Saline Rinse May Cut Cold Symptoms

With the U.S. Food and Drug Administration's recent decision that cough and cold medications are unsafe for children under the age of 2, many doctors were happy to hear of a safe treatment alternative to standard medication for young, stuffy-nosed children.

According to Dr. Anne Moscona, professor of pediatrics, microbiology and immunology at the New York Weill Cornell Medical Center, and New York Presbyterian Hospital, any safe alternative to the standard cough and cold medications for children is good news for parents.

"I've never recommended over-the-counter cough and cold medications for use by children, and there's never been evidence that they help kids with cough and cold," Moscona said. "In fact, many studies have suggested they don't do any good.

"So, if anything, here's a simple remedy that has no risk, that is not only good, but intrinsically better than over-the-counter cough and cold medications. I would suggest my patients choose this approach."

However, doctors remain unsure of exactly how the washes help treat, and further prevent, upper respiratory tract infections.

The saline washes are believed to help treat infections by clearing out the nasal passages, thereby reducing the amount of inflammatory compounds in the respiratory system, Slapak noted.

Despite the uncertainty about how the nasal saline wash works to treat cold and flu symptoms, many doctors already recommend that their patients try this treatment before reaching for traditional cough and cold medications.

"I would encourage parents to use this method, and have long advised the use of saline spray in kids," said Dr. Marvin Fried, president of the American Rhinologic Society, and chairman of the Department of Otorhinolaryngology at Montefiore Medical Center in New York City.

"I have long used normal nasal saline in the pre- and post-operative care of patients with sinus disease, and have found it beneficial ... This is a very safe method of caring for children that avoids the issue with medications. It takes more 'work' than popping a pill, however."

Effective, But Less Convenient

Because the nasal saline wash requires more time and energy than simply downing a dose of cough and cold medication, some doctors have concerns about the capability of saline nasal washes to replace standard cough and cold medications as the go-to treatment for children with colds.

Although Slapak noted in the study's results that "overall, saline nasal wash was well tolerated," many doctors remain skeptical of patients adhering to a treatment plan which requires three to six washes per day.

Dr. William Schaffner, professor and chair of the department of preventive medicine at Vanderbilt University in Nashville, Tenn., believes the saline treatment solution might be too cumbersome for many parents to manage.

"I am puzzled [by] how they were able to perform nasal washes six times a day on kids [in the study]," Schaffner said. "Thus, the exact method — including [using the saline wash] three times a day as a preventive activity — does not sound practical. A warm shower twice a day would provide some of the same benefits."

Moreover, some doctors noted that children and young adults will have trouble complying to the treatment, in the absence of supervision by a doctor or parent.

"With children, compliance is an issue, because it usually requires adult supervision," said Dr. Peter Catalano, chair of otolaryngology at the Lahey Clinic in Burlington, Mass.

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