New guidelines for cough syrup use in children: What parents should know

After reports of child deaths linked to contaminated cough syrups, Kerala’s health department has issued clear guidelines to ensure safe and responsible use in children.

In lieu of recent reports of child fatalities linked to cough syrup consumption outside of Kerala, the heath department in the state has released technical guidelines for the use of cough medicines. Based on the findings of a three-member committee, specific guidelines were issued. These guidelines aim to standardise care, prevent misuse of medicines, and protect young patients.

Why the New Guidelines?

A state-level expert committee was formed after reports emerged of children’s deaths outside Kerala attributed to contaminated or misused cough syrups. The committee’s findings led to stricter protocols for cough treatment in children.

The goal: safer prescribing, better public awareness, and uniform practices across doctors, pharmacists, and health centres.

Key Principles of the Guidelines

Age-Based Use of Cough Syrups

• Cough syrups should not be given to children under 2 years old at all.
• For children aged 2–5 years, use is discouraged and should only happen after careful assessment.
• For children above 5 years, cough medicines may be considered, but only if clearly justified, in small doses, and for short duration.

All prescriptions must be tailored to a child’s age and body weight — a one-size-fits-all approach is unacceptable.

Also Read: Lung disease and chronic morning cough, breathlessness: Here's why should see a doctor

Strict Medical Supervision

Parents should only administer these medications if they are prescribed by a qualified doctor. The health department has advised to avoid over-the-counter or self-medication.

Safety and Quality Control

Every cough syrup formulation that is given out by health centres has to adhere to manufacturing standards and be devoid of dangerous impurities like ethylene glycol or diethylene glycol.

What is the Role of Pharmacists

When distributing cough medications, chemists are required to follow regulations issued by regulatory bodies.

What Parents Must Keep in Mind

• Never give cough syrup to a child under 2 years old.
• Always consult a paediatrician before giving any cough medicine, especially for children aged 2 to 5.
• Even if your child is older than 5, use the minimum effective dose and only for as long as needed.
• Be alert to coughs that persist beyond a few days or come with symptoms such as high fever, difficulty breathing, or chest pain — these require immediate medical evaluation.
• Do not use any medicine from uncertain or unverified sources

These guidelines strengthen child safety and seek to prevent tragic outcomes from misuse or contamination of cough syrups. The emphasis on age-appropriate use, medical oversight, and manufacturing quality is a step toward responsible paediatric care.

FAQs on Cough Syrup Guidelines

1. Why should cough syrups not be given to children under 2 years old?
Cough syrups can pose significant health risks to children under 2, leading to severe complications or fatalities.

2. What precautions should parents take for children aged 2–5 years?
Cough syrup use is discouraged and should only be considered after a thorough medical assessment by a paediatrician.

3. How should cough syrups be administered to children above 5 years?
Cough syrups may be given if clearly justified, in small doses, and for a short duration, under medical supervision.

4. Why is it important to tailor dosage based on age and weight?
Tailoring the dosage ensures the medication's effectiveness and safety, preventing the risks associated with a one-size-fits-all approach.

5. What should parents do if their child's cough persists or is accompanied by severe symptoms?
Seek immediate medical evaluation if the cough lasts beyond a few days or is paired with high fever, difficulty breathing, or chest pain.

6. Why should over-the-counter or self-medication be avoided?
Self-medication can lead to misuse, improper dosing, and exposure to contaminated products, posing serious health risks.

Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for a specific health diagnosis