How to treat your child during a children's cold medication shortage

Many parents may feel that they are facing a perfect storm right now, but it is not a nor’easter filling the streets with snow.

An increased demand for medications due to the current severe respiratory illness season, combined with a decreased supply due to manufacturing and supply chain issues, has led to pharmacy shelves being empty of many of the infant and children’s pain and fever-reducing medications used for respiratory illnesses and typical childhood infections.

The shortage includes common liquid preparations of acetaminophen and ibuprofen and other cold and flu medications. So, what should a parent do to weather this current medication shortage?

DO NOT PANIC

“The first thing parents should do now is not to panic, and not to panic buy,” says Dr. John O’Reilly of Baystate General Pediatrics. “It is common for kids to get a viral infection at least once a month in the winter, and most healthy kids get through them with only a few days of fever and discomfort.”  

Fever is the body's natural way to fight off infections and can only cause damage at levels above 107 degrees Fahrenheit – and most children’s bodies have the means to keep their fevers from becoming that dangerous. Parents should not panic if their child has a low-grade fever and they do not have acetaminophen or ibuprofen at home to give them. While this can be distressing, it’s important to remember that fever-reducing medicines do not cure or even shorten the duration of illness and only treat the symptoms.

The Baystate Children’s Hospital pediatrician noted that a natural way to help your child's body reduce fever is to place them in a lukewarm bath for 15 to 20 minutes. Sponge the lukewarm water over the skin to cool it down. Do not use cold water which can lower the child’s body temperature too quickly. 

There are several other steps to comfort children if they develop a fever and you are unable to find fever-reducing medications, such as keeping their room comfortably cool and dressing them in light clothing.

WHEN TO SEEK MEDICAL ATTENTION FOR A FEVER

“Pediatricians do not worry as much about the height of the fever, but how ill the child appears. We worry if children are having difficulty breathing. If parents see their children breathing fast and breathing with their belly or pulling in on their ribs, then they should contact their pediatrician or be seen in the emergency room,” says Dr. O’Reilly.  

If your child is not drinking and not peeing more than 4 times a day, they may be at risk for dehydration, and you may need to contact your pediatrician to plan how you can keep your child hydrated during their viral illness. The more fluids your child takes in the better their body can fight off their viral illness. If your child is not feeling well, go ahead and spoil them with fruit juice ice pops if that is what it takes to get that fluid in, notes Dr. O’Reilly. 

It’s important to remember that fever in children should never be treated with aspirin or rubbing alcohol as both can cause serious illness.

COUGHING IS NATURAL

What about dealing with a cough?

“Coughing is a natural way to clear and protect your child’s airway, so don’t be too concerned about a mild cough alone if your child is not having difficulty breathing,” says Dr. O’Reilly.

If your child is over age 1* and has a cold and a mild cough, don’t worry if you can’t find an over-the-counter cold medication. The best cough medicine that you can give your child is honey, he noted, and giving 1 or 2 teaspoons of honey on a spoon will soothe the back of the throat and decrease the irritation of some of the nerves that are causing your child to cough.  

*Babies younger than 1 year old should never be given honey. Honey can contain bacteria that causes infant botulism. However, honey is safe for people over the age of 1.

EASING NASAL CONGESTION

“The best medication for nasal congestion, especially in children under 6, is to use saline drops to unclog and moisturize the nasal passages,” says Dr. O’Reilly. 

If you cannot find commercial nasal saline drops, he recommended that caregivers mix 1/2 teaspoon of table salt in 8 ounces of water, then place 3 or 4 drops of the saline mixture into their child's nose. If the child is old enough to blow their nose, encourage them to blow all the mucus out. If they are unable to blow their nose, a caregiver can use a nasal aspirator (like a bulb syringe) to clear out the nose.  

“Viral illnesses are a natural part of your child's growing up, and it will allow their body to build up antibodies against future infections. If your child has special medical needs, you will want to speak to your pediatrician about how you should treat the many respiratory infections they may encounter over time. If you cannot find medications in the pharmacy, remember that a few tried and true home remedies and a lot of ‘TLC' will help your child get through their viral infection,” says Dr. O’Reilly.

WHAT ABOUT PRESCRIPTION MEDS?

 It isn’t only over-the-counter medications in short supply right now.

"Because some prescription medications are in short supply during the current respiratory outbreaks and other illnesses, parents, pharmacists, and pediatricians have to work together as a team to be sure that your child will be able to get the correct medicines. If your child needs an antibiotic, parents should call their pharmacy to be sure the medication is in stock. Parents can work directly with their local pharmacist to see where the medication is available, and perhaps transfer the prescription to another pharmacy. Good communication and good teamwork is the key to getting your child the medications they need,” says Dr. O’Reilly. 

WHEN TO GO TO THE ER

If you still have concerns about your child’s fever or flu symptoms, review tips from Baystate Health’s Pediatrician-in-Chief to decide if you should take them to the ER. Consider letting your pediatrician know that you’re taking your child to the ER, and be sure to follow up with them afterwards. 

Symptoms that should prompt an ER visit include: 

• Difficulty breathing
• Flu-like symptoms that improved but then returned worse
• Chest pain or pressure
• Confusion or worse-than-normal mental function
• Severe or persistent vomiting
• Loss of appetite or refusal to eat or drink
• Decreased urine or wet diapers

During this current shortage of fever-reducing medications, please purchase only the quantity that you need for your child. Buying only what you need will help avoid worsening shortages and ensure available medicine for others.  If you don’t see fever-reducing products on the store shelf, ask the pharmacy staff as they may be storing their limited supply behind the counter.

If you have questions about the medications you have at home, or have purchased, check with your healthcare provider or pharmacist.