Coughs and colds can be miserable—for children and for weary parents trying to get some sleep. So it can be tempting to resort to one of the dozens of over-the-counter cold meds that line drugstore shelves.

But you’re usually better off skipping them, says Marvin M. Lipman, M.D., Consumer Reports’ chief medical adviser. “There’s little evidence that these medications help,” he says. “Plus, like any medication, they can cause side effects, some of which pose special risks to kids.”

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For example, the Food and Drug Administration has urged caution when giving any cold or cough medicine to children that contains an antihistamine or a decongestant, because those drugs were linked to a slew of emergency room visits in the early 2000s. Manufacturers now warn against giving those drugs to children younger than age 4, and the FDA says parents should take extra precautions even with older children.

The agency has additional childhood precautions for other OTC drugs used to treat a cold, from aspirin to codeine, which, surprisingly, is still allowed in some states in nonprescription cold remedies.

So what should you do instead? See below for the home remedies that work and, when drugs are needed, how to use them safely.

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Home Remedies to Try for Kids

“Your best bet is to stay well-hydrated and to use tried-and-true home remedies,” Lipman says. Here’s what to try:

  • Drink plenty of fluids. That helps thin mucus so it doesn't get stuck in the throat or chest. Warm drinks and soups— including chicken soup—can provide relief. They can loosen congestion and soothe an irritated throat.
  • Consider honey to reduce coughing. It works better than the OTC cough meds dextromethorphan and diphenhydramine, according to a 2014 review of four studies. For children 1 and older, the American Academy of Pediatrics suggests a half-teaspoon of honey to start. And don’t worry; a little sugar when your child is sick won’t hurt. But never give honey to babies under the age of 1. While rare, it can lead to infantile botulism, which can cause paralysis.
  • Ease sore throats and coughing with throat lozenges. For kids 5 years of age and older, sucking on a throat lozenge can reduce the urge to cough and ease a sore throat. Keep lozenges away from younger kids because they can swallow and choke on them.
  • Try a topical rub for cough and nasal congestion. The pungent mix of camphor, menthol, and eucalyptus oil in topical ointments such as Vicks VapoRub may help children—and their parents—sleep better, according to research from Ian M. Paul, M.D., a professor of pediatrics and public health sciences at Penn State College of Medicine.
  • Use a cool-mist humidifier. That can ease breathing and help a child feel better. The FDA says to avoid warm-mist humidifiers because they can cause nasal passages to swell, making breathing harder. Humidifiers should be cleaned daily when in use according to the manufacturer's directions.
  • Rinse with nasal saline. To ease congestion in babies, put two to three drops of saline solution in the nostril and use a bulb syringe to suction it out. You can make a solution by dissolving a half-teaspoon of table salt into 1 cup of warm distilled or sterile water. For older children, use a nasal saline spray.
  • Gargle often. If your child is up to it, encourage him or her to try gargling with warm salt water to ease sore throats. Use a pinch of salt in a 6-ounce glass of warm water.

How to Use Cold Meds Safely

To start, don’t ask your doctor for an antibiotic. Those drugs treat bacterial infections, not viral infections like a cold. So taking them won’t help but will unnecessarily expose your child to the risk of side effects, including diarrhea and nausea. In addition, the overuse of antibiotics contributes to the development of "superbugs," bacteria resistant to several types of antibiotics.

In addition, skip any cold medicine—OTC or prescription—that contains either codeine or the pain medication tramadol. The FDA warned earlier this year that both drugs have been linked to life-threatening breathing problems for kids.

With all other cold and fever meds, take these precautions when giving them to children:

  • For a fever, start with acetaminophen. This drug, found in Tylenol and many other products, is often safer than alternatives, including ibuprofen (Advil and generics) or naproxen (Aleve and generics). And you should avoid aspirin altogether for infants and use it with caution for other children because it can trigger a rare but serious disorder called Reye’s syndrome.
  • Use nasal decongestant sprays briefly. For children ages 6 and up, nasal sprays including oxymetazoline can sometimes help. But they should be used only for a short time—three days maximum. Extended use can actually cause congestion to worsen.
  • Check for age limits. Look carefully at the packaging to make sure your child is old enough to take the medicine, says H. Shonna Yin, M.D., who is conducting FDA-funded research on improving the labeling and packaging of OTC cough and cold products for kids and is an associate professor of pediatrics and population health at NYU Langone Health. For example, a cough medicine label may indicate it’s not for children under age 4; some antihistamines are labeled not for children under 6, unless directed by a doctor.
  • Make sure that medications don’t overlap. If you’re giving your child acetaminophen for a fever and pick up a cold and cough medication that also contains acetaminophen, you may unknowingly be giving a double dose to your child. Check all ingredients.
  • Choose single-ingredient products. Many OTC cold meds contain several ingredients meant to treat multiple symptoms at once, a shotgun approach that increases the risk of side effects. Instead, choose products that target your child’s specific symptoms, such as fever, runny nose, or cough.
  • Understand dosing instructions. Most OTC cough and cold medicines for kids have a chart showing different levels of dosing by age. Find the appropriate dose for your child’s age. Acetaminophen or ibuprofen labels sometimes list doses by weight and age. When given the choice, go with the weight, Yin says.
  • For liquids, always use the dosing tool that comes with the product. Kitchen spoons are not meant to measure medication. Use the syringe, dosing cup, or dropper that came with the medicine, and read the markings on it carefully. For prescription drugs, you may not get a dosing tool with your medication. If that happens, ask your pharmacist for the right dosing tool for your medication.
  • Keep all medicines up high and out of sight. Kids find a way to get into medications and end up in the emergency room. A scary figure: About one in 70 children ends up in an emergency room by the time he or she reaches the age of 5 as a result of getting into medicine when an adult isn’t looking, according to the Centers for Disease Control and Prevention.
  • When in doubt, ask. Check with your pharmacist or healthcare provider if you’re unsure about any medication.

Important to Know

Contact your doctor if your child's symptoms last longer than a week or a fever persists for more than two days. In infants younger than 2 months, call your doctor right away for a fever or severe ear pain.  

Editor’s Note: This article and related materials are made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).