Standing in a steamy bathroom at 3 AM, holding a coughing little baby. Croup and coughs can put parents on a real emotional roller-coaster. Most of us parents have suffered through miserable nights alternating between steam, cold air, and chest rubs. We were following the suggestions of our doctors, health websites, and most importantly, the advice of our parents and grandparents.
Turns out study after study failed to find any indication that steam helps at all.
So why tell parents to steam up the bathroom with their sick little ones? Honestly, I think a lot of health care professionals know it doesn’t do any good, but it keeps the parents doing something.
So what about that typical case of croup or chest cold not requiring aggressive therapy? If it was our baby at 3 AM this morning? You would not find us in a steaming bathroom. We would be sitting next to our child’s bed, diffusing essential oil, applying warm compresses, reading or singing. We would be comforting our baby with researched supportive alternatives that had worked for other parents we know and network with while keeping a watchful eye out for symptoms that would prompt is to call a health professional or head to the doctor’s office.
The Fog of Medical Advice
Steam cleaning. Give your child steam, steam, and more steam. For infants and young children, turn the bathroom into a steam room with the door closed and the shower on full hot. Sit in there for 10 or 15 minutes. — Dr. Sears, Natural Treatments for Coughs, Runny Nose and Congestion.
Dr Sears’ recommendation makes sense when you read it. Your parents and grandparents probably would agree – although it might have been a homemade steam tent using a teapot. Doctors present this information with in an authoritative voice. After all, it seems to work for older kids and grownups. Nothing makes me feel better than a hot shower when I have a bad cough or chest cold. However, what is hot and steamy for big noses and throats may be too hot and too steamy for tiny noses and lungs. And while steam may help with simple nasal congestion,
Surely this approach has some scientific backing. Or does it?
Steam fails the safe and effective test
Surprisingly, there are few studies how effective steam is for bronchitis. One research team looked for well-controlled studies for acute bronchiolitis in babies. They found almost no published research, and the one study they did find that
there is insufficient evidence to inform practice regarding using steam inhalation or mist therapy for acute bronchiolitis in children up to three years old. They concluded more research was needed. 1. Other studies do support additional research into essential oils. 2. To be fair, the children in the horseradish study may have just pretended to get better more quickly.
Turns out, steam is about as effective as antibiotics for acute bronchitis. And the American Medical Association and US Centers for Disease Control and Prevention have pushed for 15 years to stop doctors from prescribing antibiotics for bronchitis. 3.
What about croup?
Steam doesn’t seem to help much for croup either. 4 Canadian researchers found no proof steam helps in any way and could even have a negative impact. 5 The British National Health Service has good basic information on their public website, but discourages the use of cough medicine, decongestants, and steam.
In the past, parents may have been advised to try steam treatment in the bathroom. Though some parents may find that this helps improve breathing, there are no studies to prove that inhaling steam in a bathroom is effective. There are also no studies to prove that breathing in moist, cool night airs helps improve breathing. – Croup and Your Young Child, American Academy of Pediatrics
How We Manage Chest Colds and Coughs in Our Home
We trust our intuition. But we are also proactive. We have an asthmatic child, so we learned from health professionals how to recognize breathing distress. The time to discuss how to monitor colds and coughs and how to recognize serious issues is the next time you see your pediatrician. We have the 24-hour nurse line memorized. We’ve already decided what essential oils we will use based on talking to other parents, alternative health professionals, and our own research. And research pointing to the use of essential oils as an effective response makes us feel we have headed in the right direction.
That doesn’t mean the next time we deal with a sick child with a horrible cough won’t be another emotional roller-coaster. But we will be riding with the safety bar in the down and locked position.
Even if all that the gentle inhalation and application of essential oils accomplishes is a relaxation and calming, how does this help? Croup can not be ‘cured’ – its a viral infection. 6 Acute bronchitis usually develops from a cold or other infection and has few effective mainstream treatments. The symptoms can be managed – and for a majority of children, managed at home.
Goals of therapy are to decrease the duration and severity of symptoms, minimize anxiety of the child and his/her parents, and to decrease intubations, hospitalizations and return visits to physicians. Keep children calm by ensuring a relaxed and reassuring atmosphere to minimize oxygen demand and respiratory muscle fatigue. There is insufficient evidence to support the use of mist therapy. Placing children in mist tents, a wet and cold environment, and separating them from their parents may provoke anxiety and agitation and should be avoided. —Croup in the paediatric emergency department
First Steps With Croup and Chest Colds
Caregivers and Family Members: Most Croup and many chest colds are viral. Frequently wash hands to avoid spreading the virus. We have replaced all the triclosan-containing soaps with an essential oils-based hand wash.
Baby/Child: Sitting or elevating the head is recommended. Babies should be placed in car seats if possible.
If breastfeeding or bottle-feeding, continue. If already introduced to other liquids, warm apple juice, warm chicken broth and cold frozen juice pops all can help sooth sore throats and loosen mucous.
Essential Oils We Use When Dealing With Kids and Colds
We want to create a calm, comforting environment that supports healing. Under two, we diffuse roman chamomile, geranium, and wild orange. All of these essential oils are safe for diffusing and have research supporting their calming and comforting effects. For older children (including Dad) we diffuse a respiratory blend which includes laurel leaf, peppermint, eucalyptus, melaleuca, lemon, and ravensara. We also use our own homemade cough and cold chest rubs..
Diffusion guidelines based on evidence are difficult to locate – in our home we would diffuse in 20 minute cycles for a baby. But as parents, at some point we have to trust our own instincts. Use what we’ve learned and observed. We know when our child’s breathing seems difficult. When our child is either responding or not responding what we are doing. When we need help. And when we just need to have patience and know that sometimes holding a hand and kissing a forehead is the medicine they need.
Don’t feel defensive about using a traditional or alternative therapy for bronchitis or croup. And don’t hesitate to call your health care provider if you need reassurance or confirmation. Even your pediatrician may be making recommendations based on folk wisdom, experience, and memories of how his mom took care of his family.
- Steam inhalation or humidified oxygen for acute bronchiolitis in children up to three years of age. ↩
- NYU Langone – Acute Bronchitis ↩
- Antibiotic Prescribing for Adults With Acute Bronchitis in the United States, 1996-2010 ↩
- Humidified air inhalation for treating croup: a systematic review and meta-analysis ↩
- Lack of efficacy of humidification in the treatment of croup: Why do physicians persist in using an unproven modality? ↩
- Croup in Children ↩