Cough Syrups and Kids: They Aren't Just Small Adults

I was reading an article on the New York Times website this afternoon. The essence of the article, 'Parents Warned Cough Syrups Imperil Infants,' discusses a Food and Drug Administration advisory issued yesterday. The FDA's website, says that in October the Nonprescription Drugs Advisory Committee will discuss the safety and effectiveness of cough and cold products for children. In particular, it says, "Questions have been raised about the safety of these products and whether the benefits justify any potential risks from the use of these products in children, especially in children under 2 years of age." (For parents and grandparents, it's definitely worth going to this site yourself, as FDA has an important statement on, "What should parents know about using cough and cold products in children?)

Back to the NYT article. The writer, Gardiner Harris, says,

"[T]he standards for drug approvals have changed sharply in the decades since many of the medicines in children’s cough and cold products were approved. If those drugs were currently up for review, they would not be approved for use in children because the manufacturers never tested them thoroughly in children.

Instead, the drugs’ makers performed studies in adults and then simply assumed that they would work in children. Such assumptions, once common, are no longer acceptable. Indeed, a growing number of studies in children suggest that cough and cold medicines work no better than placebos."

Harris' statement highlights something I've come to understand from my research into environmental health: "children are not just small adults,", a statement that researchers and physicians at the forefront of this topic make quite frequently. A growing number of their studies show that all kinds of exposures that would be inconsequential for adults have profoundly negative impacts on kids. Because they are going through frenetic development their bodies react differently to chemical exposures than an adult's would to the same exposure.

Children are generally the most vulnerable to exposures, so we need risk assessments that focus on them.