A Pediatrics study this past week starts out stating that, “Upper respiratory infections (URIs) are the most common acute illness in the world.” Wowza, that seems like a show stopper right there. But it’s true, anyone who works with kids or has kids or knows kids (let’s be honest) also knows that winter brings snot to little noses. And lots of it. I really believe that snot and mucus are a part of being a kid in the wintertime.

Kids typically have 6-10 colds a year, mainly between October and May, so if your child is snot-free today this mid-November, consider yourself lucky. Kids get upper respiratory infections (“a cold”) one after another after another and its often difficult to know when one cold ends and a new one begins. The far majority of these colds are caused by viruses. And because we don’t have treatments to impair the virus or kill the viruses that cause colds, we recommend supporting the machine that does: the body. Support your child as they fight off infections. Immune systems are amazingly efficient. Feed these immune systems the proper fuel: rest, hydration/liquids, energy, and most important, time.

We see many children in clinic with colds when families come in concerned about fever, cough, sore throat, congestion, or possible ear infections. Fortunately we rarely have to use antibiotics or other medication interventions. And although it’s nice not to have to prescribe medications for well children with uncomplicated colds, I hate not having much in my tool box to help a family. After a terrible sleepless night of coughing, hacking, fever, and snottiness, families come in absolutely exhausted. Pediatricians really do get this and we do want to do “something.” But often our advice comes off as “The doctor did nothing.” I look at it this way, we ruled our bacterial infection, provided ideas for improving cough (humidifier in the room, honey before sleep for kids over 1 year of age, nasal suction [love NoseFrida], and upright positioning to let the snot drip the right way) and gave guidance about why or when to return. But I do want more tools in my toolbox. This study may help.

As I mentioned last week, sleep is a major commodity while raising children (duh). The study on Vicks VapoRub surprised me. Previously when parents asked me about VapoRub I would say something like, “There’s no data to say Vicks does any good and it may be dangerous to young children under age 2. Yet besides unlikely irritation to the skin in older kids, it’s safe to use I believe it gives the experience of easier breathing because kids can feel the air moving in your nostrils. So go ahead and use it on their chest at night if you feel it helps.” And although that sensation of easier breathing may really be the mechanism that vapor rub works, a new study found that when compared to using Vaseline or nothing at all, Vick’s stood tall. It helped children and their families SLEEP.

The Study (it’s free to the public so click on the hyperlink if you’d like to read it):

  • 138 children between 2 and 11 years old enrolled in a 2 day study while they suffered from cold symptoms. These kids did not have asthma or other lung issues and weren’t using any other medications or interventions, not even honey.
  • Parents were randomly placed in 4 different groups: one group that used no treatment and 3 treatment groups that used either placebo ointment, petrolatum (think Vaseline) on a child’s chest, or Vicks VaporRub (petrolatum with camphor [4.8%], menthol [2.6%],
    and eucalyptus oil) on the chest. To ensure families in ointment groups didn’t know which ointment they were rubbing on the child’s chest, they had parents put a strip of the vapor rub under their own nostrils so they couldn’t smell if the ointment they applied was medicated or not. Hmmmmmmm…would you be able to comply with this? Would you sneak a sniff at another time?
  • Children (and parents) were assessed for cough, congestion, and difficulty sleeping (one of the biggest consequences of colds).

Findings:

  • Most significant were results rated by parents: children treated with Vapor Rub were significantly more able to sleep than were children randomized to receive petrolatum or no treatment.
  • Researchers wrote, “Combinations of aromatic oils in a petrolatum base have been used for generations, but this study demonstrates that this therapy is indeed effective.”
  • As rated by their parents, children with URIs who were treated with Vapor Rub had more nighttime relief from cough, congestion, and sleep difficulty than did children treated with a placebo ointment, petrolatum, or with no treatment.
  • It’s unclear why Vapor Rub helps children sleep. The researchers theorize that it is due to relief of other symptoms (cough/congestion).
  • Twenty of the 44 parents in the Vapor Rub group reported one or more mild adverse event, such as skin irritation. No parents in the other two ointment groups reported side effects.

Although Vicks doesn’t work to cure the cold, it may help families of children over age 2, restore sleep during the night through cold (URI) season. Although I don’t think Vick’s will change much, this may help exhausted families in 2 ways: they will have a tool to intervene to help relieve symptoms in their school-age child and they may improve their sleep. I’m not certain I’m reaching for the Vicks any time soon, but this data does put the recommendation into perspective. When the snot starts flowing and when the nighttime cough is ongoing, consider getting Vapor Rub for your child’s chest. And keep us updated on how you think it fares.

NOTE: Most pediatricians (and I) don’t recommend Vicks or any Camphor-containing products for infants or children under age 2. You always want to avoid any oral ingestion of camphor-containing products (don’t eat or let a child eat the Vicks!). There are concerns about Camphor-containing products causing seizures and other serious concerns about exposures and ingestion of camphor in young children. Talk with your pediatrician. Of note, there is a product designed for babies (BabyRub) that is made without Camphor, but I don’t know of any data/evidence for its effectiveness with baby’s cough/congestion. So save your money or put it towards buying a humidifier.