MADELEINE BRAND, host:
Most pediatricians say cough medicines don't really help but they don't hurt either. So, parents, if you want to give your kids some cough medicine, just go ahead. Well, that might not be such good advice. Federal regulators are now looking into whether cough medicine is actually dangerous for small children.
A report in today's New York Times says the FDA is particularly concerned about the use of these drugs in children younger than two. Our medical expert, Dr. Sydney Spiesel is here now. He's a pediatrician in Woodbridge, Connecticut, and also a professor at the Yale Medical School.
Welcome back to DAY TO DAY, Sid.
Dr. SYDNEY SPIESEL (Pediatrician, Professor; Yale Medical School): Thank you. I always like to be here.
BRAND: Well, we always like having you.
Which cough medicines are we talking about?
Dr. SPIESEL: There are about 10 bazillion of them. If you go into any drugstore, you're going to come across just shelf after shelf of all these pretty much worthless medications.
BRAND: Right. So pediatricians I keep hearing, and I've heard from you on this show, that cough medicines are essentially worthless. But now, it looks like they might be worse than worthless, they might actually be harmful.
Dr. SPIESEL: That was suggested actually in a study that was done by CDC. It was reported back in January. They did a survey over two states so to see if they can find any kids who had really been harmed by these medications. And they found actually, probably about 1,500 kids who had been harmed. And three kids who had died…
BRAND: What were the problems? What caused their medical problems?
Dr. SPIESEL: Of the three who died, which is the - are three we know most about - the levels of the medication probably reflect the fact that their heart was pushed into an arrhythmia, an abnormal rhythm, by very high level of the medication they were taking.
But the problem is that none of these things have really been tested in young people - in very young people.
BURBANK: And Sid, what are the ingredients in these medicines that are of particular concern?
Dr. SPIESEL: There are couple of active ingredients, and one ingredient is sudafedrine, which is a drying agent. And it has, in high doses, it affects the heart. It really is able to cause the heart to beat in an irregular way, but you have to get quite high doses for that. The other active ingredient, or possibly active ingredient, is dextrometorphan which is a cough suppressant.
BRAND: Well, what does work? What do you recommend for parents, who are understandably quite anxious when their child has a bad cold or a debilitating cough?
Dr. SPIESEL: The standard recommendations are things like - are those nose snorkers(ph), to suck out the mucus and - but honestly, there's nothing that is tremendously helpful here. We often can't do anything and we want so desperately to make our kids feel better that we start reacting irrationally.
BRAND: Well, given the fact that there are some questions now raised about cough medicine, would you recommend that parents avoid it completely?
Dr. SPIESEL: It sounds to me like it's a good idea to avoid it completely, especially because there's little evidence that they're helpful. Let me just remind you of my first law of pediatrics: if there's any disease for which there a hundred treatments, you know that none of them works.
BRAND: Dr. Sydney Spiesel is a pediatrician in Connecticut and also a contributor to the online magazine Slate. And Sid, it's always great to talk with you.
Dr. SPIESEL: It is always my pleasure.
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