Do kids even need cough syrups? Doctors say they may do more harm than good

The recent child deaths in MP and Rajasthan have reignited debate on whether cough syrups are safe or even effective for kids or are they a needless and risky habit?

The deaths of at least 15 children in Madhya Pradesh, Rajasthan, and Nagpur after consuming contaminated cough syrups have triggered nationwide alarm. But beyond the contamination lies a deeper question: do children even need cough syrups at all? Experts point out that most of these medicines offer little to no real benefit for kids, while carrying the risk of side effects, or worse, toxic harm. It raises a hard question for parents: are we reaching for cough syrups out of habit, or because children truly need them?

According to Dr Vivek Jain, Senior Director & Unit Head – Paediatrics, Fortis Hospital, Shalimar Bagh, children should not be prescribed cough syrups. “Most coughs in children are caused by viral upper respiratory infections (URIs), which usually clear on their own in 7–10 days. Cough syrups are not needed. They do more harm than good,” he said.

 

 

Global bodies like the World Health Organization (WHO), the American Academy of Pediatrics, and the Indian Academy of Paediatrics all recommend against the routine use of over-the-counter (OTC) cough syrups in children, especially those under six years old.

 

Why? Because they don’t work well, and they can cause side effects ranging from nausea to sedation, or in rare cases, even breathing problems.

India should tighten rules on paediatric cough syrups: Doctor

Dr Jain highlighted that many countries have already banned cough syrups for children under four or six years. India, he said, should take a hard look at its policies, especially after repeated contamination scares.

 

A temporary ban, mandatory batch testing, and transparent age restrictions could go a long way in preventing more tragedies.

Isn’t cough relief important for a sick child?

Dr Jain explained that while cough relief is important, coughing itself is protective. It helps clear mucus and germs from the airways.

 

However, that doesn’t mean children should be left suffering. When a cough becomes severe, doctors may consider short-term, safer alternatives — but always after assessing the child’s age, health, and cause of the cough.

 

For most children, simple remedies like hydration, rest, saline nasal drops, or using a humidifier work better than medicine.

How do toxic contaminants even get into syrups?

The deaths in Madhya Pradesh and Rajasthan are linked to diethylene glycol (DEG) and ethylene glycol, which are industrial chemicals sometimes used illicitly or accidentally instead of safe, pharmaceutical-grade solvents.

 

Contamination usually happens due to substandard raw materials, poor quality checks, or lax regulatory oversight.

 

To prevent this, Dr Jain says pharma companies must use only batch-tested, pharma-grade excipients, while regulators like the Central Drugs Standard Control Organization (CDSCO) must step up random testing and market surveillance.

Do cough syrups actually work for kids at all?

Not really. Multiple studies, including a 2018 Cochrane review titled “Over-the-counter (OTC) medications for acute cough in children and adults in community settings,” found little to no benefit of antitussives (like dextromethorphan), expectorants (like guaifenesin), or antihistamines in children.

 

In fact, most of the time, cough syrups work no better than a placebo. 

At what ages are cough syrups most risky?

The risks are highest in children under six, especially infants and toddlers, because their bodies cannot process these drugs well. Even in kids between six and twelve years, the evidence is weak.

 

Dr Jain advised parents to avoid multi-ingredient syrups altogether. For older children, single-ingredient formulations may be considered only under a doctor’s supervision.

Are there safer, home-based alternatives?

According to Dr Jain: 

• Honey (for children over one year) helps reduce night-time cough and improves sleep. 
• Warm liquids, steam inhalation, saline sprays, and humidifiers soothe the airways. 
• Hydration and rest remain the most effective and underrated treatments.

 

If you are caring for a sick child, avoid rushing to give cough syrups or any medicine before consulting a paediatrician. Home remedies often work better and are far safer than over-the-counter syrups.

 

As Dr Jain reminds, “The goal is not just to avoid dangerous drugs, but to keep children safe, comfortable, and healing naturally when possible.” 

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This content is for informational purposes only and is not a substitute for professional medical advice.