About one in five kids under age six continued to be given over-the-counter cough and cold medicines, despite a Health Canada-mandated warning against use of the products in young children, researchers have found.
Since October 2009, the federal department has required that labels on cough and cold medications carry a warning that parents and caregivers should not administer the drugs to children under six because they are not only ineffective, but also potentially harmful.
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But in a study that looked at parents' reported use of the OTC preparations a year before October 2009 and roughly two years after, researchers found usage dropped only about four percentage points — from 22 per cent to almost 18 per cent by October 2011.
"It went down a very little bit, saying to us that even having a label on the bottle is probably not enough to deter its use," said principal investigator Dr. Jonathon Maguire, a pediatrician and researcher at St. Michael's Hospital in Toronto.
"And I think parents just don't know that they're not supposed to be used in little kids."
Maguire said there is no scientific evidence that these off-the-shelf remedies reduce the duration of a cold or its symptoms.
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The products — which typically include some combination of antihistamines, decongestants, cough suppressants and an analgesic like acetaminophen — can cause side-effects such as heart palpitations and high blood pressure, which kids under six may be unable to communicate to their parents.
If young children are given too much of the medications — due to a mix-up in measuring the dose or from overlapping doses — they could suffer seizures or a coma.
"Some of these medications are sedating and that has caused children to pass away," Maguire said.
"We know these medications are harmful. We know they're not recommended for use in children. We also know a lot of families seek them because, let's face it, when your child is sick with a cough and cold, it's a really tough time and parents are grasping for solutions for relief."
The study, published Wednesday in the Canadian Journal of Public Health, included almost 1,100 children aged one to five who were seen at one of seven primary-care practices in the Greater Toronto Area that make up the TARGet Kids! research network.
Use more likely with older siblings at home
Researchers found that children under six who had younger parents and those in families with older siblings were more likely to be treated with cough and cold remedies, despite warning labels advising against the practice.
"We think younger parents are more likely to do it just because they don't know, they haven't been around as parents very long and they just don't know," said Maguire.
"And I think the older siblings has to do with parents who have a number of children. They may have used the cough and cold medications in their other children when that labelling requirement wasn't around and continue to do so with their younger children."
The researchers suggest that warnings not to use the medicines in young children should be made more prominent on the front of bottles, and that the products be put behind the pharmacist's counter to make them less easy to access.
"It's just so easy now to pick them off the (drugstore shelves)," Maguire said.
"I think further efforts to inform people about the risks involved might be helpful."