Something to cough at: The truth about cough medicine in children
11/3/2025 by Alexa Jensen, M.D.
Nearly every parent has experienced this at least once (if not many times): your child has a cold and can’t seem to stop coughing. You want to do anything you can to help them relieve those pesky cough symptoms and allow them — and you — to finally get some rest. You may think, "Cough medicine has been helpful when I’ve used it; could it also help my little one?"
Most clinicians will say cough medicine is not recommended for children, particularly those under age 4. Here’s why:
Why is cough medicine not recommended?
- Coughing has some benefits: Coughing clears out germs and mucus. Suppressing this process can increase the risk of worsening or prolonging the infection, since mucus remains in the airway and the lungs, allowing bacteria to grow.
- Evidence shows cough and cold medicines don't work well in children:
- Studies show that over-the-counter (OTC) cough medicines don’t help kids get better faster or stop the cough.
- When the common active ingredients in cough medicine, like dextromethorphan (a cough suppressant), are compared to a placebo in children ages 1–12, there is no significant difference in how often the children cough at night, how much they vomit after coughing, or how well they sleep.
- Over-the-counter (OTC) cough medicine ingredients can have serious risks for young children:
- Below is the typical cough medicine ingredients and the serious side effects they could cause in children under 4 years old:
| Ingredient | Common Side Effect(s) | Dangerous Side Effect(s) | |
| Dextromethorphan |
Nausea, dizziness | Hallucinations, seizures, coma, serotonin syndrome, bromism, death | |
| Antihistamines | Drowsiness, dry mouth | Fast heartbeat, hallucinations, seizures, respiratory depression, death | |
| Decongestants |
Insomnia, jitteriness | High blood pressure, heart rhythm, problems, stroke, seizures | |
| Guaifenesin | Nausea, headache | Constipation, sleepiness | |
| Codeine / Hydrocodone |
Constipation, sleepiness | Dangerous slowed breathing, death | |
- Many cough medicines have more than one active ingredient.
- Acetaminophen: a pain reliever and fever reducer.
- Dextromethorphan HBr: a cough suppressant.
- Phenylephrine HCl: a nasal decongestant.
- Guaifenesin: an expectorant to help loosen mucus.
- There is an increased risk of accidental overdoses when the same ingredients are consumed through different medicines. (For example: using both a liquid cough/cold medicine and liquid Tylenol at the same time, both of which contain acetaminophen, could lead to an accidental overdose).
The bottom line is that cough medicine doesn’t work well in kids, and when taking the risks and potentially harmful side effects into account, it isn’t worth it!
What works for children’s coughs?
- Let the body heal: Most coughs from colds or viral infections improve in 1–2 weeks without cough medicine, and coughing can be essential to healing.
- Honey for children over 1 year of age: Research shows one teaspoon of honey at bedtime can calm a cough and help kids (and parents) sleep. Never give honey to children under age one because it can cause botulism, which is a rare but serious illness caused by a toxin produced by a bacterium found in honey.
- Other helpful remedies:
- Encourage drinking plenty of fluids (water, decaffeinated tea, clear soup).
- Use a humidifier in the room.
- Try saline nasal spray or drops and gentle suctioning for stuffy noses.
- Make sure the child gets enough rest.
When to call your healthcare clinician
If the cough lasts over a week or is accompanied by trouble breathing, persistent fevers, or other severe symptoms, contact your doctor.
Alexa Jensen, M.D., is a pediatric resident at Mayo Clinic in Rochester, Minnesota. She loves working with children and families and is preparing to become a mom at this year's end. She aspires to be a great pediatrician by providing objective evidence to families while making it easy to understand and practical to use in everyday life.