NEW YORK - After investigating the deaths of three infants between 1 and 6 months old linked to cough and cold medication use, officials with the Centers for Disease Control and Prevention are emphasizing that these drugs should be used only after talking with a physician.

Between 2004 and 2005, about 1,500 children younger than 2 years old were treated in emergency rooms for adverse events associated with cough and cold medications, Dr. A. Srinivasan and colleagues at the CDC note in Friday's issue of the Morbidity and Mortality Weekly Report.

For each of the three dead infants, a medical examiner or coroner determined that the cough and cold medications were the underlying causes of death. Blood levels of the decongestant pseudoephedrine at autopsy were far above what's normally expected after therapeutic dosing in children between 2 to 12.

Because of the risk of toxicity, the lack of dosing instructions, and the scarcity of published evidence on effectiveness of these medications in children younger than 2, the authors had this advice: "Parents and other caregivers should not administer cough and cold medications to children in this age group without first consulting a health-care provider and should follow the provider's instructions precisely."

In an editorial note, the CDC adds that the results of controlled trials indicate cough and cold medications are no more effective than placebo in children younger than 2.

Furthermore, the American College of Chest Physicians in 2006 released clinical practice guidelines for management of cough, advising clinicians to refrain from recommending cough suppressants for this age group.

Safer and probably more effective treatments for young patients' symptoms include softening nasal secretions with saline nose drops or a cool-mist humidifier, then clearing nasal congestion with a rubber suction bulb.