Coughing up worries: Nagaland paediatricians warn on unsafe syrups

DIMAPUR — Following the Centre’s advisory to all states and Union territories directing that cough and cold medications should not be prescribed to children below two years of age, young parents across the country—and in Nagaland in particular—have expressed confusion and concern.

Eastern Mirror spoke with several paediatricians from the state in an attempt to understand the ongoing ‘cough syrup’ issue that has caused alarm after reports of child deaths allegedly linked to contaminated syrups.

In response, the Indian Academy of Paediatrics (IAP), Nagaland State Branch, led by Dr. Akumtoshi as president, issued a statement highlighting key points for public awareness.

The IAP Nagaland branch cautioned that combination cough and cold syrups should not be used in children below two years and advised parents to avoid giving such medicines without a doctor’s prescription.

Also read: Health Ministry to hold key meeting amid cough syrup row

It stated that combination syrups should only be prescribed after proper clinical evaluation and in strict adherence to recommended dosages.

The statement also advised parents to use bronchodilators and mucolytics judiciously.

“In children with cough due to bronchospasm, asthma, or wheezing disorders, bronchodilators such as salbutamol or levosalbutamol may be used — preferably through inhalation under medical supervision,” it said.

Mucolytics or expectorants such as ambroxol, bromhexine, or acetylcysteine may be considered in selected cases with thick sputum, but only under paediatric guidance, it added.

Paediatricians further stressed that routine or unsupervised use of such medications is not advised, especially in infants and toddlers.

Antihistamines, they said, may be considered in children above six months for specific conditions like allergic rhinitis, but should not be used routinely for simple coughs or colds.

Read more: Centre advises against prescribing cough syrups to children below 2 years

A concerned mother of three shared, “After reading the news, fear took over, and I checked if any of the medicines I’d given my kids were on the list. Thankfully, our paediatrician has always avoided cough syrups and preferred nebulisation during severe cases.”

Another parent said financial constraints often lead to self-medication: “When my child coughs, I usually buy medicines from the pharmacy without a doctor’s prescription. But now I realise the risk I’ve been taking.”

The IAP team reiterated that Over-The-Counter (OTC) cough syrups should be avoided without medical consultation, as OTC medications can be dangerous for vulnerable groups, particularly infants, children, and lactating mothers.

The academy urged all healthcare providers and parents to follow rational and evidence-based practices to ensure children’s safety and well-being.

It also reminded that adequate hydration, rest, saline nasal drops, and supportive home care remain the safest and most effective first-line approaches for managing most childhood coughs and colds.

Currently, about 30 paediatricians are practising across different parts of Nagaland, according to the IAP.

The advisory from the Directorate General of Health Services (DGHS) came amid reports of child deaths allegedly linked to contaminated cough syrups in Madhya Pradesh and Rajasthan.

Following this, the Central Drugs Standard Control Organisation (CDSCO) initiated risk-based inspections of drug manufacturing units in six states.

The Tamil Nadu government has also banned the sale of ‘Coldrif’ cough syrup after sample tests.

Uncertainty remains, however, regarding the sale or availability of contaminated or unsafe cough syrups in Nagaland.

IAP Nagaland: Key safety guidelines

·         Avoid giving OTC cough syrups without medical consultation

·         Use bronchodilators and mucolytics judiciously

·         Avoid giving medicines without a doctor’s advice

·         Antihistamines should not be used routinely for simple coughs or colds

·         First-line care: Adequate hydration, rest, saline nasal drops, and supportive home care