Hack, hack, hack – my daughter is suffering badly from a cough just now. During the daytime, and especially at the doctor’s surgery, her lungs are wheeze-free, but as soon as her head hits the pillow her throat begins to tickle and the coughing starts. Like many other parents we dread the arrival of these coughs, as they tend to go on for weeks and exhaust us all.
Our bathroom cabinet is full of sticky bottles of cough mixture, but these syrupy concoctions are a waste of hard-earned cash. Us mums and dads are suckers for buying medicines, and don’t the pharmaceutical companies know it. There is a bewildering array of useless sugar solutions to choose from.
Young children get masses of coughs as colds, and it is all too easy to crack and buy a potion. A study published in The Lancet suggested that on average children under 1 year in the UK get about 6 colds a year, children 1-2 years get 5.7, 3-4 year olds get 4.5 and 5-9 year olds get 3.5 colds per year.
So why can’t we buy something more potent; something that will ease that cough and help our little-ones get a good nights sleep?
The answer is a rather tangled tale. Prior to 2008 parent’s used to be able to buy quite powerful cough medicines over the counter for all but the youngest babies. These medicines contained rather random mixes of active ingredients, often including nasal decongestants, expectorants, antitussives, analgesics and antihistamines. And the resulting bottles were sold as ‘cure-alls’ for coughs and colds.
Some of the combinations of active ingredients were mad – like antihistamine (which dry up and thicken mucus, helping to suppress a cough) and expectorant (which is believed to make secretions easier to expel).
But all of us were merrily buying these concoctions and pouring large amounts down our children’s throats – a study published in the US in 2008 showed that in a given week over 10% of children were being given cough and cold medication.
Then someone studied the hospital admissions associated with these medicines, and alarm bells began to ring. Too many young children were arriving at A&E suffering from nasty side-effects.
Consequently these medicines have been withdrawn from use for children under the age of 6 in the UK, US and Canada. The logic being that overdosing children over the age of 6 is less likely because they are bigger, they have fewer colds and they can explain how they feel.
Meanwhile, what can we do for our under-6s when they get a hacking cough? It is fair to say that there is scant evidence that any of the active ingredients used in the more potent medicines have much of an effect, so perhaps it makes little difference.
Nonetheless it is frustrating that so few studies have been done to assess the effectiveness of these medicines, particularly in young children who suffer so frequently from coughs and colds.
Normally I’m content to let illnesses run their course, and tend not to resort to medicines at first opportunity. But, I have to admit, that when it comes to Beth’s hacking night-time cough I’m very tempted to try an ‘over 6 years’ cough medicine. The dearth of studies mean that there is a lack of evidence as to whether they work or not, but equally the data I’ve seen suggests that the risk of an adverse reaction has also been overblown.
Hands up who would be prepared to take part in a controlled study on the effectiveness of these medicines in the under-6s? We’ll be first in the queue.