Nasal Congestion (Infant/Toddler)

Nasal congestion is very common in babies and children. It usually isn’t serious. Newborns younger than 2 months old breathe mostly through their nose. They aren't very good at breathing through their mouth yet. They don’t know how to sniff or blow their nose. When your baby’s nose is stuffy, he or she will act uncomfortable. Your baby will have trouble feeding and sleeping.

Nasal congestion can be caused by a cold, the flu, allergies, or a sinus infection.

Symptoms of nasal congestion include:

  • Runny nose

  • Noisy breathing

  • Snoring

  • Sneezing

  • Coughing

Your baby may be fussy and have trouble nursing, taking a bottle, or going to sleep. Your baby may also have a fever if he or she also has an upper respiratory infection.

Simple nasal congestion can be treated with the measures listed below. In some cases, nasal congestion can be a symptom of a more serious illness. Be alert for the warnings listed  below.

Home care

Follow these guidelines when caring for your baby's or child's nasal congestion at home:

  • Clear your baby’s nose before each feeding. Use a rubber bulb syringe (nasal aspirator). Sit your baby upright in a car seat. (Don’t use the bulb syringe with the child on his or her back.) Gently spray saline 2 times into one nostril. Then use the bulb syringe to suck up the loosened mucus. Repeat in the other nostril. Saline spray is salt water in a spray bottle. It's available without a prescription.

  • Use a cool mist vaporizer near your baby’s crib. You can also run a hot shower with the doors and windows of the bathroom closed. Sit in the bathroom with your baby on your lap for 10 or 15 minutes.

  • Don’t give over-the-counter cough and cold medicines to your child unless your healthcare provider has specifically told you to do so. OTC cough and cold medicines have not been proved to work any better than a placebo (sweet syrup with no medicine in it). And they can cause serious side effects, especially in children younger than 2 years of age.

  • Don’t smoke around your child and don't allow other people to do so. This includes smoking in your home and car. Cigarette smoke can make the congestion and cough worse.

Follow-up care

Follow up with your child’s healthcare provider, or as directed.

When to get medical advice

Call your child's provider right away if any of these occur:

  • Fever (see Fever and children, below)

  • Symptoms get worse or new symptoms develop

  • Nasal discharge persists for more than 10 to 14 days

  • Fast breathing. In a newborn up to 6 weeks old: more than 60 breaths per minute. In a child 6 weeks to 2 years old: more than 45 breaths per minute.

  • Your child is eating or drinking less or seems to be having trouble with feedings

  • Your child is peeing less than normal.

  • Your child pulls at or touches his or her ear often, or seems to be in pain 

  • Your child is not acting normal or appears very tired

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

  • Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

  • Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

  • Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

  • Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

  • Mouth (oral). Don’t use a thermometer in your child’s mouth until he or she is at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell him or her which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

  • First, ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead: 100.4°F (38°C) or higher

  • Armpit: 99°F (37.2°C) or higher

Fever readings for a child age 3 months to 36 months (3 years):

  • Rectal, forehead, or ear: 102°F (38.9°C) or higher

  • Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

  • Repeated temperature of 104°F (40°C) or higher in a child of any age

  • Fever of 100.4° F (38° C) or higher in baby younger than 3 months

  • Fever that lasts more than 24 hours in a child under age 2

  • Fever that lasts for 3 days in a child age 2 or older

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