Vapor Rubs for Toddlers with Upper Respiratory Infections
Topically applied vapor rubs are effective for reducing cough and improving sleep in toddlers with upper respiratory infections and should be recommended as a safe, evidence-based symptomatic treatment option. 1, 2
Evidence Supporting Vapor Rubs
Vapor rubs have been demonstrated to improve symptoms in children with upper respiratory infections, specifically reducing nighttime cough and improving sleep quality for both the child and parents. 1, 2
Research shows that vapor rubs are one of the few products that actually work for URI symptoms in young children, in contrast to over-the-counter cough and cold medications which lack efficacy and carry safety risks. 1, 2
Why Vapor Rubs Are Preferred Over Alternatives
The American Academy of Pediatrics and FDA strongly recommend against using combination antihistamine-decongestant products in children under 6 years due to significant safety concerns, with 54 fatalities associated with decongestants and 69 fatalities associated with antihistamines in children ≤6 years between 1969 and 2006. 3
Controlled trials have demonstrated that antihistamine-decongestant combination products are not effective for symptoms of upper respiratory tract infections in young children, and the efficacy of cold and cough medications has not been established for children younger than 6 years. 3
Over-the-counter cough and cold medications should not be used in children younger than four years due to potential for harm and no demonstrated benefits. 1
Other Effective Options to Consider
Honey (for children over 1 year of age) is another evidence-based option that improves cough symptoms in children with URIs. 1, 2
Adequate hydration, acetaminophen or ibuprofen for fever management, and gentle nasal suctioning are recommended supportive care measures by the American Academy of Pediatrics. 3
Critical Safety Points
Never prescribe combination antihistamine-decongestant products to children under 6 years for URI symptoms. 3
Avoid topical decongestants in young children due to narrow therapeutic margin and risk of cardiovascular/CNS side effects. 3
Recognize that most URIs in children are viral and self-limited, requiring only supportive care—antibiotics should not be prescribed without evidence of bacterial infection. 3