For generations, a child's cough has sent parents straight to the medicine cabinet. But that instinct is now being quietly reconsidered across India, as regulators tighten rules on children's cough medicines and doctors increasingly argue that many childhood coughs need comfort, not chemistry.
The shift has been driven by two connected developments. The first is safety. Last August, the government restricted a common combination medicine (chlorpheniramine maleate and phenylephrine hydrochloride) for children under four, requiring packs to carry a clear warning against use in that age group. A separate government advisory goes further, saying cough and cold medicines should not be given to children under two at all, are generally discouraged below the age of five, and should only be used in older children after a proper check-up, the right dose, and never mixed with other similar medicines.
The second development is far more sobering. In the latter half of 2025, several children in Madhya Pradesh died after being given a locally sold cough syrup called Coldrif. Testing later confirmed the syrup contained diethylene glycol, an industrial chemical never meant for human consumption, which can cause severe kidney damage and death in small children. Reports eventually put the death toll linked to this single contaminated batch at more than twenty children.
Taken together, these events don't mean cough syrup itself is dangerous. They show what can go wrong when unnecessary medicine, poor-quality manufacturing, and careless dosing combine in children whose small bodies simply cannot handle mistakes the way adults can.
How parents can manage a child's cough at home
Doctors increasingly point out that a cough is often the body's own way of clearing mucus from the airway, and it isn't always something that needs to be switched off. In most ordinary cases, the aim isn't to stop the cough but to keep the child comfortable and hydrated while the illness runs its natural course, which usually takes about a week to ten days.
For young babies, this can mean feeding more often, using simple saline nasal drops to loosen a blocked nose, and gently clearing mucus if the baby cannot do this on their own. For children over one year old, a small spoonful of honey before bedtime is a genuinely effective and safe way to calm a scratchy throat and reduce night-time coughing, though it must never be given to a baby under twelve months, because of a rare but serious risk of poisoning from bacteria sometimes found in honey. Steam inhalation is a very common home remedy in Indian households, but it carries a real risk of scalding a young child, so a cool-mist humidifier in the room is a much safer way to ease congestion. And however unwell a child seems, it's worth remembering that most coughs are caused by viruses, and antibiotics simply do not work against them, so giving one will not speed up recovery.
Key pointers before giving a child any cough syrup
When medicine genuinely is needed, a little caution at the chemist's counter and at home can make all the difference:
- Check the age on the label carefully. A product marketed as "for children" isn't automatically suitable for every age.
- Read every ingredient, not just the brand name. Many syrups combine several things at once — an antihistamine, a decongestant, something to loosen phlegm, sometimes even paracetamol. It's easy to accidentally give a child the same ingredient twice through two different medicines.
- Never mix or double up. If a child is already on a fever medicine, check that it doesn't share an ingredient with the cough syrup being considered.
- Don't guess the dose or copy it from another bottle. Two syrups that look similar can have very different strengths, so doses shouldn't be borrowed from an older sibling's bottle or a friend's prescription.
- Always use the proper measuring syringe or cup that comes with the medicine — never a regular kitchen spoon, which can lead to giving too much or too little.
- Check the expiry date, batch number, and condition of the seal and bottle. Any change in colour, smell or consistency of the liquid is a reason to stop and check with a pharmacist.
- Buy only from a licensed, trusted pharmacy. Given what happened with Coldrif, this single step matters more now than ever.
- Never give leftover medicine, adult cough syrup, or another child's prescription.
When a cough is more than "just a cough"
None of this is meant to make parents afraid of treating their child. A straightforward cough, managed with rest, fluids and the comfort measures above, rarely needs anything further. But certain warning signs should never be ignored, whatever medicine has or hasn't been given: struggling to breathe or breathing very fast, the skin between the ribs pulling in with each breath, a whistling or noisy breathing sound, blue or grey-tinged lips, refusing to feed or drink, unusual sleepiness that's hard to wake from, fits, or a cough that suddenly starts after the child was seen choking. A fever in a baby under three months old should also always be checked by a doctor without delay.
The lesson from the past year isn't that cough syrup should be feared. It's that treating a child's cough deserves a bit more thought than simply reaching for the nearest bottle — understanding what's actually needed, checking medicines carefully when they are used, and knowing the few signs that call for a doctor, together offer a far safer path than habit alone.
The author is the director - Neonatology & Paediatrics at CK Birla Hospital, Gurgaon.
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.
