Thiruvananthapuram: In the wake of the recent child deaths linked to contaminatedcough syrup, theKerala health department on Thursday issued new technical guidelines for the treatment of cough in children, along with special precautions for dispensing medicines to young patients. A three-member expert panel studied the issue, and the state-specific guidelines were issued. 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, according to PTI news agency. Also Read:Kerala Paediatricians criticise Centre's cough syrup ban for children under 2 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 children between two and five years, the use of such medicines 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 also stressed 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. Also Read:Union Health Secretary chairs high level meeting with States, UTs on quality, rational use of cough syrups