Cough Medicines and Kids

Cough suffers from a bad reputation. Far from being a nuisance, cough keeps nasal mucus from dripping down into the lungs and clears infected mucus from the lungs. If children didn’t cough when they were sick, every little sniffle could turn into pneumonia.

It’s easy to sing the praises of cough when your sick child hasn’t kept you up for five straight nights. Doctors know that parents and children need to get as much rest as possible so the body can heal. We also know that tired parents with sick children are often tempted to try cough medicines.

Despite the widespread use of cough medications for children, researchers haven’t studied their effectiveness or proper dosage. No good studies have ever shown that cough medicines work better than a placebo for children under 12 years old. In fact, groups like the American Academy of Pediatrics don’t recommend cough medicines for children. Many times your child will do just as well with home remedies like running a vaporizer and drinking lots of fluids.

Suppressing a cough can be dangerous if your child has asthma or whooping cough (pertussis) or is very young. A productive cough that brings up mucus should never be suppressed.

Home remedies for cough include running a vaporizer or humidifier and encouraging your child to drink. Both of these may keep the mucus in the nose and chest looser and make it easier for the child to move them up and out of the lungs. Hard candy or lozenges can be tried for cough in children over 4 years old, but they are a choking hazard in younger children. You can also try tea with honey and lemon, but remember no honey for babies under one year old. 

If you are going to try a cough for an older child, know that they can be sold alone or in combination products that also treat cold symptoms. Choose a product tailored for your child’s symptoms that contains the fewest active ingredients.

Dextromethorphan is the active ingredient in over-the-counter cough medicines. It tells the cough center in the brain not to cough so much. The lungs, however, have better cough receptors that can only be disabled by heavy sedation. Some cough medicines also contain guiafenesin, an expectorant that is supposed to stimulate cough and thin mucus. When you think about it, using a cough medicine with dextromethorphan to suppress cough and guiafenesin to stimulate cough makes no sense. Although few studies show that guiafenesin does anything, it can be hard to find a cough medicine without it.

Cough medicines may also contain decongestants and antihistamines. If your child’s nose is running so much that it drips down the back of the throat and triggers coughing, you might want to consider these medications. But since no one has shown that decongestants and antihistamines are effective in children under 6 years old, it’s best to avoid them.

Do not use cough medicines for more than a week. Do not use cough medicines if the cough persists, worsens, or is accompanied by fever, rash, or headache. Like most over-the-counter medications, cough medicines are very inconsistent in active ingredients and, therefore, dosing. Read the label carefully. Side effects of cough medicines may include dizziness, drowsiness, sleeplessness, rash, vomiting, and diarrhea. If you are concerned about your child’s cough, call your pediatrician.

About Lisa M. Asta, MD

Lisa M. Asta, M.D. is board-certified by the American Board of Pediatrics and is a Fellow of the American Academy of Pediatrics, for which she is also a Media Representative (she has been interviewed for “Kids Health” on Health Radio, and quoted in Parenting Magazine, USA Today, and the New York Times, among other publications). She is a Clinical Professor of Pediatrics at the University of California at San Francisco and past pediatric chair at John Muir Medical Center in Walnut Creek. She graduated from Temple University School of Medicine and the Johns Hopkins University. Dr. Asta is also a writer whose fiction has appeared in Inkwell, Philadelphia Stories, Schuylkill, and Zeniada. Her essays have appeared in the Journal of the American Medical Association, Hippocrates, the San Jose Mercury News, and The New Physician Magazine. She is an occasional contributor to KQED public radio’s Perspectives series, and has written articles for Bay Area Parent, Valley Parent, Parents’ Press, and Parents Express, as well as online at,, and She wrote a chapter in The Field Guide to the Normal Newborn, ed. Gary Emmet, M.D. currently has two how-to videos for parents in production which feature Dr. Asta. For more on Dr. Asta’s writing, visit
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3 Responses to Cough Medicines and Kids

  1. Pingback: What’s in Cough and Cold Medicines for Children? | Casa Verde Pediatrics, Inc. Blog

  2. Pingback: Why Doesn’t Cough Medicine Work? | Casa Verde Pediatrics, Inc. Blog

  3. Pingback: COVID19 101: Care Instructions after Testing | Casa Verde Pediatrics, Inc. Blog

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