Local physicians urge caution when using over-the-counter medications with young children.

Labels recently changed on some cough medication and cold syrup to recommend the products not be given to children under 4 years old.

"This is stuff doctors have known a long time," said Dr. Brandon Price, a family practice physician with the St. Alexius Medical Center Mandan clinic.

Drugs that have antihistimines, cough suppressants, expectorants and decongestants can cause problems in young children. They can lead to higher blood pressure and increased heart rate, said Dr. Parag Kumar, a pediatrician at Medcenter One.

Antihistimines make children sleepy and decongestants restrict blood vessels, while cough suppressants inhibit the coughing reflex and expectorants make mucus dry and thick, Kumar said.

The medications can have other side effects, too. Some over-the-counter medications can make children hyperactive, Price said.

Dosing for the medications is based on weight. This can lead to overdosing in younger children, along with mixing medications that have the same ingredients, Price said. Previously, over-the-counter medicines were not recommended for children under 2.

Children have seven to 10 colds a year, Kumar said. Most of those colds, however, can be taken care of at home with rest and liquids, he added.

The more liquids a person drinks, the thinner the mucus becomes, which makes it easier to get out of the body. People should not be concerned about colored mucus, which is what happens to mucus over time, and does not indicate infection, Kumar said.

Broth-based soups, like chicken noodle, also help relieve symptoms because they are warm and mostly liquid. Parents also should consider milk because it is mostly water, as well.

"Milk has no relation to causing mucus," Kumar said.

Other ways to relieve cold symptoms in children include breathing steam from a shower or running a humidifier near the child and using saline spray to relieve nasal congestion.

There are times when a child should see a doctor or go to the emergency room. If a child is wheezing or a few days into a cold spikes a fever accompanied by facial pain, they should see a doctor.

Usually, doctors or their nurses can answer questions by phone to determine if a child should see a doctor, Kumar said. Price also encourages their parents to call with questions.

(Reach reporter Sara Kincaid at 250-8251 or sara.kincaid@;bismarcktribune.com.)