The Directorate General of Health Services (DGHS) on Friday issued an advisory to all states and Union Territories, directing that cough and cold medications should not be prescribed to children under the age of two years. The advisory by DGHS comes amid reports of child deaths allegedly linked to contaminated cough syrups in Madhya Pradesh.
Meanwhile, the Union Health Ministry noted none of the tested syrup samples in Madhya Pradesh contained Diethylene Glycol (DEG) or Ethylene Glycol (EG) - contaminants that are known to cause serious kidney injury. The DGHS, which comes under the health ministry, said in the advisory that cough syrups are generally not recommended for children below five years.
DGHS (Directorate General of Health Services) issues advisory on rational use of cough syrups in paediatric population
October 3, 2025
"Cough and cold medications should not be prescribed or dispensed to children under 2 years. These are generally not recommended for ages below 5 years and… pic.twitter.com/gqQ94VJIqxDGHS' Advisory
The advisory by DGHS reads, "In our continuous efforts to ensure rational drug use and patient safety in pediatric care, this advisory reiterates the judicious prescribing and dispensing of cough syrups for children."
1. The advisory states that most acute cough illnesses in children are self-limiting and often resolve without pharmacological intervention.
2. Cough and cold medications should not be prescribed or dispensed to children under 2 years. These are generally not recommended for ages below 5 years and above that, any use should follow careful clinical evaluation with close supervision and strict adherence to appropriate dosing, the shortest effective duration and avoiding multiple drugs combinations. Further, the public may also be sensitised regarding adherence to prescription by the Doctors.
3. Non-pharmacological measures, including adequate hydration, rest, supportive measures should be the first-line approach.
The advisory asked all healthcare facilities and clinical establishments to ensure the procurement and dispensing of products manufactured under Good Manufacturing Practices and formulated with pharmaceutical-grade excipients.
"Sensitisation of prescribers and dispensers across public and private sectors is essential to uphold these standards of care. It is requested that all state/UT Health Departments, District Health Authorities, and all Clinical Establishments/healthcare facilities under your jurisdiction should implement and disseminate this advisory across government dispensaries, PHCs, CHCs, district hospitals, and medical institutions," the advisory said.
Deaths of children in Chhindwara Due To Cough Syrups
Earlier in the day, the health ministry said a joint team comprising representatives from the National Centre for Disease Control (NCDC), National Institute of Virology (NIV), Central Drugs Standard Control Organisation (CDSCO), among others, visited the site in Madhya Pradesh to collect samples of various cough syrups amid reports linking the recent deaths of children to the consumption of cough syrups.
A multi-disciplinary team comprising experts from the National Centre for Disease Control (NCDC), NIV, Indian Council of Medical Research (ICMR), AIIMS-Nagpur, and state health authorities is investigating all possible causes behind the reported cases.
Currently, 13 children, comprising eight in Chhindwara and Nagpur, are undergoing treatment. Three of the five in Nagpur are on dialysis, as reported by news agency PTI.
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