Steam for Babies and Toddlers: What the Evidence Says

When a baby’s nose is blocked many families turn to the big bowl of hot water. Steam feels like it should help and it has been the default home cure for colds for generations. Paediatricians now say skip direct steam for babies and young children, and the reasons are very specific: confirmed burn damage, and no good proof that it works. 

The common cold is the most common sickness in humans, nearly every parent will have a baby with a cold. Cold lasts around five to seven days and as a child’s immunity grows they get fewer colds. Most babies get better at home with minimal treatment.

In this post we’re going to examine what the science says regarding steam, what to do instead for newborns (0 to 6 months), what changes for older kids and toddlers, and when a runny nose needs a doctor.

Why direct steam is not recommended

Two issues keep surfacing in the several research and clinical trials. Burns, and the absence of proof that steam helps with common cold.

1. The risk of burn: Several Hospital burn units around the world have published children suffering burn injuries from steam inhalation.

2. Unproven method: A Cochrane review study 2017 investigated heated, humidified air for the common cold. It discovered no evidence of any benefit from humidified air. Many studies concluded that steam did not provide consistent benefits and was not advised for regular use.
   

Newborns to 6 months

Blocked nose is very common in babies up to six months and is usually just normal mucus collecting in the nose. If babies get a cold it can last for 2 weeks.

1. Saline drops: Salt-water drops thin the mucus so the baby can clear it more easily. Use them just before feeding and only when the nose is actually blocked, because overuse can make the skin around the nose sore or injured. KidsHealth suggests 2 to 3 drops in each nostril is enough.

2. Light, gentle suction: If the mucus is thick, use a bulb syringe to suction it out . The saline will loosen it up . Do it before a feed not after, sucking after feeding can make them vomit. KidsHealth recommends no more than approximately 3 times a day, too much suction can make congestion worse and cause the lining of the nose to swell or bleed.

3. Cool-mist humidifier: Cool-mist humidifiers may help with cough and congestion from a cold, but further study is needed. Cleaning tips: Empty the tank and dry all surfaces regularly, then refill with distilled or filtered water as stagnant water can spread minerals, bacteria and mould.

Older babies and toddlers

Everything in the newborn section still applies for older babies and toddlers. These additions suit older babies and toddlers.

The steamy bathroom: Several US children's hospitals suggest creating moist air by running a hot shower and sitting in the steam-filled bathroom with your child for 10 minutes. 

Plenty of fluids and rest: According to hospital guidelines, children with croup should consume plenty of fluids to avoid dehydration and receive plenty of rest. 

Honey, only after age 1: In children aged 12 months to 18 years, honey was probably better than no treatment for relieving cough and improving sleep. Honey is not safe for children under 12 months. Honey can contain botulism spores and a survey indicated that 10% of honey samples had them. The CDC and the American Academy of Paediatrics suggest no honey for newborns younger than 12 months.

Older children and adults

The burn reports above aren’t just newborns. The traditional approach of placing the head over a bowl of very hot water, with a towel over the top, had a considerable risk of direct steam burns. 

Also steam has no improvement has been shown in adults either. Studies revealed that heated humidified air had no benefit nor harm for the common cold.

For relief if you or an older child wants it, the safer options are the same as for toddlers: a warm shower, a cool-mist humidifier, lots of fluids and rest. If you do use a steam approach, never put a towel in a bowl of hot water. 

What about  saline nebulizer?

No study that shows it works better than saline drops for a common cold. If you use a nebuliser, use only saline intended for nebulisers. Do not add any other drugs unless your doctor tells you to. Wash the parts after each use. Saline drops and gentle suction before feeds are still the initial step, so ask your paediatrician before buying one, especially for babies under 6 months.

Bottom line for your baby

The usual first steps are saline drops with mild suction before feeds. A saline nebuliser is optional and its effectiveness for a basic cold is not well documented. If you buy one, ask your pediatrician first, especially for a baby under 6 months or one with fast breathing, wheezing or trouble feeding. See the warning signs in the next section.

What moms do at home (and what they told us)

Science is only part of the story. Steam is a comfort many of us grew up with. We asked moms in our community how they practise steam safely with their babies, and we’ve collected their practical tips below. 

Disclaimer: This article shares general information and data from research studies. It is not medical advice. Please speak with your paediatrician before trying any steam-based practice with your baby, especially under 12 months, and see a doctor immediately if your baby has fast breathing, wheezing, trouble feeding, fever, or a cold that isn’t curing.