Is it safe to apply Vicks (camphor, menthol, and eucalyptus oil) to the nose of infants under 2 years old with cold symptoms?

Do Not Apply Vicks to the Nose of Infants Under 2 Years

Vicks VapoRub and similar products containing camphor, menthol, and eucalyptus oil should NOT be applied to or near the nose of infants and young children under 2 years of age due to serious safety risks including respiratory distress, seizures, and even death. 1, 2, 3

Why This Is Dangerous

Direct Toxicity Risks

• Camphor-containing products are only approved for children 3 years and older according to FDA labeling, and menthol products only for children 12 years and older 4, 5
• Ingestion or excessive topical application of camphor and eucalyptus oils can cause life-threatening complications including seizures, coma, and respiratory failure in young children 3
• A review of 251 pediatric exposures to essential oil products (including 90 cases of Vicks VapoRub ingestion) found the most common symptoms were cough, vomiting, and seizures, with one reported death 3

Respiratory Complications

• Application near the nose increases risk of inhalation and ingestion, as infants frequently touch their faces and put hands in their mouths 3
• Terpenic derivatives like camphor and eucalyptus oil can induce neurological disorders and convulsions in infants and small children 6

What Actually Works for Infant Colds

Safe and Effective Options

• Gentle nasal suctioning to clear secretions and improve breathing 1, 7
• Nasal saline irrigation with isotonic or hypertonic saline solutions provides modest symptom relief with minimal side effects 8, 1
• Adequate hydration through continued breastfeeding or formula feeding to thin secretions 1
• Weight-based acetaminophen for fever and discomfort (can help reduce coughing episodes) 1
• Supported sitting position during feeding and rest to help expand lungs 1

One Exception for Topical Application

• Topical vapor rub may be applied to the CHEST and FEET (not the nose or face) in children over 2 years of age, which has shown benefit for cold symptoms 2, 9
• For children under 2 years, even chest application should be avoided given the FDA age restrictions 4, 5

Critical Pitfalls to Avoid

• Never use OTC cough and cold medications (decongestants, antihistamines) in children under 2 years—these have caused 69 antihistamine-related and 54 decongestant-related fatalities in children, with 41 antihistamine deaths occurring in children under 2 years 8, 1, 10
• Do not apply topical decongestants in children under 2 years due to narrow therapeutic window and risk of cardiovascular and CNS toxicity 8, 1
• Avoid antibiotics for viral upper respiratory infections, as they provide no benefit and contribute to antimicrobial resistance 8, 1

When to Seek Immediate Medical Attention

Watch for red flag symptoms requiring urgent evaluation 1:

• Respiratory rate >70 breaths/minute (infants) or >50 breaths/minute (toddlers)
• Difficulty breathing, grunting, or cyanosis (blue discoloration)
• Oxygen saturation <92%
• Poor feeding or signs of dehydration
• Persistent high fever ≥100.4°F (38°C) for 3+ consecutive days

Expected Clinical Course

• Most viral upper respiratory infections in children resolve within 1-3 weeks, with 90% of children cough-free by day 21 1
• Reassure parents about the self-limited nature of colds to manage expectations and avoid unnecessary treatments 2