Friday, October 12, 2007

Bye Bye Baby: So Long Infant Cold Medicines

Am I the only one wondering if we've overreacting with the cold meds?

Parents are being told by the FDA to throw away all the tiny bottles of cough syrup, decongestant, and anithistamines they've been storing up or using for their children age 2 and younger according to yesterday's article in The New York Times. Here's an interesting case for parents who like a little uncertainty in their lives...



The cold products are being pulled from the market on the basis of two little-researched assumptions: 1) cold products don't help these smaller children and 2) cold products actually harm smaller children. Let's take the first. There's very little evidence that these cold products do any good - there's just not much research on their efficacy. A July 2004 Pediatrics article reports cough syrups have no effect on children's symptoms. We just don't know. Why not? Doing an experiment would be nearly impossible here. We can't really assign parents to either forgo the medicines or to use them. For one thing, how in the world would we gather up all the parents at the same time (those that have kids with colds?). Real life is tricky for sure. All we can do is poll parents - mostly after the fact.



How about the safety of cold medicines? Again very little information. According to The New York Times, the FDA reports that from 1969 to 2006, 111 children have died after taking either antihistamines or decongestants (I'm not sure the ages of the children who died, they might have been older than 2 - I can't find the numbers). Experts suggest that in some cases parents might have given a higher dose than recommended especially if they were combining medicines that often contain the same ingredients.



These medicines may pose dangers for smaller children even when given an appropriate dose. It may also be true that parents that the medicines don't relieve cold symptoms. They are not the same thing. The first speaks to their safety, the other, the efficacy.



As a parent, naturally I'm a lot more concerned about the first. And I know I'll catch some flack, but I have to wonder if we're overreacting here. I'm not dismissing the 111 deaths of children who used the products (@ 3 per year), but I question how dangerous these medicines really are. Parents face 800 of these products at the local drugstore. And they've purchased over 40 million bottles of children's cough and cold medicine (approx. 8 million were drops for infants) - in just over over 6 months this past year. That's around 70 to 80 million bottles a year. I must have at least ten myself. Leaving a syrupy goop at the bottom of my medicine cabinet.

But let's do the math. Let's say right now, at this point in time - there are 16 million "infant drops" bottles in homes across the country - or have been in the past year. But let's be conservative and assume that parents opened only half the bottles - that's 8 million doses a year. And that's assuming parents only use each bottle once (one dose per bottle), again being conservative. So out of 8 million doses or 8 million uses - 3 children will die. That's a .0003% chance of death. .0003.

That seems pretty low. And if the death rate included older children - than it's 3 deaths per 35 - 40 million bottles opened or per 70 - 80 sold - either way a much, much smaller number.


I'm not sure about how this compares to other medicines children use. What are the numbers on antibiotics? Anyone know?

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