An Infant Given a Nasal Decongestant Drug

3/17/2008

I evaluated a two and a half month old baby today who was seen by another pediatrician 24 hours ago. The baby presented with a two day history of nasal congestion and slight difficulty maintaining a nursing session due to the stuffiness. The baby was given Neosynephrine nasal spray by the other pediatrician. The mother had the presence of mind to not give the medication as her sense was that this was excessive in view of her baby’s age.

This intuitive mom was absolutely correct. Neosynephrine (the ingredients are listed below) should never be used in a child. The active ingredient of this drug, phenylephrine, raises blood pressure. Since the nasal passages are chock full of blood vessels close to the surface (mucosa), this drug is absorbed rapidly and efficiently by the baby. Add to that the presence of thimerosal, an ethyl mercury containing additive that is now removed from childhood vaccines and you have a perfect example of a bad medication choice for a young child. Nasal decongestants with these vasoconstrictive drugs (causing blood vessels to constrict) typically have a rebound effect once stopped. It will help transiently but the congestion often returns with a vigor once it is discontinued. This is an example of the type of medical and parenting practice that should never considered.

Saline nasal drops without drugs added are readily available in any pharmacy. Moisturizing dry nasal passages is a good idea and easy to do in a baby. Make sure that you are purchasing a nasal spray that only has saline (salt water). Parents can buy a baby nasal aspirator to clean out excessive mucous before feedings and before sleep time. Babies are obligate nose breathers and cannot easily switch to mouth breathing as is required when one has a stuffy nose. That is why they get irritable when congested or when trying to feed with a stuffy nose. An easy to clean cool mist humidifier is also a good idea. For older children or adults consider a neti pot to clean out stuffy noses. This low cost easy to use item will offer great relief when really congested. They are available at all large pharmacies. For an instructive video click here.

Be a smart parent and avoid unnecessary drug use in your kids, especially a young baby.

INGREDIENTS: Active Ingredients: contains: Phenylephrine Hydrochloride (0.25%).Inactive Ingredients:Benzalkonium Chloride (0.001%), Thimerosal, Citric Acid, Purified Water, Sodium Chloride, Sodium Citrate.

      

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