According to a new study the popularly used Vicks VapoRub rather than helping could cause airway inflammation that can restrict breathing in infants and toddlers.

The study by doctors at Wake forest University was published in Chest, the journal of the American College of Chest Physicians and it reported that this treatment could be dangerous when used in children under the age of 2 years and may even exacerbate breathing problems rather than reliving them.

Despite the label on the balm recommending the product not being used on children under the age of 2, parents do so anyway. Lead author Dr. Bruce K. Rubin professor and vice chair for research at Wake Forest's Department of Pediatrics at Wake Forest University Baptist Medical Center in Winston-Salem, N.C. said, "People don't read warnings on prescription medications, so to [read a warning for] a salve on the outside of the body that has been around for 100 years . . . I think it would be a rare parent who would do that."                

The researchers realized the potential risks when they treated an 18 month old girl brought to the emergency room after her respiratory infection grew worse on having the salve applied directly under her nose to relieve her cold symptoms.

"The company is really clear that you don't put it in the nose, and you never use it in kids under 2," said Dr. Rubin. "Sure enough, when we stopped all the medicine, the child got much better very quickly." Subsequently the team identified three more infants brought to emergency rooms with breathing problems after receiving Vicks VapoRub and all recovered quickly once application of the ointment was stopped.

To study infant respiratory problems the researchers used ferrets whose airway anatomy and cell lining are similar to humans. They applied the ointment directly to cultured ferret tracheal cells as well as under the noses of healthy ferrets and ferrets with tracheal inflammation similar to that of humans with a cold. The researchers found that the ointment increased mucus secretion by 59% in the cultured cells, 14 % in airways of healthy animals and 8 % in the animals with inflamed airways. The ability to clear mucus was also reduced by 36%.  Rubin explained that as infants airways are much narrower than those of adults, "any increase in mucus or inflammation can narrow them more severely."

David Bernens, a spokesman for Proctor & Gamble, the makers of Vicks VapoRub said, "The product is safe and effective when used as directed. To say it was the Vicks VapoRub that caused the respiratory distress -- I'm not sure we have made that link yet." He added that one incidence could not form a basis and the company's post-marketing surveillance shows only three adverse incidents per 100 million units sold, with no mention of respiratory distress among them.

"The safety and efficacy of the product has been determined by multiple clinical trials with over 1,000 children tested. . . . Our results are inconsistent with the claims of this study," Bernens added.

Dr. Daniel Craven, a pediatric pulmonologist at University Hospitals Rainbow Babies and Children's Hospital in Cleveland, said, "Previous research has failed to demonstrate any respiratory benefits of VapoRub, and conscientious pediatricians have thus usually tried to dissuade families from spending money on this and similarly ineffective therapies," Craven said. "Although the findings are someone limited, this study raises the possibility that this product may not just be ineffective, but possibly might have adverse respiratory consequences -- particularly if there is an intense exposure -- as when it is applied directly under the nostrils."

Craven added, "There are no miracle cures for a respiratory virus infection." The body has evolved ways to fight such infections, with coughs, sneezes and mucus that traps microbes and moves them away from the throat said Rubin. "All of those are great things," he said. "To help the body's defenses, the best things are love and hugs, warm liquids like chicken soup, and time."