What's the difference between an expectorant and a cough suppressant?
Jo Ann Rohyans pediatrician
You'll find expectorants and cough suppressants in many over-the-counter and prescription cough medicines for older children and adults — but they're no longer recommended for children under the age of 2 and have been shown to be ineffective in children under the age of 6. In fact, the FDA warns that these products can have "potentially life-threatening side effects" for children under age 2.
The purpose of an expectorant (often guaifenesin, or glycerol guaicolate) is to thin or liquefy the body's secretions, such as mucus, that cause congestion. No studies show any benefit from these medications, but in the past they were combined in cough medicine with a decongestant — and parents often felt that expectorants helped their children cough up the secretions. (Only adult men do this well!)
The purpose of cough suppressants, on the other hand, is to stop the body's reflex or desire to cough. Suppressants are divided into nonnarcotic (which you can buy over the counter) and narcotic (prescription) preparations. Dextromethorphan is the most common nonnarcotic suppressant, and codeine and hydrocodone are popular narcotic ones.
When it comes to effectiveness, there's no data that supports the use of cough suppressants in children. Besides, a cough is a protective reflex, your body's way of clearing secretions, so it's not always a good idea to suppress it. And cold remedies don't actually shorten the duration of a cold, which is caused by a virus; they simply try to address the symptoms.
In my practice, we always encourage parents to let their child's cold "run its course." Using a humidifier or vaporizer to increase fluids and moisture in the environment works best to loosen secretions. Talk with your baby's doctor if you feel you need help taking care of your baby when he has a cold.
Bottom line: All of these medicines have risks and little proven benefit. They should never be given to a baby. If you have any of these products in your home, you should safely dispose of them (where your baby or other children can't reach them).
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