Stephen J. Schueler, M.D.

Influenza Congestion in Children

Home treatment for congestion in children with influenza includes general measures and medications. Medications include oral decongestants, decongestant nasal sprays and antihistamines.

General Measures

  • Ask your child to blow the nose gently. Forceful blowing can cause pain and bleeding.
  • Apply petroleum jelly to the nostrils if the skin becomes dry.
  • Drink plenty of liquids.
  • Place a vaporizer or nebulizer in the bedroom at night.
  • Use saline (saltwater) nose spray, such as Ocean Nasal Mist: saline helps to keep the lining of nasal passages moist.

Oral Decongestants
Oral decongestants, such as pseudoephedrine (Sudafed), help to thin the mucus responsible for the congestion. Decongestants are safe for children more than 6 years old. Talk to your doctor before providing a decongestant to a child less than 6 years old.

Decongestant Sprays
Decongestant nasal sprays, such as pseudoephedrine (Afrin), can relieve congestion faster than oral medications, but should not be used in children less than 12 years old.

Examples include:
  • Afrin Nasal Spray
  • Duration Nasal Spray
  • Four-Way Fast Nasal Spray
  • Neo-Synephrine Nasal Spray
  • Vicks Sinex Nasal Spray

Precautions include:
  • Do not use decongestant nasal sprays for longer than 3 days. After three days, the nasal tissues become dependent on the medication. When the medication is stopped, the nasal tissue swells and congestion worsens.

Antihistamines, such as diphenhydramine (Benadryl) brompheniramine and chlorpheniramine, dry nasal tissue. Antihistamines are safe for children more than 5 years old. Talk to your doctor before providing an antihistamine to a child less than 5 years old.

Examples include:

Precautions include:

Diphenhydramine Dosing Chart
AgeDoseIntervalMax Daily Dose
2-5 years6.25 mg4-6 hours37.5 mg/day
6-11 years12.5-25 mg4-6 hours150 mg/day
12 and older25-50 mg4-6 hours300 mg/day

Chlorpheniramine Dosing Chart
AgeDoseIntervalMax Daily Dose
Under 6consult your physician
6-11 years2 mg4-6 hours12 mg/day
12 and up4 mg4-6 hours24 mg/day

Continue to Influenza Cough in Adults

Last Updated: Dec 16, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Influenza References
  1. Centers for Disease Control and Prevention (CDC)
  2. Ebell MH, White LL, Casault T. A systematic review of the history and physical examination to diagnose influenza. J Am Board Fam Pract. 2004 Jan-Feb;17(1):1-5. [15014046]
  3., HHS Interagency Public Affairs Group on Influenza Preparedness and Response
  4. Jefferson T, Smith S, Demicheli V, Harnden A, Rivetti A, Di Pietrantonj C. Assessment of the efficacy and effectiveness of influenza vaccines in healthy children: systematic review. Lancet. 2005 Feb 26-Mar 4;365(9461):773-80. [15733718]
  5. Montalto NJ. An office-based approach to influenza: clinical diagnosis and laboratory testing. Am Fam Physician. 2003 Jan 1;67(1):111-8. [12537174]
  6. Strategy for Off-Site Rapid Triage(c) (SORT) and Real-time Epidemiological Assessment for Community Health(c) (REACH), Emory University, Principal Investigators: Alexander Isakov, MD, MPH; Arthur Kellermann, MD, MPH, Collaboration with the Emory at Grady Health Literacy Team (Ruth Parker, MD; Kara Jacobson, MPH, CHES; Lorenzo DiFrancesco, MD)
  7. VHA Office of Public Health Surveillance and Research; Influenza Algorithm Work Group
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