Vicks VapoRub Misuse May Hurt Infants

Jan. 13, 2009— -- Dr. Bruce Rubin, has seen a lot of puzzling cases of respiratory problems. But Rubin, the vice chair of pediatric pulmonology at Wake Forest University Medical Center in Winston-Salem, N.C., said he had never encountered anything quite like the case he saw about three years ago.

An emergency room physician consulted Rubin when an 18-month-old girl who had a common upper respiratory infection suddenly developed severe breathing problems.

"The patient was disproportionately ill for having just an upper respiratory infection," Rubin said.

According to a case report published in the journal Chest by Rubin and his colleagues, the child was recovering relatively well while battling her respiratory infection until about two hours before she was admitted to the emergency room.

When doctors began questioning the patient's grandparents about what might have caused the girl's respiratory distress, the only answer her grandparents could come up with was that they had rubbed Vicks VapoRub under the child's nose earlier that day.

"Sure enough, we demonstrated that the Vicks produced increased mucous in the patient's airway, which was already inflamed and narrowed because of her respiratory infection," Rubin explained.

To confirm that the menthol-containing rub was responsible for the patient's respiratory stress, researchers tested the product on ferrets. Indeed, they found that exposure to VapoRub increased mucous production, thereby causing inflammation in the rodents' airways.

Rubin said this case should not be viewed as an isolated incident. Although the labeling on Vicks VapoRub indicates that the product should not be used on children younger than 2 and should not be rubbed directly under the patient's nose, he said some parents may still be putting young children at risk by not paying heed to these warnings.

"I don't think that parents ignore this warning, but I think they feel relief when they use [Vicks VapoRub] themselves, and it's an over-the-counter drug ... and, therefore, not thought of as anything that can cause problems," Rubin explained. "But sick children may respond differently than you'd anticipate."