According to the American Academy of Pediatrics, codeine and kids are a bad mix. And that’s been known for a long time.

Yet a study in the Journal Pediatrics says more than 577,000 prescriptions for a codeine containing product were written within a recent one year period — in fact the average number of Rx’s is well over half a million a year for each year of this 10 year study.

That’s despite a recommendation way back in 1998 that, in general, children should not take codeine — a recommendation that was re-issued again in 2006.

We generally use codeine for two reasons: pain and cough. Yet research shows it’s really a lousy drug for cough, and not the preferred medication for pain.

Liquid codeine product (credit: Dr. Dave Hnida)

Liquid codeine product (credit: Dr. Dave Hnida)

For kids over one year of age the best cough remedy is a simple one: honey. It has been proven in study and after study.

As for pain, children’s ibuprofen tends to be best. Acetaminophen isn’t so bad a choice either. And for severe pain, there are prescription drugs we can use that are safer.

When we talk safety, what do we mean?

For starters, codeine messes with the respiratory center of the brain, meaning it slows things down and interferes with normal breathing in a child. This is a scary side effect.

Then there are the other side effects: nausea, vomiting, allergic reactions, extreme drowsiness, and so forth.

Despite the fact this study mainly looked at emergency room prescribing, doctors and other healthcare providers are quick to reach for the codeine prescription pad in other settings such as urgent care centers as well as the office.

Bottom line: if someone tries to prescribe codeine to your child, you need to ask why. The list of “okay” uses is a short one.

The last thing you need is to sit next to your sleeping child making sure each breath is followed by another.


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