Children with troublesome coughs should be treated with ‘old-fashioned’ honey and lemon rather than over-the-counter (OTC) cough medicines, a leading paediatrician has advised.
When taken in large doses, many OTC cough and cold medicines and medications can be toxic or have adverse effects, Oliver Bevington, chair of the Royal College of Paediatrics and Child Health’s (RCPCH) trainees’ committee warned.
In an article published on the medical blog Hippocratic Post, Bevington said there was “absolutely no evidence that cough medicines work” and that “potentially they could actually do the child more harm than good”.
These medicines “often also contain a lot of sugar, which is also not good for children’s overall health,” he added.
He said that “nine times out of ten”, coughs and colds were caused by a self-limiting viral infection — so do not need antibiotics — and get better with rest, plenty of fluids and possibly paracetamol and/or ibuprofen.
Bevington, a senior registrar in paediatrics at Southampton Children’s Hospital, said a lot of OTC cough and cold medicines contained active ingredients such as nasal decongestants, antihistamines and “cough suppressors”, that may have adverse effects or be toxic if consumed in large quantities particularly to the under 6s who are much more susceptible.
They may also contain ingredients such as paracetamol, and parents may unintentionally find themselves overdosing their child he warned.
“Also, as with any medicine, there remains a potential risk that any of the ingredients could cause an allergic reaction or other unwanted side effect,” he said.
His advice for parents was to “to stick to old-fashioned honey and lemon, rest, lots of fluids and paracetamol and/or ibuprofen as per the pack instructions”, and that if symptoms persisted they should talk to their GP or pharmacist.
Bevington’s intervention followed the announcement by NHS England on 30 November 2017 that it is launching a formal consultation on taking up to 3,200 OTC medicines, including cough mixtures, off prescription.
At the same time NHS England published national guidance on a range of medicines which should no longer be routinely prescribed in primary care including homeopathy, omega-3 fatty acid compounds, co-proxamol, and rubefacients.