Educate Caregivers About Proper OTC Cold and Cough Medications for Children


Approximately 40% of caregivers make dosing errors when administering liquid medication to children.

Although cold and cough medications are popular OTC products to treat the common cold and influenza, there has been some debate around how to use them in children. According to 2019 study results published in Academic Pediatrics, approximately 10% of US children received a cold and cough medication every week. Furthermore, the authors stated that 10% of medication-related adverse events were caused by medication errors.1

Child coughing and wrapped in a blanket, child with a cold

Image credit: Pixel-shot |

In another study, with results published in 2014, it was reported that approximately 40% of caregivers make dosing errors when administering liquid medication to children, including OTC acetaminophen and ibuprofen, which are recommended as treatment for children with a cold or the flu.2

According to an article published by the Mayo Clinic News Network, Jay L. Hoecker, MD, an emeritus pediatrics specialist at Mayo Clinic in Rochester, Minnesota, said OTC cough and cold medications are intended to treat the symptoms of cough and cold but do not treat the underlying disease. Fever reducers and pain relievers are a good option to treat children younger than 12 years old, according to Hoecker, whereas pain relievers such as acetaminophen and ibuprofen can reduce fever and pain, such as a sore throat or headache. However, Hoecker cautions caregivers to carefully follow the dosing guidelines, which can prevent dosing errors.3

Oral syringes, dosing cups, and droppers, when combined with low health literacy, can impact how medication is administered and increase the risk of improper dosing for children. However, pharmacists can help explain how to best administer medications to children depending on age and weight. Communication strategies and demonstrations can be beneficial for caregivers who are handling medications for pediatrics. Furthermore, printed pamphlets as well as supplemental online examples can also help reduce dosing errors for children.2

As for aspirin, caregivers should use caution, according to the article by Mayo Clinic. Aspirin has been linked to Reye syndrome and should not be used in children and adolescents who are recovering from flulike symptoms or chicken pox. Further, caregivers for children younger than 3 months should not administer acetaminophen without first consulting a physician. Children younger than 6 months or children who are vomiting or dehydrated should not be given ibuprofen.3

Additionally, the FDA limits the use of products with codeine or hydrocodone to adults 18 years and older due to the potential for adverse effects; misuse; risk of abuse; overdose; and, in some cases, death.3 Finally, pharmacists should educate patients and caregivers that antibiotics are beneficial only for bacterial infections and will not have an effect on viruses, which cause the common cold and influenza.3


1. Wang GS, Reynolds KM, Banner W, et al. Medication errors from over-the-counter cough and cold medications in children. Acad Pediatr. 2020;20(3):327-332. doi:10.1016/j.acap.2019.09.006

2. Yin HS, Dreyer BP, Moreira HA, et al. Liquid medication dosing errors in children: role of provider counseling strategies. Acad Pediatr. 2014;14(3):262-270. doi:10.1016/j.acap.2014.01.003

3. Cold medicines for kids: what’s the risk? Mayo Clinic News Network. February 28, 2020. Accessed May 22, 2024.

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