A blocked nose can make a baby pull off the breast or bottle again and again, gasping and fussing, and it often wrecks sleep too. Here is what the AAP’s parent resources say about easing congestion at home, and when it is time to get help.
Why It Happens
Babies have very small nasal passages, and young infants tend to breathe mainly through the nose. Even a small amount of extra mucus from a cold virus can make a nose feel completely blocked. HealthyChildren.org, the AAP’s parent site, explains that most colds in babies are caused by viruses, so care focuses on comfort rather than a cure. Dry air and dust can also thicken mucus and add to the problem.
How It Differs by Age
Newborns and young infants are not skilled at breathing through the mouth, so congestion shows up quickly as trouble feeding and sleeping. The AAP’s bronchiolitis guidance notes that bulb suction works best for babies younger than about 6 months. As children grow, they can often blow their noses, and saline spray or a humidifier may be enough without any suction at all.
Care at Home
The AAP recommends plain saline with no added medicine. You can buy it ready-made, or make it with 1/2 teaspoon of non-iodized salt and 1/4 teaspoon of baking soda in 1 cup of warm water, using sterile, distilled, or previously boiled water. Lay the baby down or tilt the head back slightly, place 2-3 drops in one nostril, and wait about a minute so dried mucus can loosen. Squeeze the bulb first, then gently place the tip at the nostril opening and release slowly. Squeezing after insertion can push mucus deeper. Try this about 15 minutes before a feed or nap so the baby can eat and rest more comfortably, then wash the bulb with warm soapy water. Keep sessions brief and do not repeat them excessively, since too much suction can irritate the lining of the nose and make swelling worse.
Common Misunderstandings
Many parents assume more saline is better, but a few drops are usually enough. Others reach for medicated nose drops, yet the AAP advises against over-the-counter nose drops that contain medicine for babies. Another common belief is that cold syrup will open the nose; the AAP recommends that over-the-counter cough and cold medicines not be given to children under 4 years old because of the risk of serious side effects. Some parents suction right after feeding, which may trigger vomiting, so before a feed is usually better. Finally, a stuffy nose does not automatically mean something serious. Cold-related congestion tends to improve within about a week or so.
When to Seek Medical Care
Go to the emergency room or call emergency services right away if you see flaring nostrils, the skin between the ribs or at the base of the throat pulling in with each breath, very fast breathing, a bluish or gray tint to the lips or face, unusual limpness or difficulty waking, or pauses in breathing. No wet diaper for 8 hours or more, or crying without tears, may signal dehydration and needs prompt care. Even without these signs, talk with a pediatrician if a baby under 3 months has a fever, feeding drops off noticeably, or congestion lasts more than about 10 days or returns after improving. This information is based on U.S. (AAP) guidance; if you live elsewhere, check with a local pediatrician for country-specific recommendations. This information isn’t a diagnostic tool and doesn’t replace advice from a medical professional.