Kerala issues new guidelines for treating cough in children

Thiruvananthapuram: The Kerala health department on Thursday issued new technical guidelines for treating cough in children and using medicines with special precautions for dispensing them to young patients. The move follows reports of child deaths outside Kerala after consuming cough syrups, PTI reported.

A three-member expert panel studied the issue, and the state-specific guidelines were prepared based on its recommendations.

The guidelines outline the clinical approach and management of cough, types of cough and related symptoms, persistent and continuous cough, clinical examination of children with cough, investigations, cough control, dosage and safety considerations, non-pharmacological measures, and directions from the Kerala Drugs Controller's circular dated October 4, 2025.

Pharmacists must strictly follow the Drugs Controller's directions, an official release said.

Special care is required when dispensing medicines for children. Healthcare providers must ensure that medicines are not expired and are procured only from manufacturers with valid quality assurance certificates.

The guidelines also contain instructions for the public.

Cough is not a disease but a symptom, and self-medication should be avoided, the Health Department advised.

"Do not demand cough syrups or formulations; use them only on the advice of a paediatric specialist. Do not use leftover medicines or expired prescriptions. A medicine prescribed for one child should not be given to another without consulting a paediatrician," the statement said.

"In children with cough, if there is chest pain, difficulty breathing, blood in sputum, excessive fatigue, seizures, cyanosis, or altered consciousness, contact a paediatrician immediately. Medicines prescribed by a doctor should be used only in the specified dose and for the prescribed duration," it added.

The guidelines caution that cough syrups should not be given to children under two years of age. For those aged two to five, their use should generally be avoided unless specifically prescribed and closely monitored by a doctor.

For children above five, medicines should be administered only after careful evaluation in small doses, and for short durations.

The health department emphasised that all cough syrups distributed at healthcare centres must comply with manufacturing standards and be free from harmful contaminants such as Diethylene Glycol (DEG) and Ethylene Glycol (EG).

Health Minister Veena George said the comprehensive guidelines are meant for doctors, healthcare workers, pharmacists, and the public, and stressed that everyone must strictly adhere to them.