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April 16, 2008

Pediatric Points: Alternative remedies for colds in children: What's the evidence?

Dear Dr. B:

I read your recent column about the removal of infant cold medicines from the market. It sounded good at the time. I mean, I don't want to give my daughter stuff she doesn't need or that isn't safe. But now, guess what? She's got a cold and I've been up all night with her! I liked your evidence-based approach, so are there any proven therapies for colds in kids?

Sleepless in Haverhill

Dear Sleepless,

Great question! Cough is the most common reason for visits to the doctor's office. Children average six to seven upper respiratory infections (colds) a year. For kids in day care, that number can be closer to eight or 10. Considering that each cold lasts seven to 10 days, that's potentially a lot of sleepless nights for these sick kids and their exhausted parents. And now that cough and cold medicines designed for infants and young children have been taken off the market, many parents have been asking me that same question.

Alternative and herbal therapies such as zinc and echinacea have been studied as treatments for or prevention of colds for many years. The results have been mixed at best.

Echinacea has been postulated to modulate the immune system and enhance the ability of white blood cells to ingest germs. Unfortunately, a recent study comparing echinacea with placebo in children aged 2 to 11 years who had colds, failed to demonstrate a positive effect. In over 700 children with over 400 colds, no shortening of cold duration or decreased severity of cold symptoms was seen. Not only that, but children using the echinacea experienced rashes significantly more frequently than those using placebo.

Results for zinc were only slightly more promising. A recent review of the literature by a professor at Stanford University School of Medicine found that in the four studies of zinc that were the most rigorous, three showed no effect on severity or duration of cold symptoms. One study reported a positive effect using zinc nasal gel, but it was a study on adults which did not include children. Also, serious side effects of intranasal zinc have been reported, notably a permanent loss of the sense of smell.

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