Children under six should not be given decongestants, experts have said, as there is no evidence they help with symptoms like a blocked or runny nose and their safety is unclear.
Decongestants, which are typically given either in nasal spray form or as tablets, are a type of medicine designed to provide short-term relief for a blocked or stuffy nose.
The NHS already advises that decongestants shouldn’t be given to children under six years old and adds they “should only be used by children aged 6-12 on the advice of a GP or pharmacist”. So what should you be giving your children instead?
Professor Mieke van Driel of the University of Queensland, Australia, and colleagues analysed a series of studies on the effectiveness of treatments for the common cold.
They found there’s a lack of trials of decongestants for children, especially those under 12 who carry the highest burden of common colds – children have around 6-8 colds per year and adults have 2-4.
The authors concluded that decongestants or medicines containing antihistamine should not be given to children under six and they advised caution between six and 12 years.
“There is no evidence that these treatments alleviate nasal symptoms and they can cause adverse effects such as drowsiness or gastrointestinal (stomach) upset,” they wrote in the BMJ.
Dr Rahul Chodhari, of the Royal College of Paediatrics and Child Health, tells HuffPost UK that congestion can be particularly distressing for young children, as they have smaller upper airways. But decongestants are never advised for this age group. “The reason we don’t recommend them is that a lot of them can cause stomach upset and also the majority of the time a cold tends to go away within a week or so,” he explains.
So what should you use instead?
The study’s authors recommend saline nasal irrigations or drops. Dr Chodhari agrees that they are the best form of treatment: “What does seem to help a lot is normal saline washes or irrigation – and they’re available over-the-counter. There are no side effects of them and they can clear the mucus from the nose very quickly and reduce congestion. They can be used multiple times in a day.”
He warns parents against using air humidifiers or steam inhalations, as there’s no evidence to show they work and there’s a risk of burns from the hot water.
The study’s findings echo this. Researchers said treatments such as steam inhalation, echinacea, vapour rub, eucalyptus oil and increased fluid intake, are either not effective or have not been studied at all.