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Stuffy Nose – Babies (6-24 months)

Baby nasal congestion or baby “stuffy nose” is typically caused by anything that inflames the nasal tissues - usually a cold, influenza, sinusitis, or allergies. Overall, baby congestion is just extremely annoying and nothing to worry about, but it can really affect sleep and eating habits. For our newborns with a stuffy nose, it is tough to breastfeed or drink from a bottle when your nose is completely plugged because the baby can’t breathe through their nose. Newborn or infant congestion can be more worrisome than it is with our older kiddos, so let’s figure out what to do with our infant’s stuffy nose!

Today we will cover:

  • Causes for baby’s congestion
  • When we should seek medical advice
  • How to decongest a baby and help them get more comfortable
  • Saline for baby’s nose and tips on how to unclog a baby’s nose

What causes our baby’s stuffy nose?

As stated above, when we have a cold or something similar, our noses get inflamed. The tissues, blood vessels, and nasal polyps inside your nose become swollen with extra fluid and it creates that very “full” or “stuffy” feeling. With our little babes, their noses are so tiny! So a little inflammation for us is very different compared to their tiny baby congested nose. And does it seem like your baby is more congested at night? This isn’t just to spite you poor, hard working parents! Our bodies react differently to allergens at night and as much as we need gravity, it is not helpful when it comes to a baby’s stuffy nose at night. Mucus builds up and has nowhere to go, increasing nasal congestion.

You know what’s really common beginning at 6 months of age? The common cold. You know what else? Teething. Great, I know. Another mystery of wondering what ailment your little one is dealing with. So, do babies get stuffy noses while they’re teething? Usually not. Teething can sometimes be related to a runny nose due to inflammation of the mouth and gums, but if what you’re seeing in your infant is nasal congestion, it’s likely the common cold. The good news is that neither of these are cause for alarm or a reason to see the pediatrician, unless other symptoms arise that we’ll discuss shortly.

Our babies can have a stuffy nose with no other symptoms but oftentimes, our baby’s stuffy nose can come with other symptoms.

  • Runny nose (yep, we often get both!)
  • Fever
  • Irritability or fussiness
  • Sleeplessness
  • Coughing (possibly worse at night)
  • Sneezing
  • Decreased appetite or difficulty eating due to a stuffy nose
  • Sore throat
  • Watery eyes
  • Vomiting or spitting up

What stuffy nose symptoms are concerning? When should we seek medical advice?

  • If your babe is under 3 months old, chat with the doctor sooner than later. Things progress quickly in our little guys, better safe than sorry!
  • If symptoms are lasting longer than 10 days.
  • Sinus pain or sinus pressure along with symptoms. Our tiny babes won’t be able to tell us this, so you’ll have to use your Mommy Radar to determine if they’re having head/sinus pain that doesn’t feel normal to you.
  • Ear pain. The build-up from stuffy noses puts our babes at risk for ear infection, so if they appear to be grabbing or pawing at that ear while they are more fussy than usual, call the doc.
  • Signs of dehydration (dry mouth, not as many wet diapers)
  • Yellow or green “goop”/discharge from their eyes.
  • Sometimes our babes spit up or throw up because of mucus draining down their throat or excessive crying. This can be normal. If it is ever blood-tinged or you feel like it’s from something else (feeding intolerance, GI bug, etc), call your doctor.
  • If you’re ever concerned it is not related to a cold or virus, ask your doctor. Maybe it’s allergy related or something else more serious. Follow your gut!
  • Fever, depending on age: 0-3 months: >100.4℉; 3-24 months: >102℉; 2 yrs+: >104℉
  • Anytime your babe is wheezing or has trouble breathing - go to the emergency room.

There’s also a myth that green or yellow drainage means we’ve got a bacterial infection and need antibiotics. This CAN be true but not always. One trick: does it START green or yellow right outta the gate? This could be a sign of a bacterial infection or a sinus infection. But if it starts clear and changes to thick and colorful, it’s likely a viral infection that your kiddo’s body is fighting off. High five, Body!

What can we do to help our baby’s stuffy nose?

  • Increase fluids! This is the most important thing you can do, as it thins out the mucus and helps us get it OUT!
  • Suction bulb, drops or sprays. You can use saline spray or nose drops to thin the mucus, then use a bulb syringe to clear their tiny nose. (A nasal suction bulb or infant nasal aspirator are both great options.) A few times a day is plenty for suctioning and clearing mucus; we don’t want to cause extra irritation to the nasal passages. (We'll run through a brief how-to below.)
  • Cool-mist humidifiers. Another way to moisten the mucus is by moistening the air.
  • Put skin protective ointment (such as Aquaphor) around their nostrils to help with breakdown or chapping. A very thin layer and I’d like to emphasize - around, not IN the nose.
  • Wash your hands every time you help your little one with their germs. And wash their little hands, too!
  • Ibuprofen or Tylenol for discomfort. Baby congestion medicines such as over-the-counter cough and cold or nasal sprays are not recommended in our kiddos because they haven’t been proven or medically reviewed. Focus on baby congestion remedies instead! (Remember: no ibuprofen for babes < 6 months old and no meds at all for babes < 3 months old - call the doc!)

How to unclog baby nose using saline spray or nose drops and a bulb syringe or infant nasal aspirator

  • For infants, saline nose drops will be easier to use. For young children and beyond, saline sprays can be used. Both options help loosen the mucus and bring it down into the nose, making it easier to clear by wiping, suctioning, or blowing for the older kids.
  • Put 2-3 drops or sprays into each nostril. Your baby might sneeze or cough with this - that’s okay and might actually help clear the nose too!
  • If you choose a nasal suction bulb, make sure you squeeze the bulb first to get rid of the air and keep it compressed while you insert the end of the bulb syringe into your baby’s nostril. Don’t go too far or it will irritate their nasal passage. Once in the nostril, release the bulb syringe to let air back in. This creates the vacuum and will pull mucus into the bulb with the air.
  • If you choose an infant nasal aspirator, place the soft tip into the baby’s nostril - again, not too far. You will then inhale through the mouthpiece (think: drinking from a straw) and mucus will be caught in the filter (thank goodness).

It’s never fun to watch when your little love is miserable. And then you add boogies and less sleep to the mix and it leaves you praying for healthier days. You’ll get there! Trust your instincts and if everything feels okay (albeit uncomfortable), let this run its course. And don’t leave the house without kleenexes, you’re gonna need ‘em!

Blake Wageman

Blake Wageman, RN, BSN has over 14 years of nursing under her belt, primarily focused on NICU babies and, just as importantly, their worried parents.