New Delhi: The Centre has issued a nationwide advisory instructing all states and Union Territories to avoid prescribing cough and cold medications to children below two years of age. The guidance, released by the Directorate General of Health Services (DGHS), comes in the wake of recent reports linking child fatalities in Madhya Pradesh to cough syrup consumption.
Dr Sunita Sharma of the DGHS, which functions under the Union Health Ministry, stated that “most acute cough illnesses in children are self-limiting and often resolve without pharmacological intervention. Non-pharmacological measures, including adequate hydration, rest, and supportive care, should be the first-line approach.”
The advisory highlights that cough syrups are generally not recommended for children under five years. For older children, their use should follow careful clinical assessment, strict dosing guidelines, the shortest effective treatment duration, and avoidance of multi-drug combinations. It also urges healthcare providers and caregivers to adhere closely to prescriptions.
“Sensitisation of prescribers and dispensers across public and private sectors is essential to uphold these standards of care,” the DGHS advisory said, directing all state and UT health departments, district authorities, and healthcare facilities to implement the guidelines across hospitals, primary health centres, and medical institutions.
The advisory also emphasises procurement of syrups manufactured under Good Manufacturing Practices using pharmaceutical-grade excipients.
The warning follows a recent investigation into child deaths in Madhya Pradesh. A joint team comprising the National Centre for Disease Control (NCDC), National Institute of Virology (NIV), and Central Drugs Standard Control Organisation (CDSCO) collected and tested multiple cough syrup samples. The Health Ministry reported that none of the samples contained Diethylene Glycol (DEG) or Ethylene Glycol (EG), contaminants known to cause severe kidney injury. The Madhya Pradesh State Food and Drug Administration confirmed similar findings in three tested samples.
Further investigations included blood and cerebrospinal fluid testing by NIV Pune, which identified one case of Leptospirosis. Environmental, water, and respiratory specimen analyses are ongoing, with multi-disciplinary teams from NCDC, ICMR, AIIMS-Nagpur, and state authorities examining all potential causes.
On separate reports of child deaths in Rajasthan, the ministry clarified that the implicated Dextromethorphan-based syrup did not contain Propylene Glycol, a potential DEG/EG source, and is itself not recommended for paediatric use.