From the Research
For a 20-month-old child with nasal congestion, supportive management using saline nasal drops and gentle suctioning with a bulb syringe or nasal aspirator is the most effective approach, as evidenced by a literature review on non-pharmacological treatments 1.
Key Management Strategies
- Use saline nasal drops (2-3 drops in each nostril) followed by gentle suctioning with a bulb syringe or nasal aspirator before feedings and sleep to improve breathing and comfort.
- Keep the child well-hydrated with frequent small amounts of fluids.
- Utilize a cool-mist humidifier in the child's room to moisturize the air and thin secretions.
- Elevate the head of the bed slightly by placing a towel under the mattress to help drainage.
Avoidance of Certain Treatments
- Avoid over-the-counter cold medications due to potential side effects and limited efficacy in children under 4 years, as noted in studies on nasal decongestants 2.
Additional Considerations
- If fever is present, acetaminophen (Tylenol) can be given at 10-15 mg/kg every 4-6 hours as needed.
- Contact a healthcare provider if congestion persists beyond 10-14 days, if the child has fever above 102°F (38.9°C) for more than 2-3 days, shows signs of respiratory distress, ear pain, or appears significantly ill. These measures prioritize the child's comfort, safety, and natural recovery process, aligning with the latest recommendations on non-pharmacological treatments for nasal congestion in infants and children 1.