By Doug Fletcher,Staff Writer

It may be well-intentioned, but using over-the-counter cold remedies to treat infants can be deadly.

A study released this week by the Montgomery County Coroner’s Office in Dayton, Ohio, found that 16 infants in that state died as a result of accidental overdoses of stock medications in a recent 12-month period.

The children were ages 1 to 12 months; more than half were under 6 months, according to Ken Betz, the office’s director.

Maine hasn’t identified a similar problem with infant mortality resulting from overdoses of Dimetapp or similar products, said Jim Ferland, the director of the State Medical Examiner’s Office.

He said the findings of the Ohio study are being reviewed on the national level.

“Part of the problem (in determining the effects of overdoses) is that there are no toxicology standards for infants as there are for adults,” said Ferland.

Still, said Dr. Diane Hemingway, a pediatrician with Central Maine Medical Center Pediatrics in Lewiston, parents should avoid giving any medications to infants under 2 months old without first consulting the child’s doctor.

“We don’t recommend any decongestant be given to children under the age of 2,” Hemingway added.

Decongestants given to young children have resulted in hallucinations and irregular heartbeats, among other problems, Hemingway said.

She also said parents should avoid using combination medications – those that promise relief of a cough and a fever. And, she added, parents need to read labels to make certain they’re not overdosing their children by giving them aspirin or Tylenol on top of similar ingredients already in so-called cold remedies.

A study led by Dr. Veronica Gunn of the Johns Hopkins School of Medicine pediatrics department in Baltimore looked at three instances of adverse outcomes of giving over-the-counter cold medicine to young children.

In one case, a 3-year-old suffered reactions to Dimetapp that led to hospitalization. In another, a 3-year-old boy needed heart catheterization after a severe reaction to Children’s Tylenol: Cold formula.

In the third case, a 9-month-old boy died after being treated with Motrin along with some over-the-counter cough and cold preparations.

Studies indicate one of the ingredients that caused problems in very young children is phenylpropanolamine, or PPA. The Food and Drug Administration issued an advisory calling for PPA to be removed from formulas due to increased risk of hemorrhagic stroke, according to the Gunn study.

Hemingway said that while she hasn’t seen any infant overdosing cases in Lewiston, she did as a resident working at a hospital in Virginia more than a decade ago. She treated several cases in which infants and toddlers had been overmedicated with cough and cold formulas.

Alerting parents

Betz, the Ohio coroner’s office director, said the study findings indicated that parents thought they were doing the right thing in trying to relieve their children’s cold symptoms.

He said his office has a twofold purpose in publicizing its findings: to alert parents to the potential dangers and to urge pharmacies to separate cold medications by grouping children’s formulas away from those intended for adults.

Sometimes, he said, parents would look at dosing instructions for adult formulas and cut that in half and give it to a child. Other times, parents erred by halving recommended doses of children’s formulas and giving them to infants.

Hemingway, the Lewiston pediatrician, said that doesn’t work. Dose instructions on children’s product labels often go by age rather than weight.

“You could have a 3-year-old who weighs 26 pounds and another who weighs 50 pounds. We don’t dose by age,” she said.

Hemingway advised parents to call their children’s doctor before offering any over-the-counter medication to infants under 2 months. For kids older than that, parents should also call rather than take a chance with a medication if they’re unsure of it, she said.

When baby has a cold

Most healthy babies have six colds or more before age 1, according to information posted by the Mayo Clinic on its Web site, www.MayoClinic.org.

Cold symptoms may include:

• Low-grade fever

• Sneezing

• Coughing

• Watery eyes

A baby’s immune system needs time to conquer the cold. Since colds are caused by viruses, antibiotics don’t help.

If a baby younger than 3 months old gets a cold, parents should call the doctor at the first sign of illness. For newborns, colds can develop into croup, pneumonia or other serious illnesses.

Most of the time, parents can treat an older baby’s cold at home. Parents may consider these suggestions:

• Offer plenty of fluids

Liquids can help loosen the congestion. Encourage frequent feedings for younger babies. Offer older babies water or juice between regular feedings. Mothers who are breast-feeding should keep it up. Breast milk offers extra protection from cold-causing germs.

• Suction your baby’s nose

Keep the baby’s nasal passages clear with a rubber-bulb syringe.

• Moisten the air

Running a humidifier in the baby’s room can help soothe irritated nasal passages.

• Thin the mucus

A doctor may recommend saline nose drops or saltwater nasal spray to loosen the baby’s thick nasal mucus.

• Try an over-the-counter pain reliever

For babies older than 3 months, use acetaminophen or ibuprofen to relieve discomfort or fever. Follow the directions printed on the label. Take note of any warnings or precautions. Call your baby’s doctor if you have any questions.

• Avoid cough suppressants and other cold medications

Coughing helps clear the mucus from a baby’s airway. For otherwise healthy babies, there’s usually no reason to suppress it.

Source: MayoClinic.com

“We don’t recommend any decongestant be given to children under the age of 2.”
Dr. Diane Hemingway