February 12, 2009 in Features

Menthol rubs should be used with caution

 

Dear Dr. Gott: My mother is old school in that I grew up slathered in Vicks and put to bed at the first sign of sniffles or a cough. The rub would allow me to breathe easier when she spread it on my chest and under my nose, but boy, did I smell bad!

Well, I’m now grown with a family of my own, and can’t believe how history repeats itself or that I am actually asking this question. Is it safe to use this same treatment on my own children?

Dear Reader: It depends on the age of your children. All menthol products, including Vicks, can cause breathing problems, eye and lung inflammation, liver damage, airway constriction and allergic reactions in some infants and children. These products don’t actually clear congestion or help reduce a cough; they simply increase the production of mucus and inflame children’s airways, which are narrower than those of adults.

Dr. Bruce Rubin writes in CHEST, an official journal of the American College of Chest Physicians, that he began his studies with ferrets, whose respiratory systems are similar to those of infants, after hearing of an infant who developed respiratory difficulty following a home-treatment of Vicks placed under her nose. Following his studies, he recommended “never putting Vicks in, or under, the nose of anybody – adult or child. Some of the ingredients in Vicks, notably the menthol, trick the brain into thinking that it is easier to breathe by triggering a cold sensation, which is processed as indicating more airflow. Vicks may make you feel better, but it can’t help you breathe better.”

Beyond Rubin’s studies, in 2008 the Food and Drug Administration was requested by a group of pediatricians to revise the standards for over-the-counter cough-and-cold remedies for children under 6 years of age, citing a lack of evidence they even work. There is mounting evidence the remedies can cause seizures, difficulty breathing, cardiac problems and more. In fact, even the Vicks packaging recommends asking the advice of a physician for use on children under 2 years of age.

It has been noted that manufacturers are not voluntarily removing cough-and-cold remedies for children from pharmacy and grocery-store shelves, since they do provide relief to older children when taken according to package inserts. Americans spend about $300 million every year on the plethora of products offered, despite warnings.

I am sure it will take a considerable period of time before the FDA takes a stand on whether to modify their present standards. In the interim, infants and young children should be under the care of their pediatricians, and parents should be guided by their medical recommendations. Should any question remain, request a referral to a pulmonologist who specializes in pediatric medicine.

To give you related information, I am sending you a copy of my Health Report “Pulmonary Disease.” Other readers who would like a copy should send a self-addressed, stamped, No. 10 envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Dr. Gott is a retired physician.

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