Stephen J. Schueler, M.D.

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Upper Respiratory Infections in Children Congestion

Home treatment measures for congestion in children with an upper respiratory infection include 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.
  • Use a humidifier, nebulizer, or vaporizer 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
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 Upper Respiratory Infections in Children Cough

Last Updated: Jan 6, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Upper Respiratory Infections in Children References
  1. Autret-Leca E, Giraudeau B, Ployet MJ, Jonville-Bera AP. Amoxicillin/clavulanic acid is ineffective at preventing otitis media in children with presumed viral upper respiratory infection: a randomized, double-blind equivalence, placebo-controlled trial. Br J Clin Pharmacol. 2002 Dec;54(6):652-6. [12492614]
  2. Butler CC, Hood K, Kinnersley P, Robling M, Prout H, Houston H. Predicting the clinical course of suspected acute viral upper respiratory tract infection in children. Fam Pract. 2005 Feb;22(1):92-5. [15640294]
  3. Fahey T, Stocks N, Thomas T. Systematic review of the treatment of upper respiratory tract infection. Arch Dis Child. 1998 Sep;79(3):225-30. [9875017]
  4. Lam TP, Lam KF. Why do family doctors prescribe antibiotics for upper respiratory tract infection? Int J Clin Pract. 2003 Apr;57(3):167-9. [12723716]
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