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Dealing With Nasal Congestion in Babies

Causes of Congestion

The causes for nasal congestion can vary. “Viral infections [such as the common cold] are common among children, and infants are susceptible as well,” says Dr. Lamenta Conway, a pediatrician with the Sinai Children’s Hospital and Access Community Health Network in Chicago.

Acid reflux is another cause, says Dr. Brown. Sinusitis/adenoiditis (secondary bacterial infection) is possible if the nasal discharge is discolored and has been present for more than two weeks straight, he adds. Allergies may be another culprit—especially if the child is over the age of 2.

How long congestion lasts depends on the cause. If it’s a typical virus, the symptoms can last for three to seven days, says Dr. Conway. “However, because children are susceptible to viral infections, there may appear to be short intervals between sickness and wellness, as children may have as many as 10 to 12 viral/cold infections per year.”

When should parents be concerned? “If a newborn’s breathing truly is labored with congestion, if it persists more than six weeks or if a baby under 3 months of age has a fever associated with it,” says Dr. Brown.

The Symptoms

Nasal congestion is more bothersome in newborns, as they are actually nasal breathers from the early neonatal period to about 2 months of age or so, explains Dr. Conway. Some typical symptoms to be on the lookout for include the following:

  • Difficulty with feeding
  • Crying or becoming agitated
  • Nasal discharge
  • Noisy nasal breathing
  • Difficulty sleeping
  • Possibility of fever
  • Greater comfort when sitting upright
  • Snoring
  • Snorting
  • Sneezing
  • Coughing

Nasal Congestion Remedies

Leslie Wilkins of Brooklyn, New York, has been there. Her 1-year-old son, Jeremiah, has had congestion on and off since he was 6 months old. “As a parent, I feel terrible,” says Wilkins. “There are few things worse than listening to your baby boy struggle to breathe. And you feel so bad for the baby [because] they don’t know how to sniff or blow their nose yet.” Her doctor suggested spending some time in a steamed-up bathroom as well as using a bulb syringe. They also ran a humidifier in his room.

Other simple things parents can do, suggests Dr. Conway, are letting the baby sleep upright—in a car seat, swing, or lying on a parent’s chest—during acute symptoms and consulting with a physician regarding use of saline drops three times a day to lubricate nasal passages and loosen thick nasal discharge, making it easier to remove with bulb suction. Saline can be purchased at a store or made at home by mixing 1/2 teaspoon of salt in 8 ounces of water, says Dr. Brown, who also recommends putting a wedge under the baby’s mattress for elevation. (Here are 8 medicine-free cold and flu remedies.)

What Not to Do

“Never use old-parent remedies like blowing into one of the baby’s nostrils to clear the other nostril,” says Dr. Conway. “This is potentially dangerous and should not be done.” She also emphasizes never using over-the-counter medicine without consulting a physician first. For example, never use acetaminophen (Tylenol) for reducing fever in an infant less than 2 months of age, she warns, because fever in this age group can be secondary to neonatal-acquired infections that can be of late onset and potentially devastating. “As a result, any fever greater than 100.4 should not be treated by parents at home and the baby should be evaluated immediately (if less than 2 months of age) by a physician.”

If you’re thinking your cold remedy would work for your child, think twice. “Most pediatricians do not feel comfortable giving antihistamines/decongestants to children less than a year old,” says Dr. Conway. “Studies suggest that while these medicines help dry nasal passages in adults, their only benefit in the young child is that of sedation. Further, the effects of pseudoephedrine for nasal congestion have not been widely studied in very young children. It is known to cause increased heart rate and raise the diastolic blood pressure of adults who take it. It is therefore not recommended for children less than 1 year of age.”

Medication, such as nasal decongestants, often “wires the babies up and then you have a snotty awake baby instead of a snotty sleeping one,” adds Dr. Brown.

Red Flags to Watch For

The important thing to remember is that “most nasal congestion will cause nothing more than a little aggravation for the baby as well as the parents,” says Dr. Conway. She says what’s most important is for parents to make sure that the baby is not:

  • Feverish
  • Having persistent difficulty with feeding
  • Unable to sleep
  • Having any respiratory distress (breathing fast with flaring of the nostrils or deep, rapid retractions of the chest muscles with breathing)

These are symptoms that require immediate attention by the physician.

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