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This, she adds, is where pharmacists and pharmacy assistants can play a role in terms of reassuring parents that a common cough or cold with a bit of a temperature and a bit of a “sniffly” nose is no “reason to panic”. “Here, I advise pharmacy assistants to emphasise to parents that kids will get coughs and colds,” she said. “It’s the order of the day no matter how hard they try and protect their kids from them. “However, when a child has a high fever, is lethargic, has laboured breathing and isn’t eating or drinking, they need to see a doctor.” Navigating the cough and cold syrup aisle While an array of syrup bottles promising cures is enticing, it should be noted that many of these will contain a cough suppressant, such as dextromethorphan, or an antihistamine, such as diphenhydramine. They may also come with side effects, such as a hike in blood pressure and consequent higher heart rate or a subduing of the need to breathe. Dr Moles says she chooses not to recommend most OTC products for coughs and colds for children aged under six years. “Children don’t need to take symptom relievers, because that’s all these medications are doing: masking symptoms,” she said. “What’s really important is that the truly sick child is recognised, which may not happen because of symptom relievers that hide their sickness.” If a child is eating, drinking and playing, but is a little grizzly and has a temperature, a dose of paracetamol or ibuprofen “could do the trick”, but it’s not necessary to do much at all, Dr Moles says. “If parents are resorting to ibuprofen or paracetamol, pharmacists should point out the correct dose when the opportunity presents itself,” she said. As to negative drug interactions, she says most children in Australia are healthy and not taking medication, but it’s always wise to make sure this is the case. Rather than OTC medications, Dr Moles advises increased fluid consumption, good nutrition, and some rest. “The pharmacist and pharmacy assistant really need to reassure the parent that the cough/cold will probably be over in seven to 10 days and that it has to be waited out,” she said. “This is because parents often want a magic medicine bullet, but there really isn’t anything on the market so wonderful that it will cure the common cold. “The body has to fight the infection. I’d advise pharmacists to spread the word that there are no magic products on pharmacy shelves, but that it’s important to keep an eye on the child if they become lethargic and need a doctor’s appointment.” Complementary therapies Another option is to advise consumption of honey, which Dr Moles says “works quite nicely” for coughs in that it’s “soothing for the throat, especially if there’s a bit of a tickle”. “I don’t think there’s any problem with parents giving their child a spoonful of honey, particularly if the child is coughing at night and they know it’s only a cold and not asthma,” she said. “The only exception is babies less than 12 months old, because of the risk of botulism.” According to a randomised controlled trial in Israel published in 2012, honey has the same benefits as many of the cough syrups on offer. During the trial, parents of children with coughs were asked to give their children either honey or date syrup, which constituted a placebo with the same taste as honey. The cough and sleep of children who had received honey improved, but this was not the case for those taking date syrup. Honey is also known for its antibacterial and antiviral properties, while its texture makes the throat feel as though it has a protective layer against the ticklish dry feeling that is causing a cough, Dr Moles says. Pharmacist input on the ground Mark Webster, owner of Stay Well Pharmacy in Christchurch, New Zealand, says he advises a quality multivitamin accompanied by “good amounts of sleep and fluid intake”. “Eating nutritious foods is important and taking minerals in some cases, such as zinc, can be helpful as long as parents are mindful of dosages,” he said. “Vitamin D can be useful too, as well as essential oils to keep the nose clear and a saline rinse to keep the nostrils clear.” Alvin Narsey, owner of Priceline Pharmacy West Brunswick in Melbourne, says the good news about the COVID-19 outbreak globally is that few children have been severely affected. The pharmacy’s treatment of children with a cold follows a holistic approach that involves first investigating their history, symptoms, medical conditions and medication being taken. “We also always look at the cause of a condition and the age of the child,” Mr Narsey said. “We usually provide some medication to reduce their symptoms, and we recommend an immune booster, depending on the child’s condition. “It could be probiotics, but it really depends on how the child presents and what medication the parents have used before.” Mr Narsey adds that it’s also important to consider whether the child prefers a flavoured liquid medication over a powder. LITTLE LEGENDS 61 COVID-19 online parenting resource A special COVID-19 online parenting resource has been launched to help parents cope more effectively with the unique challenges of the coronavirus pandemic. The University of Queensland (UQ) and Triple P International resource is available now for parents who need support. It has been developed by the Director of UQ’s Parenting and Family Support Centre and founder of Triple P Positive Parenting Program, Professor Matthew Sanders and Associate Professor Vanessa Cobham from UQ’s School of Psychology. Professor Sanders says it’s important that families work together to create solutions in these challenging times. “The online resource will give parents strategies to cope with these emotions, to avoid damaging relationships with their kids,” he said. “It also provides tips and strategies to help children manage their own feelings, to stay emotionally resilient.” The Triple P COVID-19 resource can be accessed via triplep-parenting.net. RETAIL PHARMACY ASSISTANTS • MAY 2020