From the Guidelines
For nasal congestion in infants, saline drops followed by gentle suction with a bulb syringe or nasal aspirator is the safest and most effective treatment. This approach is recommended as it helps loosen and remove mucus, improving breathing without the use of medications that can have serious side effects in young children 1.
Key Treatment Steps
- Place 2-3 drops of saline solution in each nostril while the baby is lying on their back
- Wait 30-60 seconds to loosen mucus
- Use a suction device to remove the mucus This can be done before feedings and sleep to improve breathing.
Additional Measures
- Keeping the air moist with a cool-mist humidifier in the baby's room and ensuring proper hydration also helps thin mucus
- Elevating the head end of the crib mattress slightly (about 15-30 degrees) can improve drainage, but always place babies on their backs to sleep It's crucial to avoid over-the-counter cold medications, including decongestants and antihistamines, in children under 4 years as they can cause serious side effects and haven't been proven effective in young children, as noted in guidelines for managing rhinitis 1.
When to Seek Medical Attention
- If congestion is accompanied by fever over 100.4°F
- Difficulty breathing
- Poor feeding
- Or lasts more than 10-14 days, contact your pediatrician immediately as these may indicate a more serious condition requiring medical attention.
From the Research
Treatment Options for Nasal Congestion in Infants
- Oral doses of vasoconstrictors such as ephedrine can be used to treat nasal congestion in infants, but care should be taken due to potential contraindications with certain drugs or conditions 2
- Vasoconstrictors can also be given as nasal drops or sprays, but only for a limited period to avoid rebound congestion 2
- Aromatic volatile oils, such as menthol or eucalyptus, can be used as rubs or inhalants, following the manufacturer's instructions for use with young children 2
- Saline nasal lavage is recommended as an adjunct therapy for rhinosinusitis and allergic rhinitis, and can be effective in treating nasal congestion in newborns, infants, and children 3
- Nasal irrigation with physiological saline solution, followed by gentle aspiration, can be an effective method for preventing and controlling nasal congestion in term or preterm neonates, infants, and children 3
Safety and Efficacy of Treatment Options
- Mometasone furoate nasal spray has been shown to be safe and effective for 1-year treatment of children with perennial allergic rhinitis, with significant reductions in overall symptoms and congestion 4
- Intranasal corticosteroids are recommended as first-line therapy for patients with moderate-to-severe allergic rhinitis and prominent nasal congestion, with greater efficacy than placebo, antihistamines, or montelukast for relief of nasal symptoms 5
Importance of Prompt Treatment
- Prompt treatment of nasal obstruction is critical in newborns and infants due to their obligatory nasal breathing, and can significantly impact quality of life and healthcare expenditures in children 6