Study Analyzes Deaths of Young Children Related to Cough and Cold Medications

Cough and cold medicine can be deadly to young children, especially when misused as a method of sedating a child. A study, “Pediatric Poisoning Fatalities: Beyond Cough and Cold Medications,” published in the November 2021 Pediatrics, finds that, despite changes in medication labeling, 40 children died between 2008 and 2016. These deaths occurred largely due to use of cough and cold medications for purposes other than what was specified on the label, including harming the child. The study (published online Oct. 4) convened a panel of members with expertise in pediatrics, toxicology, emergency medicine and forensics to analyze 180 deaths of children under age 12 who were identified by the Pediatric Cough and Cold Safety Surveillance System as having been exposed to one or more of these medications. Of the 40 deaths judged to be “related” or “potentially related” to use of cough and cold medications, 60% occurred in children under age 2 and 70% included medication with the ingredient diphenhydramine. In six cases, the medication was administered with the intent to kill the child, and in another seven cases, death followed the intentional use of medication to sedate the child, according to the research. In 2008, the FDA released a Public Health Advisory recommending that cough and cold products not be used in children under 2 years old, and manufacturers subsequently voluntarily changed cough and cold medication labeling to state “do not use” in children under age 4. Additional labeling changes on medication containing antihistamines instructed caregivers against using the product to make a child sleepy. The authors recommend that child health providers educate parents and caregivers on avoidance of cough and cold medications, particularly diphenhydramine.

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.