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Why children under five should not be given cough syrups –Paediatrician



A consultant Paediatrician at the Federal Teaching Hospital, Katsina, Dr. Abdurrazzaq Alege, has said children under the age of five should not be given over-the-counter cough syrups.

Alege said there was usually no need to treat a child’s cough with cough syrups as coughing helps a child remove mucous, infections, and irritants from their respiratory tracts.

He noted that most cough syrups contain multiple ingredients which can be toxic to the child’s body system.

However, he said, cough syrups can be given to a child under the supervision of a medical doctor if the child is experiencing distress or disturbed sleep.

“Children don’t need cough syrups for cold or flu, especially children that are less than five years. We find out that in children, the commonest cause of the cold or flu is virus. And cough on its own is just a natural response or I will say it is more protective because the cough is trying to clear the airways by bringing out the mucous, so, in a way, it is helpful when the child coughs.

“For children, we don’t want anything to suppress the cough. We understand that parents worry more of the cough than the catarrh or the fever but the truth is that the cough is helping the child to manage the infection.

“Even if what we want to treat is the cause of the cough and once we start the treatment, we will explain to the parents. Part of what we explain to the parents is that the last thing that will go is the cough. If a child comes down with a fever or cold, when you start treating, you find out that the fever will go within a few days or even a day but the cough will only reduce gradually.

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“For children above five years, to an extent, we allow cough syrups. Why we don’t allow cough syrups for children under five is that we realise that most of the contents of the cough syrups are not usually one but a mixture and at that age, the body is not able to metabolise most of these mixtures. Most times, it could be toxic to the body system.

“Most cough syrups are mostly mixture of anti-allergies, some of them are cough expectorant, some of them are cough suppressant but we find out most times they mix it up with some compounds that will reduce the body temperature. It is just like the concoctions of many things mixed together, so the younger child may not be able to handle the compounds. So you find out that most times, you end up giving overdose,” he said.

The paediatrician noted that cough syrups should only be cautiously given to children with distressing coughs.

“There are conditions we give cough syrups and one of it is when a child has a distressing cough and that is typically whooping cough where the child will cough continuously until he throws up. For this kind, we give cough syrup and we do this cautiously while the child is on admission because for the child to be on admission with a whopping cough, then we need to take care of that cough,” Alege added.

The expert said parents or caregivers can help ease the symptoms of a cough and help a child feel more comfortable using home remedies.


“Warm fluids can be given to them. It helps to smoothen the airways and relieves mucous. A child is not like adult where we spit out the sputum, a child will rather swallow it, the secretion will become less thick and the child bring it out but most times, they swallow it and it comes out through the faeces.

“Then, you can give fruits, especially fruits rich in Vitamin C. You can give them ginger and honey. Most times, they don’t reduce the frequency of the cough but they help the child recover faster.

“When you give warm fluids and these natural products, they help in remodelling the airways and the child gets better,” he stated.

He urged the government to regulate over-the-counter medications in the country.

“It’s not all OTC drugs that are meant to be dispensed without caution. In some countries, you need a prescription to buy pain relief drugs, but unfortunately, we don’t have that here. Ideally, they are supposed to be controlled.

You’ll find out that in most chemist shops, you will find out that the person behind it is just an SSCE holder not trained.

“Cough syrups for children less than five are not supposed to be dispensed anyhow. It has to be by the prescription of a doctor. The doctor will determine if the cough should be suppressed or you want the child to expectorate.

“A good way to go is education of the public and improved government policy in controlling these medications,” he added.

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