Topical Mentholated Cold Remedy May Cause Respiratory Distress in Infants
NEW YORK (Reuters Health) Jan 13 - A popular over-the-counter salve touted to relieve symptoms of cold and congestion may actually worsen mucus production and airway inflammation in infants and toddlers, pediatricians at Wake Forest University School of Medicine report.
"I recommend never putting Vicks VapoRub in, or under, the nose of anybody - adult or child," senior author Dr. Bruce K. Rubin said in a statement. "I also would follow the directions and never use it at all in children under age 2."
Vicks VapoRub (Proctor and Gamble; Cincinnati, Ohio) contains aromatics - camphor, menthol, and eucalyptus oil - believed to improve symptoms of chest congestion. In the January issue of Chest, however, Dr. Rubin and his associates in Winston-Salem, North Carolina describe an 18-month-old, previously healthy girl who developed severe respiratory distress within less than an hour after having the ointment rubbed directly under her nostrils.
The research team investigated the effects of the medication on the respiratory system of ferrets, which have an airway anatomy and cellular composition similar to that of humans.
In ferret trachea tissue, Vicks VapoRub increased mucin secretion by 59% over baseline and decreased ciliary beat frequency by 36%.
In vivo, the ointment caused a 34% increase in tracheal mucociliary transport velocity in inflamed airway, but not in normal airway.
"In summary," the authors write, the active ingredients of Vicks VapoRub "are ciliotoxic and mildly proinflammatory, increasing mucus secretion while decreasing mucus clearance." As such, they "may lead to mucus obstruction of small airways and increased nasal resistance."
Dr. Rubin noted that similar products, including generic brands, could be just as hazardous to young children.
"The best treatments for congestion are a bit of saline (salt water) and gentle rubber bulb suction, warm drinks or chicken soup, and, often, just letting the passage of time heal the child," he said. He added that a child struggling to breathe is a medical emergency requiring medical attention as quickly as possible.
The American College of Chest Physicians opposes the use of any over-the-counter cough or cold medicines for infants and young children.
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