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Cold Formulas and Your Child

Reviewed by: Steven Dowshen, MD

Jessica Walker's parents gave her an over-the-counter cold remedy to dry her runny nose and help her sleep. It had the opposite effect: Half an hour later, the toddler was bouncing off the walls. She stayed that way most of the night. "She just went nuts," recalls her father, Allen Walker, MD, a pediatric emergency-medicine specialist at Johns Hopkins Children's Center in Baltimore.

Although cold formulas are generally safe when taken as directed, small children can have a "paradoxical reaction," says Dr. Walker, often resulting in hyperactivity. This is what happened to Jessica, even though her parents followed instructions to the letter.

Fortunately, she suffered no lasting effects, but more than 29,000 annual exposures to cold products require medical attention. Many cases involve small children, who end up in emergency rooms where they may undergo procedures such as spinal taps to rule out more serious conditions.

Dr. Walker urges parents to watch for unexpected drug reactions and not try to counteract them on their own. For example, if a child becomes hyperactive, don't give more medication in the hope of sedating her. The Food and Drug Administration (FDA) reminds parents and caretakers to follow instructions carefully for over-the-counter medicine, and offers these safety tips for all drugs:

  • Never cut an adult dose in half. Assuming it will be the right strength for a child can be dangerous.
  • Consult a doctor before giving children two or more nonprescription products at the same time.
  • Store medicines where children can't reach them.
  • Use child-resistant safety caps.
  • Use medicine strictly for the purpose intended. Never give a child medicine that isn't recommended for him or her, either by a physician or on the label.
  • Check dosage cups before use so there's no confusion about whether measurements are in teaspoons, tablespoons or ounces.
  • Always consult your pediatrician before giving children any medicine containing aspirin.


Reviewed by: Steven Dowshen, MD
Date reviewed: September 2000