Parental Views on Cough and Cold Medicine – PediaCast 095

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Announcer 1: Welcome to PediaCast, a pediatric podcast for parents, the News edition. And now, direct from Birdhouse Studios, here is your host, Dr. Mike.

Dr. Mike Patrick: Hi, everyone, and welcome to PediaCast, it is episode 95 for Monday, December 17, 2007. It's our News edition. We're talking about Noisy Toys, Playgrounds and Hurricanes, plus couple other new stories on there for you as well. And I want to thank everyone, you know I've been kind of drumming up this "Give me 200 reviews on iTunes by the end of the year”… and I think you guys are actually starting to take me serious. Well, you know, I'm flattered by that.


Honestly, I'm sorry. I got a little frog in my throat. It's that time, a year. Definitely, a viral season. I did not think that it's going to be possible, you know, 200 seem like a pretty [01:15] lofty goal. But I've had about 10 new reviews in the last couple of days. so, we are up to 173 reviews. So, now you know, it seems maybe it's possible. So, if everyone just says "Oh! You know, it's getting plenty and I'll never make it to 200….

But if you have not left a review on iTunes, please do, and after we get the 200 I promised I won't mention iTunes reviews again for a very, very long time. I promised you that. So, if you're tired of me talking about iTunes reviews, [laughing] then please to go and do one, so we will get up to 200 and get the show on the road. Why, why is this important? It's not just stroke in me ego, folks. The more reviews you get on iTunes and the better reviews you have, the more likely that you stay on the front featured page in a prominent position.


And so, they are important, they're important to get the words out so that other people who are looking through the iTunes directory can find the PediaCast very easily. It's my little push for it, and hopefully we'll get the 200 by the end of the year. We'll see how that goes. All right. So we're going to talk about pre-reviews on cough and cold medication all the way in a minute. OK. Hold on folks. You know, I forgot to take the autoplay [laughing]

I'm using a little bit of a new; you know, I'm always trying out new things. A little bit of a new software package to do the live music, and the interludes, and all of that. And all of you out there, who are regular PediaCast listeners, noticed how much I hate to do post production, so we're just going to leave that in there. OK. We'll start on the week off, that was our mistake for the week, OK? Well, hopefully that all PD only one. So we'll see.


Anyway, where was I? What are we talking about today? Pre-reviews on cough and cold medication. Watch out for noisy toys. How to get kids more active on the playground. Kids are still feeling the aftermath of the 2005 hurricane season. And fewer United States teenagers are taking illegal drugs. So, some good news there. Don't forget if there's a topic that you would like us to discuss just go to, and click on the contact link.

You can also email, or call us on our voice line at 347-404-KIDS. And as always, the information presented in PediaCast is for educational purposes. We do not diagnose medical conditions, or formulate treatment plans for specific individuals.

If you have a concern about your child's health, call your doctor and arrange a face to face interview, and hands on physical examination. Also, your use of this audio program is subject to the PediaCast Terms of Use Agreement, which you can find at And with all that in mind, we will be back with News Parents Can Use, right after this.



You know, it's kind of funny that we have that little snafu with the music earlier because for some reason today's show I just had a lot of trouble getting it started. I started the show, and then had it stop, and just start all over because I would just tripped enough over words. And then did a second take, and got about halfway to the first new story and it just was not going well. So this was the third time. And finally, I'm cruising along here; then you know the music playing.


And I am thinking I am not stopping, on fourth times. That's the way it goes.

It's Monday, what do you expect? Our news parent's, News edition is brought to you in conjunction with news partner Medical News Today, the largest independent health and medical news website, and you can visit them online at NPR’s morning edition reports a new survey from NPR, the Kaiser Family Foundation and the Harvard School of Public Health. The survey examined parents' views and laid recent concerns about the safety and effectiveness of giving over-the-counter cold and cough medications to children.

An FDA adviser committee on October recommended that drug maker stop marketing over-the-counter cold medicine for use in children under age 6. The recommendation came after six clinical trials by a group of pediatricians showed that over-the-counter cold medicines are no more effective than placebo in relieving cold symptoms. A few children die each year after taking cold medications, and the deaths have been link to potential overdoses, according to the morning edition report.


The survey found that while 86% of parents are aware of the safety concerns, 58% still think over-the-counter cough and cold medications are somewhat safe for children between ages 2 and 6, and 23% believe the medications are very safe. The survey also indicates many more parents are simply not sure whether they should continue to use cough and cold medicine for their young kids.

More figures from the survey: 34% of parents with children under age 6 said that they at least temporarily stopped using over-the-counter cold medications, since concerns about the treatments arose. Fifteen percent of parents with children ages 2 to 6, so they plan to stop using such medicine, 30% said they plan to continue to use the treatments, and 28% of parents said they have not yet decided what to do. The survey also looked at who parents trust when making decision about the safety of over-the-counter cold and cough medicine in their children.


Seventy-one percent of parents with children under age 6 trust pediatricians "a lot.” While half of parents said they have confidence in pharmacists. Finally, only 29% of parents said they have a lot of trust in the FDA. Finally, 62% of parents with children under age 6 said their doctor has recommended using over-the-counter cold and cough medicines for their children.

The survey was conducted by telephone from November 15th to the 25th, and includes responses from 1,500 adults who are parents of young children. OK, so you know, this is definitely controversial. I think they were all sort of heading in a direction of agreeing that for kids under 2, the risk of the cough and cold medications really out way any benefit, and we probably shouldn't be using them in the really young kids. But, what about these 2 to 6 years olds? And you know, at some point, you know, we talked about research here a lot. But sometimes, you just have to look at your own family, and your own kid, and your own little study with the number 1 in your sample size.


You know what I'm saying? And if you have a kid who has cough and cold, and they're not getting a lot of sleep, and you're not getting a lot of sleep, and you give him a cold medicine, and it makes him sleepy, and they sleep, and you sleep. You know, that does not show up any studies because the studies are looking at the cold symptoms. So, you know, they compare the cold medicine with placebo and they say well, you know, they both the same amount of work in terms of the running nose and the cough.

What about sleeping? So you know, you're dragging your kid up and helping them sleep. You know, and there's a risk involved in the cough and cold medicines. But the risk is small, you know, a handful of kids were talking. Certainly more kids die in car accidents, and we don't say "Oh! Let's just get rid of all the cars. And there is something to be said for kids to get a goodnight sleep, and for parents to get a goodnight sleep.

Now, so you know, my saying is fine, give your 2 to 6 year old a cough and cold medicine. No, I am just saying, got to look at the whole picture. You got to make the decision that's right for your family, and then talk to you doctor about it because I can't give you medical advice.


Ok. Watch out for noisy toys. I love this one. During a press conference on Parliament Hill, the Canadian Association of Speech Language Pathologist and Audiologist urged their government to include further on noise, as it relates to toy safety and revise current legislation.

With the holiday season just around the corner, toyso…toy safety is a pressing matter [laughing]. See, my lips still are not moving, but I am not starting over again. In line of recent discussions and public and governmental concerns surrounding toy safety, there are many items to be considered by Health Canada.

“We want noise to be one of those issues,” said Dr. Linda Rammage, president of the association. The group voice concern over the current Hazardous Products Act, which bans toys that making noise levels exceeding 100 decibels, measured at the distance of the product ordinarily would be from the ear of the child using it.


They believe this level too high, and they are asking the government to include noise in their current review of toy safety. The International Standards Organization states that, “All toys except those close-to-ear toys shall not exceed 85 decibels.” I am guessing the close-to-ear toys should be even softer.

According to Dr. Rammage, the current Canadian Act permits the noise level, which it too high and it does not take into account the typical use of toys. Yield test conducted for 2004 study revealed that the majority of toys designed for 0 to 3 age group were in fact held much closer to the ear than the distance specified in the current loss measurement protocol.

Is there an average distance so that 0 to 3 years old hold toys from their ears? [laughing] I mean, really? Most of these kids are chewing on the toys; you know what I am saying. Audiologist and speech language pathologist also warn parents to be cautious when purchasing noisy toys for their children.


It is essential for parents to know that excessively noisy toys have the potential to harm their children hearing, if they are not played with as intended. As a rule of thumb, if you have to raise you voice above the noise level of a toy to be heard, then the noise is too loud, and could be causing damage to your child's hearing. Not to mention, damage to the parents’ sanity [laughing].

I mean, if the toy is so loud that you have to raise your voice to be heard over, I agree, get it out of the house. Do not get it to begin with, and not just because of your child's hearing. OK. And then speaking of that… being a safety issue, you know, so lead toys from China is not the only thing moms and dads needs to worry about this holiday season.

All right, how to get kids more active on the playground? Children play harder and longer, when their child care centers provides portable play equipment like, balls, hula hoop, jump ropes, and riding toys, more opportunity for active play and physical activity training and education for staffs and students.


That is according to a published study in a January 2008 issue of the American Journal of Preventive Medicine. Researchers at the University of North Carolina’s School of Public Health examine environmental factors that encourage children to be active with greater intensity and for longer periods of time.

Increase activity level helps children maintain a healthy weight, according to researchers, and it is critical as obesity rates climb nationwide especially among children. "Childhood obesity is an epidemic that threatens the health of our nations,” said Dr. Dianne Ward, Director of the School of Public Health Nutrition, Intervention and Policy Division and the co-author of the study.
“We know that about 57% of all 3 to 5 year olds in the United States attend child care centers. So it is important to understand what factors will encourage them to be more active, and hopefully less likely to become obese.” Researchers assessed the physical and social environmental factors that will influence healthy weight at 20 child care centers across North Carolina.


And then, they evaluated the physical activity levels of children attending the centers. Additional data were gathered through interviews and documents provided by the child care directors. The study showed that children had more moderate and vigorous physical activity and fewer minutes of sedentary activity, when their center have more portable play equipment including balls, hula hoops, jump ropes and riding toys.

“Also, if they offered more opportunities for active play both inside and outside, and have physical activity training and education for staff and students. Stationary equipment like climbing structures, swing, and balance beams were associated with lower intensity physical activity,” researchers said. But they are still beneficial to other aspects of child development such as motor and social skills.

The researchers also noted that centers with more computer and TV equipment actually scored better on activity levels. "It is unlikely that TV and computers promoted active behavior.” Ward said. But it could be that centers that have the resources to buy media equipment also spend more on equipment and activities that promote physical activity, and provide supplemental training and education for the staff.


Although previous research pointed to a link between physical activity, and the child care center a child attends. There has been little data examining which aspects of the child care environment actually promoted vigorous physical activity.

Not surprisingly, researcher said, "children and centers that ranked higher and supportive environmental criteria in the study receive approximately 80 more minutes of moderate to vigorous activity, and 140 fewer minutes of sedentary activity per week, compared to centers having less supportive environments.”

Child care providers can play huge role in encouraging children to be active in developing habits and preferences that will help them control their weight throughout their lives. Ward said, "The easiest way of increasing physical activity may be as simple as providing more active play time, and providing relatively inexpensive toys, like balls and jump ropes.”


“Our data does not go this far, but parents buying toys and games for children at time of the year might consider stacking up on jump ropes and hula hoops. And for their own health, they should get outside with their children and run, jump, and play too.” So, something else to consider when you are looking for child care center for your kids. What kind of portable equipment, do they have, such as balls and jump ropes and those kind of things. So, something else to think about.

Kids are still feeling the aftermath of the 2005 hurricane season. The New York Times reports more than 46,000 Gulf Coast children are experiencing mental health problems and other serious after effects of the 2005 hurricane, according to the study by the Mailman School of Public Health at Columbia University and the Children's Health Fund.

Further study, researchers examined school enrollment statistics, data from the Federal Census and the Federal Emergency Management Agency, and data from the study that is been following about 1,200 families displaced by the storms. The study found that about 163,000 children were displaced by the hurricanes, and about 90,000 have returned to Louisiana and Mississippi.


Researchers estimate that 50,000 children are experiencing serious post-storm problems. The researchers continuing study of Gulf Coast families found that nearly one-third of the children examined have developed depression anxiety or behavioral disorders since the hurricanes.

The children who at most risk are those who have returned to their home states of Louisiana and Mississippi, but lacks stable leaving situations, according to the study. Around 11,000 children were still leaving in FEMA trailers, government, or private trailer parks at the end of September.

But the number has been declining, as the government begins closing those parks. In addition, many of the children have limited access to medical care. And many in Mississippi have lost health insurance and physicians, the report said.


Roberta Avila, Executive Director of Mississippi Coast Interfaith Disaster Task Force said, "We saw a lot of families and trailers and the stress of leaving in that situation is really tough,” adding that she is hearing increased reports of problems with children ranging from trouble completing homework to suicides.

Irwin Redlener, President of the Children's Health Plan and the Director of the National Center for Disaster Preparedness at Columbia said, "Physicians treating children who survived Katrina have been reporting just tremendous problems especially the Mental Health Providers.” He added, "We are alarmed at the continuing downward trend, the longer the state of Limbo continues.”

And finally, a new survey of US teenagers shows that overall smoking and illicit drug use have fallen over the last 10 years, which have substantial drops in 8 graders. But there are still some worrying trends, such as increase in Ecstasy use and continued abuse of prescription drugs. The survey, the result of which were announced at the news conference at the White House last Tuesday, was carried out by researchers from the University of Michigan, and is called the Monitoring the Future project, now on its 33rd year.


WHO sponsored the National Institute of Drug Abuse, which is part of the National Institute of Health or NIH. The researchers surveyed 48,000 students in grade 8, those are mostly 13 to 14-year olds, grade 10, which are just mostly 15 to 16-year olds, and grade 12 mostly 17 to 18-year olds, in 403 public and private US schools.

Surveyed participants reported their use of drugs, alcohol, and cigarettes across three-time periods, the past month, the past year, and lifetime. The survey also asked students about their attitude toward these substances. The biggest fall was found in 8 graders, 13% of whom reported using an illicit drug at least once in the last year, in 2007, which is nearly half the 24% WHO reported doing so in 2006.


Eight graders also showed a significant long term fall in past year alcohol use, down to 31.8% compared with 46.8% in 1994. Lifetime and past month daily smoking among this group also dropped considerably in the last year. Daily cigarette smoking went down from 4 to 3%, but had peak at 10.4% back in 1996.

Also down among 8 graders is the annual prevalence of marijuana use from 11.7% in 2006 to 10.3% in 2007. That had peak at 18.3% in 1996. So, 10% of 8 graders are doing marijuana? Crazy! “The 2007 result could signify a cultural shift among teenagers with a different attitude to smoking and using illegal drugs,” said the National Institute of Drug Abuse in a prepared statement.


NIH Director, Dr. Elias A. Zerhouni said, "Over the last decade, there has been a large science based effort throughout the public health community to drive down the rates of smoking, illicit drug and alcohol use among teens.” “These results show us, we are definitely seeing a decline in substance abuse among our youngest and most vulnerable teens, and we are committed to continuing our efforts,” added Zerhouni.

National Institute on Drug Abuse Director, Nora Volkow said, "We are especially [20:30] heartened to see the decrease in smoking among eighth graders, and we will be watching the next two years closely to see if this decline will stick as these kids get older.” “If this change in attitude is carried with them to the rest of their teen years, we could see a dramatic drop in smoking related deaths in their generations,” she added.

However, the other results are not so dramatically pleasing. The past year, use of marijuana among 10th and 12th graders remain steady, although there has been a slow downward trend and illicit drug use that has driven by a decline in reported marijuana smoking.


Among 10th graders, marijuana use has a steady at 24.6% down from a peak of 34.8% in 1997. While among 12th graders, it is holding at 31.7% after a 1997 peak of 38.5%. So, a third of 12th graders are doing marijuana? That seems like a lot.

A worrying area of the survey concerns prescription drug use, which remains high with no significant drop in nonmedical use. Vicodin is still one of the most commonly abused prescription drugs among 12th graders, 1 in 10 of these group, reported nonmedical use of Vicodin in the past year.

This is the first year to survey has public other data for all prescription drugs as a measurable group that shows 15.4% of high school seniors reported nonmedical use in the past year of at least one of the prescription drugs monitored by the survey. The survey now monitors the use of Vicodin, Oxycontin and other opiates, Ritalin and other amphetamines, sedative, barbiturates, tranquilizers and over-the-counter drugs such as cough syrup.


Binge drinking or consuming five or more drinks in the row within the last two weeks, which is a very dangerous pattern of alcohol consumption, has not badges Figures of this pattern of abuse have remained at worrisome levels for all three student age groups.

Also, recent data on alcohol consumption has remained to the study high for 10th and 12th graders. The survey also pinpoints another area of concern, the softening of attitudes towards Ecstasy and LSD in the younger group.

For the third year now, there has been a decrease on the perception of how harmful Ecstasy is among 8th graders. And in 10th graders, there has been a decrease on the perception of how harmful LSD and Ecstasy are, as well as the decrease in the disapproval toward taking LSD. This is an addition to an increase in past year use of Ecstasy among 10th to 12th graders in the last two years.


[23:00] Volkow said they will be monitoring the trends on Ecstasy and LSD use in the future years. “This decrease in both disapproval and perceived harmfulness among 8th graders shows us that we need to be vigilant in our educational efforts with every drug in each succeeding generation.” These are just some eye opening numbers, folks. You know, it is way too many kids out there doing marijuana and prescription drugs that are not meant for them.

All right. We are going to take a break. We definitely need to take a break; I have to apologize to you, folks. I have just been stumble and all over the script today. But you know, you guys are so great and I appreciate you bearing with me. We will have some listener's show coming up later on the week. Let's take a quick break and I'll be back, then we'll wrap up the show.


OK, see what I'm talking about? This is what I'm talking about. This show has been jinxed from the very beginning. I think we need to change the title to the Jinx Show. Let's try this again.



If you are listening to PediaCast for the very first time, this is your very first episode listening to it, please do not judge the quality and content of this podcast based on today's episode. But I am leaving it because I am not starting over again.

Thanks to the Nationwide Children's Hospital for providing the Bandwidth for this show. Also, Medical News Today, Vlad, over And of course, to all of you for stopping by, and putting up with some of the immaturishness of this show today, in any case. Once again, iTunes reviews are most appreciated. The PediaCast shop has some shopping ideas for you, for your favorite PediaCast fan.

And also, poster page is available at the website as well, so you can download those on that. Hang them up on bulletin boards all over the place. More listener questions are on the way later this week. And until next time, this is Dr. Mike, saying, stay safe, stay healthy, and stay involved with your kids. And we will see if the music will work here at the end. Hopefully, it will. All right, so long everybody.


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