Infant Deaths Linked to Cough and Cold Medications

Summary
Could the overuse of cough and cold medications available over the counter harm infants? A study was done to explain the consequence of overuse of these common medications in infants. It was found that more than a convincing number of infants had, in fact, had an overdose of these medications before sudden death. The study authors state that, “These findings support the recommendation that such medications not be given to infants.”

Introduction
Coughs and colds are common in infants and children. These are often treated with over-the-counter (OTC) medications, which are easily available. This is seen not only in the U.S. (where the study was done) but all over the world. Despite having no proof that they work to relieve the symptoms and regardless of warnings from health authorities against administering these drugs to children less than two years old, this problem is still rampant. The death of every child in the state of Arizona has to be examined for cause. This study was done to investigate the sudden death of 10 infants in Arizona in 2006 and determine whether OTC drugs played a role in their deaths.

Methodology
•    For this study, the death reports of all apparently healthy infants in the age group 17 days to 10 months who had unexpected deaths in the year 2006 in the state of Arizona were analyzed.
•    Documents reviewed included medical reports, autopsy details, police notes, laboratory test results, etc.
•    All reports of these infants were analyzed thoroughly by the study authors.
•    Social and economic status of the babies’ families was also studied.

Results
•    There were 90 unexpected infant deaths in Arizona in the year 2006. Evidence of recent administration of an OTC cough and cold medicine was confirmed in 10 of those deaths, by way of quantitative laboratory tests checking for the presence of ingredients of common cold and cough medicines.
•    All 10 infants were known to be suffering from a cough, cold or both; but only four of them had been seen by a doctor.
•    Only one of these four children had been prescribed medication.
•    The rest of the infants were given OTC drugs, without consulting a physician.

Shortcomings
During review of the cases, the review authorities were not allowed to interview the families of the children in person; they had to study the interviews that other authorities (e.g. police, etc.) had taken. The authorities “may not have included questions regarding the use of OTC” cold and cough medications.  Also, only 21 autopsies had been performed out of the total number of unexpected infant deaths. There might have been more relevant cases uncovered had autopsies been done in all the cases. Lastly, in quite a few instances, only qualitative and not quantitative tests were performed to check for presence of the drugs in the babies’ bodies, thus making it difficult to pin the reason for death on the drugs.

Conclusion
The high incidence of misuse of over-the-counter medications is a serious issue. Although these medications have detailed instructions and warnings regarding dosage and consultation, certain people, especially the less educated, may not follow these warnings. Awareness among parents must increase. With infants, medications should never be self-prescribed by the parent or guardian. There is no supporting evidence to prove the effectiveness of these easily available medications. In the case of older children, OTC drugs continue to be available. It is always best to consult a physician first. Doctors should educate the parents on the potential dangers of using OTC medications.

For More Information:
Unexpected Infant Deaths Associated with Use of Cough and Cold Medications
Publication Journal: Pediatrics, 2008
By Mary E. Rimsza, MD, Susan Newberry; University of Arizona College of Medicine, and the Arizona Department of Health Services, Phoenix

*FYI Living Lab Reports Are Summaries of the Original Research.
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