Unexpected Infant Deaths Associated With Use of Cough and Cold Medications

[Guest guest]

whole text freely online

- - - -

Unexpected Infant Deaths Associated With Use of Cough and Cold Medications

E. Rimsza, MDa and Newberry, MSWb

http://pediatrics.aappublications.org/cgi/content/full/122/2/e318

a Department of Pediatrics, University of Arizona College of Medicine,

Tucson, Arizona

b Arizona Child Fatality Program, Arizona Department of Health Services,

Phoenix, Arizona

OBJECTIVE. The objective of this study was to determine whether

caregivers had given infants who died unexpectedly over-the-counter

cough and cold medications before the infant deaths to identify

sociodemographic risk factors for their use.

METHODS. The Arizona Child Fatality Review Program reviews the

circumstances surrounding every child death that occurs in the state

each year. By statute, the multidisciplinary review teams have access to

all medical charts, autopsy reports, law enforcement reports, and other

records for their review and use these data to determine the cause of

death and its preventability. The data on all infants who died

unexpectedly in 2006 and had an autopsy and postmortem toxicologic

studies were reviewed for this analysis.

RESULTS. Ten unexpected infant deaths that were associated with

cold-medication use were identified. The infants ranged in age from 17

days to 10 months. Postmortem toxicology testing found evidence of

recent administration of pseudoephedrine, antihistamine,

dextromethorphan, and/or other cold-medication ingredients in these

infants. The families who used these medications were poor and publicly

insured, and 50% of them had limited English proficiency. Only 4 of

these infants had received medical care for their current illness before

their death. The over-the-counter cough and cold medication had been

prescribed by a clinician for only 1 of these infants.

CONCLUSIONS. Review of these infants' deaths raises concern about the

role of the over-the-counter cough and cold medications in these deaths.

These findings support the recommendation that such medications not be

given to infants. In addition, these findings suggest that warnings on

these medications " to consult a clinician " before use are not being

followed by parents. Educational campaigns to decrease the use of

over-the-counter cough and cold medications in infants need to be

increased.