Saline drops shorten colds for children – and prevents spread

The respiratory viral season is here and keeping your baby or young child’s nose clear so they can breathe easier can be a challenge.

Hypertonic nasal saline (saltwater) drops have a higher content of salt than normal saline and is a simple medication that can help you relieve the constant runny and congested nose of the common cold and the variety of other upper respiratory viruses.

“We’ve been using hypertonic saline nose drops for years,” said Geoffery Schreiner, MD, MPH, a Boston Children’s Hospital pediatric hospitalist at Cape Cod Hospital. “Since we strongly recommend avoiding over-the-counter cough and cold medications in children under 6 years, hypertonic nasal saline drops are one of the few things we can use to help infants and young children.”

In addition to relieving symptoms, a study published in 2024 by the European Respiratory Journal showed that hypertonic saline nose drops shortened the duration of the virus from eight days to six days and limited the spread of the virus to household family members.

“We’ve known the drops are helpful in reducing symptoms, and I’m glad the study shows additional benefits,” said Dr. Schreiner.

How the Drops Work

According to Dr. Schreiner, the drops help reduce discomfort and symptoms by:

• Flushing and cleaning out mucous and debris created by the virus and your own cells that cause swelling of the nasal passages.
• Thinning mucous and allowing it to flow more easily, which improves airflow.
• Drawing water out of the swollen tissues which reduces inflammation and build-up of fluid.
• Helping the body produce hydrochloric acid, a mild acid that naturally helps the body fight viruses.

“All of this really helps to reduce the viral load which makes it better for the child and there is less virus to spread around to others in the family,” he said.

How to Give the Drops

He also offered the following additional tips when using the nose drops:

• Swaddle your baby or young child like a papoose before using the nose drops because they are not going to like having the drops put into their nose.
• A bulb syringe can be used to suction the secretions from their nose.
• You only need to suction if the child is really stuffed up or congested. Otherwise, just use the drops.
• Give two to three drops of 2.5-3 percent hypertonic drops in each nostril four times a day. If you mistakenly give four drops on each side, it won’t be a problem. If you are using a nasal spray, do not use it forcibly because it can cause irritation of the nasal membranes.
• Make sure to wash your hands before and after giving the drops.

While nasal saline drops can be made at home, Dr. Schreiner recommends parents speak with their pediatrician about the correct ratios of water and salt to use in making the solution.

A Word of Caution

Another type of saline treatment is a nebulized normal saline treatment sometimes used to treat bronchiolitis in children under 2 years old. This type of saline is not hypertonic like the recommendation for nasal drops. Using nebulized hypertonic saline in the treatment of bronchiolitis can cause bronchospasm. 

“In addition to the nose drops to make your child more comfortable, make sure they are staying hydrated, and urinating regularly throughout the day,” said Dr. Schreiner. “If they develop a persistent fever, are breathing fast or have any color change, contact your pediatrician, go to urgent care or the emergency room.”