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The Indian Academy of Pediatrics (IAP) Kerala has released a press note in response to the recent advisory issued by the Directorate General of Health Services (DGHS), Government of India, regarding the rational use of cough syrups in pediatric practice. The DGHS advisory cautions against administering cough syrups to children below two years of age, as most acute cough illnesses in this age group are self-limiting and recover without the need for medication.

The IAP Kerala emphasized the importance of adhering to evidence-based treatment practices and urged healthcare providers and parents to exercise caution while managing cough in children.

Key Points from the IAP Kerala Clarification:

1. Avoid cough syrups for children under 2 years:Combination cough syrups and cold medications should not be prescribed or dispensed for children below two years. For older children, their use must be based on careful clinical evaluation, close supervision, appropriate dosage, and avoidance of irrational combinations.

2. Use bronchodilators only when necessary: Bronchodilators may be given if the cough is due to bronchoconstriction, such as in asthma or wheezing disorders. Inhaled forms, preferably through a Metered Dose Inhaler (MDI) with spacer, are both effective and safe for children.

3. Antihistamines in suitable cases: These may be considered for children above six months of age, in appropriate conditions such as allergic rhinitis accompanied by cough.

4. Prioritize non-drug measures: Non-pharmacological remedies including adequate hydration, rest, saline nasal drops, and supportive care should remain the first-line treatment for most cough-related illnesses.

5. Avoid self-medication: Parents are strongly advised not to self-medicate their children and to always seek professional pediatric consultation for safe and effective management.

The IAP Kerala has called upon all healthcare providers to follow this guidance strictly and to educate parents on the rational and safe management of childhood coughs.