US doctors say infants may develop severe breathing problems

A new report says Vicks VapoRub may irritate the airways of children younger than two, causing increased mucus production and inflammations. 

LOS ANGELES: Many parents slather Vicks VapoRub on a child who has cough or the sniffles-because that was what their parents did to them. But for children younger than two, the folksy remedy could be dangerous, especially when applied directly under the nose, researchers warned yesterday.

Reporting in Chest, the journal of the American College of Chest Physicians, the researchers said that using the Procter & Gamble Co product to ease coughing and congestion in children of this age might lead to severe breathing problems by increasing mucus production and inflammation. The ointment’s risks came to the attention of Dr Bruce Rubin and his colleagues when they treated an otherwise healthy 18-month-old girl who was taken to the emergency room by her grandparents after her respiratory infection suddenly grew worse.

Dr Rubin, the report’s lead author, said the ingredients in Vicks can be irritants, causing the body to produce more mucus to protect the airway.

And since infants and young children have airways that are much narrower than those of an adult, any increase in mucus or swelling can narrow them severely.

“I recommend never putting Vicks in, or under the nose of anybody-adult or child,” the pediatrician from Wake Forest University Scholl of Medicine in North Carolina said in a statement, adding that he would not use it on a child under the age of two.

Vicks VapoRub’s label cautions against using the product on children younger than two, but many parents do so anyway, putting their infants at risk, experts said.

The girl’s case led Dr Rubin and his colleagues to study ferrets, which have an air-way anatomy similar to humans. In the animals with a chest infection, the product in-creased mucus secretion and decreased the animal’s ability to clear mucus.

“We were able to document changes that we think explain this,” Dr Rubin said. The ointment also slowed the action of the hair-like cilia in the throat that carry mu-cus away.

The team has since identified three more infants taken to emergency rooms with breathing problems after being treated with Vicks VapoRub. All four recovered quickly once application of the ointment was stopped.

While the researchers only tested the Vicks product, Dr Rubin said similar products, including generic versions, could cause the same negative effects in infants and toddlers.

Dr David Bernens, a spokesman for Procter & gamble, said the finding came as a surprise.

“Vicks VapoRub has been proven safe and effective through multiple clinical trials. It has been in the market for over 100 years,” Mr Bernens said, noting that the label says the product should not be used in children under the age of two without a doctor’s advice, and not under the nose.

“We warn people not to do that,” he pointed out.

Conscientious pediatricians would not recommend that parents use Vicks Va-poRub, “because it hasn’t been shown to be effective,” said Dr Daniel Craven, a pediatric pulmonologist, who was not involved in the study.

Pediatricians and the health authorities have lately been warning parents about the risks of using cough syrups and decongestants in infants and young children.

“To help the body‘s defenses, the best things are love and hugs, warm liquids like chicken soup, and time,” said Dr Craven.

Singapore doctors don’t prescribe ointment to treat cold

SINGAPORE doctors say they will not advise patients to use Vicks VapoRub to treat a cold as the ointment has not been proven to improve the condition.

And in some cases, it can even make a blocked nose worse, they say.

Dr Kevin Soh, an ear, nose and throat surgeon at Mount Elizabeth Medical Centre, said the product has no real effect on a cold. “It might offer some relief to patients, but in reality, it does not reduce resistance in the nasal airway,” he said.

The use of the ointment can actually make some people feel worse. “Vicks VapoRub has menthol and some other chemicals in it which can irritate the nose further,” said Dr Soh.

He added that it can also do harm when applied on a person’s chest or throat area. “If a lot of ointment is used, the patient can still inhale the volatile chemicals,” he said.

Another specialist, respiratory physician Ong Kian Chung who runs his own practice at Mount Elizabeth Medical Centre, said there is no “convincing data” that shows Vicks VapoRub actually works.

“It’s frequently used and is widely available, but there’s been no proof it’s of any actual benefit,” he said.

Both doctors said they will not recommend the ointment to patients. How-ever, Dr Soh added that he will not ask patients to stop applying it if they do not encounter any problems.

The specialists were reacting to a new study by American researchers which showed that the use of Vicks VapoRub on young children could lead to severe breathing problems.

When applied directly under the nose, it can lead to mucus build-up, which is potentially dangerous for children as they have narrower airways, the study said.

Addressing the findings on its web-site, Vicks said in a message to parents that the study findings, which were based on tests on animals, were of “un-known human clinical relevance”.

“The safety and efficacy of Vicks VapoRub has been demonstrated in multi-ple human clinical trials, which have included more than 1,000 children aged one month to 12 years,” the statement said.

It added that the ointment should not be used in the nostrils and should be ap-plied to the chest and throat instead.

Parents interviewed yesterday said they will not stop using the ointment on their children, although they will make sure to apply it only to the chest area.

Freelance graphic designer Jessica Wong, 31, who has a 14- month-old daughter, said: “I used to apply a bit to her nose when she got a really bad cold but I’ll probably keep it to just her body next time.”