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Nebulizer and Saline ... Yes Please!

When the kids get sick with a sore-throat or cough, have you ever thought of doing a nebulizer treatment with saline? It has been something I’ve recommended for years for children who have chronic respiratory issues including asthma, allergies or a persistent cough. I had never considered doing it for my children though. However, my mind started to shift during our current pandemic and the symptoms that most often hospitalize people are those with a cough and difficulty breathing or low oxygen levels.

I purchased a nebulizer for our family for when someone does fall ill due to COVID which I expect to happen at some point just based on how this virus is moving through the population (of course I hope it is a less virulent one when our family has to face it). I have never had the expectation that we as a family or species would stop getting sick. But with the more serious nature of the COVID illness I wanted to do all I could to be prepared.

Cough and Bronchiolitis symptoms are the number 1 cause of hospitalization in children and infants (they aren’t all that low in adults either and even more so in the elderly). Parents are most familiar with Nebulizers for the treatment of children with asthmatic symptoms and it’s widely used with medications such as Albuterol. An Alternative Therapy that is more recently being studies is Hypertonic Saline Solution and its us in a nebulizer to stabilize the lung tissue and in the management of bronchitis.

One article in The Journal of Pediatric Pharmacology and Therapeutics which review multiple studies on Hypertonic Saline showed that hypertonic saline improved bronchitis scores for infants and children in the hospital and reduced their hospitalization stay. The article also hypothesized on how this could be used to reduce admission rates of children in the first place to the hospital.

Conclusions on Hypertonic Saline (with limitations of course occurring):

  1. Reduced hospital admissions

  2. Reduced hospital stay times

  3. Reduced Bronchiolitis scores

  4. Extremely safe and can be used with other bronchitis treatments

  5. Sometime the only option in some health conditions of bronchitis.

How to treat:

  1. Buy an electric nebulizer because usually the portable kind can be used but they are not powerful enough to help with a patients total health issue. Choose a sturdy nebulizer with a high nebulization effect for a family as well as adjustable flow.

I have this one and recently used it on my kids who got a cold:

  1. Purchase Hypertonic Saline 3% to 7% strength. I like a brand out of Israel that patients rave about which reduces mucus and congestion and we love it.

We used the hypertonic saline and I recommend 2 times a day during an illness based on severity. If you use saline in your nebulizer you can still wash it out and use Albuterol in it as well.

  1. Mild Cough – Nebulize 1x a day

  2. Moderate Cough and congestion – Nebulize 2x a day

  3. Severe cough – Nebulize 3-4x a day.

Each time you will nebulize 20 minutes and open up the breather to toleration of the patient who is using it. Kids generally need fairly low amounts of pressure so use the lowest setting. Have them breathe as normally as possible and keep water handy as it will dry out the mouth some too.

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1 Comment

Lisa Walker
Lisa Walker
Oct 28, 2021

Thank you so much Dr. Walker! That is very helpful and it could be useful in our home.

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