My opinion about herbal cough syrups for children

Over the counter cough syrup and herbal syrups – how are they different?

It is important to recognize the differences between these two.
There are medical cough syrups out there that are sold over the counter, for children over a certain age (usually that age is 5 or 12, depends of each country), at the pharmacy. Some of them can be purchased with a doctor’s prescription for younger children, as young as 2 years.
These are syrups that contain “real” medical products that can deal with the cough. Are they good for your child? Are they bad? Are they helpful? Are they useless? It’s not always easy to tell because most of them have active ingredients that can cause your congested child to cough less but also to be a little more sleepy.
I think that a good pediatrician will make use of most of these syrups, which tend to dry congestion and relieve some of the cough symptoms in older children (and definitely not in every other 2-year-old that has been coughing for a day or two) and for limited periods of time.
But this post isn’t about these medical syrups but rather about the herbal syrups that are sold over the counter.

What are the natural products that are found in all cough medication?

What are herbal or natural products? That’s a good question. The reason behind why all these syrups are labelled “herbal” or “natural” is because they usually contain a variety of plant extracts. And plants are natural. And this tends to give people a sense that this stuff is healthy to use.

Have these syrups been tested for children in clinical trial?

Not really. Even though it depends what it is you are looking for exactly.
There have been different small-scale research studies that have been conducted on some of the different ingredients within these plant extracts. Take for example, the extract echinacea. Despite that, there is insufficient, good scientific evidence to prove that these extracts are helpful or efficient. And this stuff has been looked at in systemic reviews, as well, because cough is a very common complaint.
Additionally, the quality of methodology of these studies and the comparisons of the ingredients used, is not ideal (to say the least) and this makes reaching any sort of significant conclusions with regards to these products very challenging.
So, it’s not that I am against plants in the world, and I am certain that some of them may indeed have a positive effect in one way or another on the human body. When I add mint and honey to my tea, I enjoy it and it even provides me some relief when I’m unwell. But nobody has been able to prove whether the cough syrup you are taking yourself or giving your children there contains sufficient active ingredient, whether their “natural” processing has maintained their beneficial characteristics and how the other ingredients in there that were used to help form the syrup affect our bodies. Nobody has really tested whether they are helpful to anyone other than the person advertising and selling them.

So, what makes these syrups so popular?

This is because of several reasons:
1. Desperate parents – when a 1.5-year-old (or 5-year-old, for that matter) walk into my clinic and they have a runny nose and are coughing and I tell the parents that this is most likely a viral infection and there isn’t much they can do about it… the parents go crazy deep down inside. I mean, who can blame them? They haven’t been sleeping for days because their child is suffering and here I am telling them that there is nothing they can do about it.
2. The market – when Amoxicillin is sold with a prescription, the pharmacy makes a couple pennies out of it. But when an herbal cough syrup is sold, they make ten times as much. Easy.
3. Lack of herbal medication regulations – if tomorrow I decide to make cough syrups out of natural raspberry extract, I can add some plant extract from mount Everest, give it a cute little name and have a teddy bear sticker on it and that’s it – I can then sell it. There is no FDA approval, no regulations behind held, nothing.

How can I tell whether the syrup is herbal/natural?

I am really inclined to write down a list of all these syrups but I’m afraid you won’t make it to the end of that long list.
The best way to find out whether a cough syrup is herbal is to ask the pharmacist whether the syrup contains any genuine active ingredient. In addition – you can take a look at the list of ingredients and if it all looks like plant extracts and Chinese medicine, be more cautious.
It is always good to get some help from your pediatrician if you have any more questions.

So, if it is not useful – it won’t do any harm right?

No, no and no! This is far from true.
Would you give your child 5mL of raspberry juice before bed, just for fun? No. It’s unnecessary. The same applies to cough syrups, as well. Trust me, they are completely useless. And some of the ingredients may have adverse effects too. Just like everything else out there.
Also – isn’t it a shame to waste your dollars on a useless purchase?

In summary, even if you think that cough syrups helped your kiddo last time he was sick, think about the placebo effect. Even if your neighbor or the nanny said that this specific syrup did wonders – do not be dismayed, their statements are far from science. Even when the pharmacist swears that this one will bring about some relief.
In the case of a productive cough, with or without fever, see your doctor. Bring him some chocolates too and wish him an easy winter.
And remember that there is a really good medicine out there for cough symptoms for both you and your kids and it is called Chicken soap. Just promise me one thing – if you like it, send me a sample to taste!