From the Guidelines
For a 3-month-old infant with congestion, I strongly recommend avoiding oral decongestants due to the risk of serious side effects, including agitated psychosis, ataxia, hallucinations, and even death, as reported in studies 1. Instead, consider the following management strategies:
- Saline nasal irrigation using a nasal aspirator or a bulb syringe to gently remove mucus and irritants from the nasal passages.
- Elevating the head of the infant's bed by about 30 degrees to help reduce congestion.
- Using a cool-mist humidifier to add moisture to the air and help loosen mucus.
- Offering plenty of fluids, such as breast milk or formula, to help thin out mucus and keep the infant hydrated.
- Avoiding over-the-counter cough and cold medications, as they are not recommended for infants under 6 months old due to the risk of serious side effects.
- Considering a trial of a hypoallergenic formula if the infant is formula-fed, as milk protein allergy can cause symptoms that mimic congestion, as suggested in study 1. It's essential to consult a healthcare provider if the infant's congestion persists or worsens, as they can provide personalized guidance and recommend further treatment if necessary.
From the Research
Management Strategies for Congestion in a 3-Month-Old Infant
- Nasal congestion in infants can be caused by various factors, including viral upper respiratory tract infections, neonatal rhinitis, and milk/soy allergies 2
- Saline nasal lavage is recommended as an adjunct therapy for rhinosinusitis and allergic rhinitis, and can be effective in treating nasal congestion in infants 2
- The Narhinel method, which involves nasal irrigation with physiological saline solution followed by gentle aspiration, has been deemed safe and effective for treating nasal congestion in babies with viral infections of the upper respiratory tract 2
- Nasal decongestants can be used to relieve nasal congestion, but their use should be limited and caution should be taken to avoid rebound congestion 3, 4
- In infants, nasal suctioning and hydration are recommended as supportive management for lower respiratory tract infections such as bronchiolitis 5
- Aromatic volatile oils, such as menthol and eucalyptus, can be used as rubs or inhalants to help relieve nasal congestion, but care should be taken when using these products in young children 4
- There is limited evidence on the effectiveness and safety of nasal decongestants in children, and more research is needed to standardize their clinical use 3, 6