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 child 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 is 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. 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 seek medical advice

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

  • Fever (see Fever and children, below)

  • Symptoms get worse

  • Nasal mucus becomes yellow or green in color

  • 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

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

  • Ask your child’s healthcare provider how you should take the temperature.

  • Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

  • Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

  • Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

  • Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

  • Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

  • Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

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© 2000-2018 The StayWell Company, LLC. 800 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.