What is the Safest Children's Decongestant?

K.C. Bruning

Usually, the safest way to clear congestion in children is to encourage consumption of fluids and administer hot steam and saline nasal spray. A children’s decongestant should usually be tried once these measures have failed, and if the child is unable to sleep or perform daily activities without major disruption. Multi-symptom medications should be avoided if congestion is the only symptom. It is also best to purchase a medication that has been tested on children.

Sorrel leaves can help relieve congestion.
Sorrel leaves can help relieve congestion.

Cold medications tend to have four major ingredients: an expectorant for loosening mucus, a cough suppressant, an anti-histamine for a runny or itchy nose, and a nasal decongestant. It is best to buy a medication that only addresses the child’s specific needs. For example, a medicine with a cough suppressant should not be used if only a children's decongestant is needed.

Prescription children's decongestants.
Prescription children's decongestants.

The two major varieties of children’s decongestant are expectorants and medications that clear nasal passages. If the child seems to have thick mucus in the chest which cannot be coughed up, an expectorant can be helpful. A nasal decongestant should be used when the mucus has clogged the nasal passages so that it is difficult for the child to breathe easily. This kind of medicine can also help to dry a runny nose.

Herbs like vervain can help relieve congestion.
Herbs like vervain can help relieve congestion.

Most over-the-counter medications have not been tested on children, as it is costly to accommodate and protect the rights of underage participants in clinical studies. For this reason, it is important to keep in mind that despite being marketed for children, many medications have only been proven to be safe for adults. The safest products are those with labels that indicate that the medication has been tested on a pediatric population.

In the United States, the Food and Drug Administration recommends that no over-the-counter medications be given to children under two. Studies as to the safety of children’s decongestants indicate that serious side effects have been observed in children from age two to 11. In all cases, it is best to consult a doctor before administering medication.

There are many natural alternatives to standard children’s decongestant. These may contain various herbs such as cowslip, gentian, vervain, common sorrel, elder, and others. In addition to prompting the drainage of mucus these alternatives also claim to offer immune system support. Many are pharmaceutical-grade products that can be taken in capsule or liquid form.

There have also been reported side effects for natural alternatives. These may include nausea and vomiting, diarrhea, weakness, and numbness. Some studies suggest that there is a theoretical possibility for kidney stones and allergic reaction from use of these products, which could include swelling, difficulty breathing, a rash or hives, and itching. As with other over-the-counter medications, a doctor should be consulted before use of these products.

Saline nasal sprays, which consist mostly of a salt-water solution, are safe for children to use.
Saline nasal sprays, which consist mostly of a salt-water solution, are safe for children to use.

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Discussion Comments


I personally don't trust those all-in-one cold medications myself. I try to get decongestant medicine that does one thing well. If my child has other symptoms like a cough or fever, I'll give him a baby aspirin or a teaspoon of children's cough medicine. Even if it says non-drowsy formula on the bottle, I still think they can cause some drowsiness in small children.


When I was really young, maybe four or five years old, my mother accidentally gave me the adult dose of a nighttime liquid cold medicine. I slept for almost 18 hours, and she was afraid I was never going to regain consciousness.

I think they've changed the formula in those liquid decongestants, but I'd still be extra careful when giving it to a small child. A decongestant made for children specifically would be a better choice. The adult versions sometimes contain alcohol and a heavy duty sleep aid.

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