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Paediatrics News South Africa

Parents warned on popular cough and cold treatment

Parents have been issued with a warning about the popular cough and cold treatment Vicks VapoRub. A US doctor says the product should not be used on children under 2 years of age.

Vicks VapoRub, a salve which can be bought over the counter, is used to relieve coughs and congestion, but can apparently harm infants and toddlers.

According to Dr. Bruce Rubin from Wake Forest University School of Medicine, North Carolina in the US, the rub can have severe effects on breathing in young children because it may stimulate mucus production and airway inflammation.

The product made by Procter and Gamble has been around since 1905 - it is applied to the chest or throat for congestion relief or to relieve sore muscles.

It contains camphor which is toxic if swallowed or absorbed into the body and the manufacturers do in fact warn that it should not be applied in or near the nostrils and not used on children under 2 years of age.

Dr. Rubin was first alerted to the dangers of the misuse of the product when an 18-month-old child developed severe respiratory distress after it was put directly under her nose.

He says the ingredients in the product can be irritants, causing the body to produce more mucus to protect the airway and infants and young children have airways that are much narrower than those of adults, so any increase in mucus or inflammation can narrow them more severely.

Never on children under 2

Research was then carried out on the effects of the salve on the respiratory system of animals - ferrets, which have an airway system similar to humans, were used and tests conducted which measured the effects of the product on mucus secretion and build up in the airways, and fluid build-up in the lungs.

It was found that the product increased the mucus secretion and decreased the clearance of the mucus and he says Vicks should not be put in or under, the nose of adults or children and never used in children under age 2.

He says even when the directions on the label are followed Vicks may make people with congestion feel more comfortable, but it does nothing to increase airflow or actually relieve the congestion and he suggests similar products, including generic brands, could cause the same adverse reaction in infants and toddlers.

The Wake Forest team say cough and cold medicines and decongestants are dangerous and neither effective nor safe for young children and medications which dry up nasal passages also present problems.

Manufacturer questions relevance

Dr. Rubin says the best treatments for congestion are saline (salt water) and gentle rubber bulb suction, warm drinks or chicken soup, and, often, just letting time heal the child.

However he says a child struggling to breathe is a medical emergency and needs would to be seen by a doctor as quickly as possible.

Experts recommend parents check with a doctor before giving infants and young children any over-the-counter medicine as they can be harmful.

Proctor & Gamble says Vicks VapoRub has a long-standing history of being safe and effective when used according to package directions and its safety and efficacy has been demonstrated in multiple human clinical trials including more than 1000 children aged 1 month to 12 years.

The company says the findings of the animal studies, prompted by a single case report, are of questionable human clinical relevance.

The research is published the current issue of CHEST.

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