Author Archives for DocSmo

Spicy Feet, The Latest Recommendations Regarding Cough and Cold Medicines for Young Children from FDA and Moms (Pedcast)

In this pedcast, Doc Smo explores the effectiveness and safety of cold medicines for young children–from what the FDA recommends to Grandma’s home remedies. Learn some practical advice for dealing with this year’s cold season.


Cough is one of the most common symptoms that children have.

Disturbs sleep and is very unpleasant for everyone.

Parents hate to see kids cough.

Anyone with young children knows. children get sick a lot, on average 7-12/yr.  Usually at least monthly.

Treatment of cough and colds is a big deal in my world and anyone with young children.

Today, we discuss recent developments with regards to cough and cold medicines.


Recently, had a 3 year old in the office with croup, a coughing illness whose mom happened to be Indian.  From India that is.

We were talking about the treatment of cough and I started to tell her about the FDA statement on the use of cough and cold medicines in children under 4 years of age.


If you don’t know, Jan 2008 the FDA and the manufacturers agreed to alter labels of these meds.  The change says, not to use in children under 4 years old. Not removed from the market!


FDA’s concern was that many of these medications had no efficacy data to prove effectiveness AND reports of hundreds of children a year in emergency departments  with adverse affects.  There have even been some deaths from these medicines.


The MANUFACTURERS claim they are safe when used properly, and we don’t need efficacy data since they have been around sooooo long.


As a consequence of all this discussion, people like me, pediatricians, are now encouraged not to recommend cough suppressants and cold meds for young children.


So we are left with grandma treatments.  Nothing against grandma.  I think she was a genius.  How did she figure out that whole cod liver oil thing???


Back to my patient, I was telling her about her options with regard to cough relief in a three year old since older treatments are off the table (OTC, alcohol, codeine cough syrups)

Humidifier-lets loosen those secretions.  Breathing warm steamy vapor in the bathroom can also help.

Honey or other syrup to coat throat.

Propping semi-erect. Lets let gravity help.

Vicks Vapor rub (Commercial Brand of Menthol Rub)…  I started to tell her about the latest rage, Vicks on the soles of the feet covered with socks.  She interrupted and said.   “Oh the spicy feet, I know, I know!”


Spicy feet. Wow. I love it!  The essence of western medicine summarized in just 2 words.. And invented in NC! Spicy feet!

You’ve heard the Vicks Vapor rub on the feet, haven‘t you? .   Urban legend or an effective therapy. I don’t know. Many parents swear by it.  It does fit into my treatment paradigm, however which is, “ Do no harm!”


Vicks ok for throat, chest and feet, but not under the nose… rarely, this can cause problems.


Bottom line:

Cough is a good thing, protective reflex keep airways open.  Really don’t want to stop it.

Cough can be a sign of real trouble.

Cough with high fever, or chest pain, or sob,  can mean pneumonia.

Cough till vomiting can mean whooping cough.

Cough with wheeze can mean asthma, foreign body, or other bronchial problems.

Cough with a barky quality usually means croup, which can be serious at times.


In young children, Suppressing coughs in my opinion is only for sleep and only with mild measures such as humidifiers, honey, and maybe, just maybe, spicy feet!



Thanks for joining me for another pedcast.

Hopefully you got some information and a smile.

Check out for references used in this pedcast as well as other pedcasts.

Feel free to leave comments.

This is DocSmo, Dr Paul Smolen from beautiful studio 1e wishing you and your children just the right application of herb so that their cough won’t disturb.


Until next time.

Smo Notes:

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Going Public with Your Newborn, How and When! (Pedcast)

Doc Smo here. Thanks for joining me today. One of the most frequently asked questions that I get in the newborn nursery is, “When can I take my newborn to church, when can I take my baby to the mall, and when can I have my friends over?” Well you will find varying opinions on this subject and the truth is that there is no science behind any of this. I don’t believe that there is a right answer to this question. Different cultures have developed different norms. For instance in traditional Greek society, I am told that babies are isolated from public exposure for the first 60 days of life and in traditional Japanese culture, the isolation period is one year. To my knowledge, the Academy of Pediatrics does not have policy regarding this subject so I thought we would take a little time to explore the subject of when should newborns venture into public places. Continue reading

What’s New with Umbilical Cord Care in Newborns (Pedcast)

This Pedcast explores some new information about umbilical cord care in newborns.  Turns out, grandma may have gotten  this one wrong!



McConnell, Tammy P. & Connie W. Lee. Trends in Umbilical Cord Care: Scientific Evidence for Practice. Medscape, 23 Mar. 2005. Web. Sep. 2010 <

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Dealing with Diaper Rashes (Pedcast)

Almost all children get diaper rashes, but why? Learn the reasons skin breaks down in the diaper area and what you can do to prevent this from happening in your infants and toddlers.

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All Rights Reserved.