Cough and Cold Medicine for Kids: What's Safe by Age

Quick answer: Cough and cold medicine for kids is not recommended for children under 4, according to the American Academy of Pediatrics (AAP). The FDA warns these over-the-counter products can cause serious, even life-threatening side effects in children under 2, and manufacturers label them “do not use in children under 4.” For ages 4 to 6, use them only if your pediatrician says so; from age 6 they are considered safe if you follow the package directions. Colds get better on their own, so for most kids the best relief is fluids, saline drops, suction, a cool-mist humidifier and, for children over 1, a little honey for a nighttime cough. Never give honey to a baby under 1.

Why cough and cold medicine for kids isn’t recommended under 4

Colds are caused by viruses, and no medicine cures them or makes them end sooner. Over-the-counter (OTC) cough and cold products only try to ease symptoms, and in young children the risks outweigh any small benefit, the AAP says.

The FDA points to a few specific dangers:

Slowed breathing. Some cough and cold ingredients can slow a child’s breathing, which can be life-threatening, especially in babies and toddlers.
Accidental overdose. Many products are “multi-symptom” mixes with several drugs in one bottle. Giving too much, giving it too often, or giving two products that share an ingredient can all lead to an overdose.
Adult products. Medicine made for adults can overdose a child.
Homeopathic and imported remedies. The FDA urges parents not to give homeopathic cough and cold products to children under 4. Some have been found to contain active ingredients at far higher levels than the label says. The FDA also advises against imported children’s medicines, which may not have been checked for safety.

What’s safe by age: a quick guide

Guidance differs slightly depending on who you ask, so here is how the major sources line up:

Under 1 year: No OTC cough or cold medicine. No honey (it can cause infant botulism). No cough drops. Use saline drops, gentle suction, a cool-mist humidifier and keep feeding. Breastfeeding is still encouraged when your baby has a cold.
Under 2 years: The FDA does not recommend OTC cough and cold medicines at all because of the risk of serious side effects.
Under 4 years: The AAP does not recommend OTC cough and cold medicines, and product labels say “do not use in children under 4 years of age.” The FDA also says to avoid homeopathic versions in this age group.
Ages 4 to 6: The AAP says to use these products only if your child’s doctor recommends it.
6 years and older: Considered safe when you follow the package directions exactly. Cough drops are also fine from this age; before 6 they are a choking hazard, according to Seattle Children’s.
Under 18 years: Prescription cough and cold medicines that contain the opioids codeine or hydrocodone are not for children. In 2018 the FDA limited their use to adults 18 and older, after concluding the risks (including slowed or difficult breathing, overdose and death) outweigh the benefits in kids.

The short version: the FDA’s line is age 2, the product labels and the AAP use age 4, and the AAP adds extra caution up to age 6. When the sources differ, the safest choice is to follow the more cautious advice and check with your pediatrician.

Home remedies that actually help a cold

If your child is playing, eating and sleeping reasonably well, the cold may not need treating at all. When symptoms are making your child miserable or keeping them up at night, these steps are recommended by the AAP, the FDA and Seattle Children’s:

Saline nose drops or spray. Saltwater loosens thick mucus so it’s easier to clear. Put a few drops in each nostril, then suction or have your child blow their nose, one side at a time. Saline is sold without a prescription. For babies under 1, Seattle Children’s suggests limiting saline drops to about 4 times a day or before feedings.
Suction for babies. A bulb syringe helps clear a stuffy nose, especially for babies under 1 who can’t blow their nose. Suctioning before feeds can make eating easier. A wet cotton swab can remove sticky mucus around the nostrils.
Honey for coughs (age 1 and older only). The AAP suggests ½ to 1 teaspoon (2 to 5 mL) of honey as needed to thin mucus and calm a cough. Research cited by the AAP found honey worked better than store-bought cough syrup for nighttime coughing. Never give honey to a baby under 12 months.
Plenty of fluids. Water, milk, breast milk or formula keep your child hydrated and help thin mucus. Warm drinks such as warm apple juice can soothe a sore throat in older kids.
A cool-mist humidifier. Moist air can ease a dry, stuffy nose and cough. The FDA recommends a cool-mist humidifier; it notes warm-mist humidifiers can make breathing harder. Clean it often. Sitting in a steamy bathroom can also help with a coughing fit.
Mentholated chest rub (age 2 and older). The AAP says it can be rubbed on the chest and neck of children 2 and up. Store the jar well out of reach.

Two things that usually don’t help a cold: antibiotics, which don’t work against viruses, and allergy medicines (antihistamines) such as diphenhydramine. Seattle Children’s notes these only help nasal allergies, not a typical cold.

What about fever and aches?

Fever is the body’s way of fighting infection, so it doesn’t always need treating. The AAP suggests treating it mainly when your child seems uncomfortable or slowed down. Acetaminophen or ibuprofen can ease fever, aches and pain. Ask your pediatrician or pharmacist which medicine and dose is right for your child’s age and weight, and follow the package directions. Never give aspirin to a child or teen.

For fever thresholds by age, see our guide on when to call the pediatrician about a fever.

If you do use a cold medicine: safety checklist

For children old enough to take an OTC product (or when your pediatrician recommends one), the FDA advises:

Read the Drug Facts label and check every active ingredient.
Watch for doubled ingredients. Many multi-symptom products already contain acetaminophen. Don’t give a separate acetaminophen pain reliever on top of one.
Use the dosing cup or syringe that came with the medicine. Kitchen spoons and devices from other medicines aren’t accurate.
Use children’s products only, never adult versions, and never more often than the label allows.
Lock medicines up. Store them out of sight and reach, and get rid of leftover medicine safely.

A note on phenylephrine: In November 2024 the FDA proposed removing oral phenylephrine, a decongestant found in many cold products, after concluding it doesn’t work as a nasal decongestant when taken by mouth. The FDA’s consumer page says these products can stay on shelves until a final order is issued. The proposal doesn’t affect phenylephrine nasal sprays. Ask your pharmacist if you’re unsure what’s in a product.

Watch out for adult prescription cough pills

Benzonatate (Tessalon) is a prescription cough capsule for people older than 10. The FDA has warned that a child who accidentally swallows it can overdose, and that as few as one or two capsules have caused overdoses in children under 2. Symptoms such as restlessness, tremors and seizures can start within 15 to 20 minutes. Keep it in a child-resistant container, out of reach.

When to call the doctor

Most colds improve within a week or two. The FDA advises contacting your child’s doctor if your child has:

A fever of 100.4°F (38°C) or higher in a baby 2 months or younger
A fever of 102°F (39°C) or higher at any age
A severe headache
Ear pain that doesn’t go away
Poor eating or drinking, or signs of dehydration such as fewer wet diapers or less urine
Unusual crankiness or sleepiness
Symptoms that are getting worse instead of better

Call also if you’re not sure whether a medicine is safe for your child’s age, or if you have any other concerns. A cough or cold that’s really the flu, RSV or COVID-19 may need a different plan; our guide to cold vs. flu vs. RSV vs. COVID in kids explains the differences, and our flu in kids guide covers when antivirals help.

When to go to the ER or call 911

Get emergency care right away if your child:

Has blue or gray lips, or a bluish face
Is working hard to breathe: nostrils flaring with each breath, ribs pulling in, wheezing, very fast breathing or shortness of breath
Is very hard to wake, limp or not responding
Has a seizure

If you think your child swallowed too much medicine, or took a medicine meant for someone else, call Poison Help at 1-800-222-1222 right away. Call 911 if your child is having trouble breathing, has a seizure, collapses or can’t be woken.

A barking cough with a high-pitched sound when breathing in can be croup; see croup in kids. Fast or labored breathing in a baby can be RSV; see RSV in babies.

Frequently Asked Questions

At what age can kids take cough and cold medicine?

The AAP says over-the-counter cough and cold medicine should not be given to children under 4, should be used in children 4 to 6 only if a doctor recommends it, and is considered safe from age 6 when the package directions are followed. The FDA warns against these products in children under 2 because of serious side effects.

Is honey safe for a child’s cough?

Honey is safe for children 1 year and older. The AAP suggests ½ to 1 teaspoon (2 to 5 mL) as needed to calm a cough, and research suggests it works better than store-bought cough syrup at night. Never give honey to a baby under 12 months because it can cause infant botulism.

What can I give my baby for a cold?

Babies don’t need cold medicine. Use saline nose drops, gentle suction with a bulb syringe (especially before feeds), a cool-mist humidifier and plenty of breast milk or formula. Call your pediatrician for any fever of 100.4°F (38°C) or higher in a baby 2 months or younger.

Can I give my child Benadryl for a cold?

Antihistamines such as Benadryl (diphenhydramine) don’t help a typical cold, according to Seattle Children’s. They are useful only for nasal allergies. Ask your pediatrician before giving any antihistamine to a young child.

Are cough drops safe for kids?

Cough drops are recommended only for children 6 and older, because they are a choking hazard for younger children. For children 1 and older, a spoonful of honey is a safer way to soothe a cough.

Are prescription cough medicines with codeine safe for children?

No. In 2018 the FDA limited prescription cough and cold medicines that contain codeine or hydrocodone to adults 18 and older, because they can cause slowed or difficult breathing, overdose and death. If your child was prescribed one, ask the doctor about non-opioid options.

What should I do if my child swallowed cough medicine?

Call Poison Help at 1-800-222-1222 right away, even if your child seems fine. Call 911 if your child has trouble breathing, a seizure, collapses or can’t be woken. Keep all medicines locked up and out of reach.

Related guides

Sources

This article is for general information and is not a substitute for advice from your child’s doctor.

Cough and Cold Medicine for Kids: What’s Safe by Age