This post is part of our Home Remedy Handbook, a tour of the landscape of home remedies from the iffy to the doctor-approved. Read more here.
Children under 4 years old shouldn’t use over-the-counter cough and cold medicines, the FDA has warned. So what do you do instead? Try home remedies, which “may work better than medicines” for young children, the American Academy of Pediatrics says.
The AAP also notes that you don’t have to treat a child’s symptoms just because they have a cold. If your kid is acting normally and the cough or runny nose don’t seem to bother them, no action is needed. This includes fevers: While you should call the doctor for a fever over 102 (or, for infants under 2 months, 100.4), fevers under that cutoff tend not to bother the child and don’t need specific treatment.
When to avoid cold medicines for kids
First of all, let’s look at the recommended age limits for over-the-counter cough and cold medicines. Under 4 years old, the AAP and FDA agree these medicines should not be used at all. Between 4 and 6 years, the AAP says you may use them, but to check with your pediatrician first.
After age 6, these medicines are “safe to use,” but double check that your child is taking the appropriate dose: That means measuring with a syringe or a measuring spoon, not a kitchen spoon (your “teaspoon” could be more or less than a standard teaspoon), and paying attention to the active ingredients in different products. If you give your kid Tylenol, and then measure out a cough syrup that includes acetaminophen, you may not realize you’ve doubled up on the same medication.
Some homeopathic products are labeled as being appropriate for young children, but these products are not FDA approved and may be useless or even dangerous. The FDA allows them to stay on the market, but is “not aware of any proven benefits for these products and urges you not to give homeopathic cough and cold medicine to children younger than 4.” (The italics are theirs.)
Cold medicines may not always help, even when they are legit medicines that are given appropriately. Home remedies like the ones we describe here are often more useful.
Get rid of the snot
If your kid is old enough to blow their nose, have them do that. Little ones can often figure it out, if you hold the tissue and ask them to blow. But until they’re old enough, a bulb syringe is your friend. Use this device to suck the snot out (in our house, we called it the “snot sucker”). They’ll fuss as you’re doing it, but then they get instant relief.
If the mucus is crusty, soften it with saline drops, or with warm water before trying to remove it. You can buy saline drops at the drugstore, or make your own with this simple recipe from AAP:
Add ½ teaspoon of non-iodized salt and ¼ teaspoon of baking soda to 1 cup (8 oz) of warm water. Stir to dissolve the salt and baking soda. You should use sterile, distilled or previously boiled water for nasal washes.
Help them to stop coughing
Honey works at least as well as cough syrup, and some studies have found it actually works better. The AAP recommends giving children 2 to 5 milliliters of honey (so, a teaspoon or a bit less) as needed to thin the mucus and reduce coughing. A spoonful of honey before bed may help with nighttime coughing.
The exception, as you may have guessed, is that infants under 1 year of age should not have honey. Not in food, and not as a cough syrup. There is a risk of botulism from spores in the honey. From toddler age on up, our immune systems can handle the spores, but the risk is higher for babies.
Keep the fluids flowing
Fluids help because when we are well-hydrated, mucus is thinner and easier for the body to get rid of. This means giving kids water, chicken soup, or whatever other liquids they will gladly slurp down.
Babies who breastfeed should continue to do so. If they have trouble feeding because of a stuffy nose, use that bulb syringe first. You can also consider giving them breastmilk or formula in a cup or a bottle.
If the air in your home is dry, a humidifier can help to keep mucus membranes (like those in the nose) from drying out. If you’re using a device, try a cool mist humidifier filled with filtered or distilled water. Or get some humid air for free by having your child sit in the bathroom when somebody is running the shower.
When to go to the doctor
Very young babies should be seen anytime they have a fever over 100.4, the FDA says. Call the doctor for any child if their fever is above 102, if they have stopped eating and drinking and may be dehydrated, if they have a persistent headache or persistent ear pain, or if they seem to be getting worse and not better.
And make sure your child gets seen right away if you see signs that they are having trouble breathing. These could include blue lips, labored breathing, wheezing, fast breathing, or the ribs showing with each breath.
