Steam inhalation treatment for children

Nasal inhalation of steam has been proposed as treatment of viral colds on the assumption that increased intranasal temperature will inhibit replication of rhinovirus.1 Some clinical trials looking at the effect of inhalation of steam on rhinovirus infection have used machine-generated heated humidified air.2 Most people at home use the old fashioned way of head over a bowl of steaming hot water.

During January 2005, three children were assessed in our burns unit following scalds with steam inhalation. All were under the age of 5 years. Two children had burns to the feet as a result of kicking the hot bowl of water. The other child had burns to the chest as a result of water spilling from the bowl. The total body surface area of the burn ranged from 1–3% superficial partial thickness and none of them required hospital admission. The parents of all three children claimed they were advised by their GP to use steam inhalation for symptomatic relief.

There is insufficient evidence in the literature to support the use of steam inhalation as a treatment. A Cochrane review of the use of heated, humidified air for the common cold found only three trials demonstrated beneficial effects on the symptoms of the common cold.3 Other studies have shown steam inhalation has no effect on viral shedding as well as a failure to improve symptoms.2^,4

The number of scalds in children has risen over the last three decades according to a Welsh study.5 Scalds also remain the most frequent type of paediatric burn admissions in Denmark where majority are due to hot beverage spillage.6 Murphy et al have reported seven cases of burns needing admission, caused by steam inhalation treatment for the common cold. In their report, two of the parents claimed they were advised by their GP to use steam inhalation treatment.7 The patients in our series were fortunate not to have sustained more extensive burns. However the morbidity of the pain and distress, possibility of wound infection, parental anxiety and several trips to the dressing clinic can not be ignored.

Scalds from steam inhalation treatment are entirely avoidable. It is perhaps time to start discouraging patients from using this form of home remedy, as there appears to be no significant benefit from steam inhalation. GPs are in prime position to educate parents on how to care for their coryzal child and avoid the risky business of steam inhalation therapy.

• © British Journal of General Practice, 2005.