From the February 2007 issue

In the January 12, 2007 Morbidity and Mortality Weekly Report (MMWR), a notice was published about infant deaths associated with cough and cold medications. Three infants between the ages of 1- 6 months old were found dead in their homes. A medical examiner determined that cough and cold medications were the underlying causes of the accidental deaths.

On autopsy, two of the infants had evidence of respiratory infections. No abnormalities in cardiac pathology were revealed in any of the infants. All three infants had what appeared to be high levels of pseudoephedrine in postmortem blood samples. One infant had received both a prescription and an over-the-counter (OTC) cough and cold medication at the same time, both containing pseudoephedrine. The other two infants also had received pseudoephedrine-containing medications (one prescription and the other one OTC).

Fortunately, the Federal Combat Methamphetamine Epidemic Act, which was signed into law on March 9, 2006, has moved pseudoephedrine products behind the pharmacy counter, only allowing patients to purchase them in limited amounts. While other cold medications are available, be aware that there are none with proven efficacy in children less than 2 years of age. Also, cough suppressants like codeine and dextromethorphan also carry a high risk of adverse events in this age group.