Seawater Nasal Irrigation Speeds Cold Recovery in Young Children

HYPERTONIC seawater nasal irrigation eased congestion and accelerated cold recovery in infants and toddlers, a randomized trial found.

The randomized, open-label controlled study included 220 otherwise healthy children aged 3 to 48 months with common cold symptoms and at least moderate nasal congestion. Children were assigned to standard care alone or standard care plus a hypertonic seawater nasal spray enriched with copper and manganese.

Standard care included hydration, rest at home, and acetaminophen as needed. Caregivers in the intervention group administered the nasal spray at least twice daily and as needed, up to six times per day, until symptoms resolved or for a maximum of 10 days.

Nasal congestion, the primary endpoint, improved significantly with seawater nasal irrigation. Between-group differences emerged on the evening of Day 0 and remained significant at multiple assessments through Day 5, with another significant difference on the evening of Day 7. Immediate improvement from baseline was also observed within minutes of spray use.

Faster Common Cold Recovery

The intervention was also associated with reductions in cough and runny nose severity. By contrast, differences in nasal crusting, thick mucus, and sneezing were limited, which the investigators noted may reflect the low frequency of these symptoms.

Recovery rates began to separate from Day 5 onward. By Day 10, 75.3% of children receiving the nasal spray had recovered compared with 58.5% receiving standard care alone. Overall caregiver-rated cold symptom relief was also greater in the nasal spray group.

Sleep quality did not differ meaningfully between groups, and rates of secondary infection symptoms were comparable. Use of acetaminophen was also similar.

Safety and Clinical Relevance

No adverse events were considered related to the nasal spray, and no serious adverse events occurred. Caregiver satisfaction was high, with most respondents reporting that they liked the product and would use it for their child in the future.

For clinicians managing common cold symptoms in very young children, the findings suggest that hypertonic seawater nasal irrigation may offer a nonpharmacologic adjunct for short-term nasal congestion relief. However, the open-label design, reliance on caregiver-reported outcomes, lack of objective congestion measurements, and 10-day follow-up limit interpretation.

Reference
Chen O et al. Efficacy and safety of seawater-based nasal irrigation on nasal congestion in infants and toddlers with common cold: a randomized controlled trial. Eur Arch Otorhinolaryngol. 2026; DOI:10.1007/s00405-026-10615-z.

Featured Image: zilvergolf on Adobe Stock.