degrees, call your pediatrician. Other symptoms that require the evaluation of a healthcare provider include:

Fast breathing or breathing that seems labored A cough that does not go away or seems severe Excessive fussiness Excessive sleepiness  An earache A skin rash

Summary

Children’s cough and cold medicines are used to ease the symptoms of a cold in children over age 2. They do not shorten the duration of a cold or prevent cold complications like ear infections or pneumonia.

Parents should only use cold medicines that treat the symptoms their child has. Multi-symptom cold medicines may expose a child to drugs they don’t need and trigger otherwise avoidable side effects, though these drugs can be useful in some cases.

Acetaminophen, antihistamines, cough suppressants, and decongestants are drug classes that are often considered. If you’re unsure of what to use (if anything) or how much to give your child, speak to their pediatrician.

A Word From Verywell

When using liquid medicines for kids, always measure the dose accurately with a measuring spoon or syringe; do not “eyeball” it.