DEAR DR.PAUL: My eight-month-old daughter has had a cold
for about a week. Symptoms are - nasal congestion with thick yellow-green
mucous. My husband and I are concerned that she may not be getting
the sleep that she needs due to her difficulty breathing. I would
like to give her a decongestant but my husband is reluctant because
of concerns about side effects. What can we do to help her?
PEDIATRICIAN DR.PAUL Answers: A very important and
common question. Young children with colds and associated nasal
congestion/secretions have a particularly hard time breathing
as they are "obligate nose breathers." In other words, they
don't really know how to breathe through their mouth if their
nose is blocked. As they get older, they learn to mouth-breath,
and therefore become less uncomfortable when their nose is congested.
Another important fact is that most younger children do not
know how to blow their nose.
As a general rule, cough and or decongestant syrups or preparations
should not be readily given to children younger than two years
of age because of their associated potential side effects. On
the other hand, if a young child is uncomfortable, we want to
help. Most of the time we can help out by using some simple
techniques, and avoid medications. Here are some practical tips
on how to handle a young child's nasal congestion/secretions
during a cold:
1. Make sure there is adequate humidity in the child's room.
2. Ensure that the child is drinking enough. The ill child will
probably drink less per feed than usual, but will drink more
frequently.
3. Try to help clear the secretions in the nose. Salt water
drops like Salinex are helpful but only if used properly. Just
putting a few drops into the nose will not clear out the secretions.
What I recommend is to put in the salt water drops, and a minute
or two later use a nasal pump to help suck out and clear the
secretions. In this way we sort of help the child "blow" or
clean out her nose.
This is an important point because the drops will not directly
help clear the secretions. In fact, what they do is help to
loosen the dry secretions so that the nasal suction pump can
get rid of them. Trying to suck out dry secretions with the
nasal pump is not very effective. If after these steps a child
is still uncomfortable, parents should discuss the next step
with their doctor.
As children get older, two things happen: One, the nasal passages
get bigger and are less easily blocked and second, children
eventually learn to blow their nose on their own. Encouraging
them to learn to do this as early as possible is helpful. Often
a child may learn to blow her nose by imitating a parent who
is blowing her nose. Older children who understand the concept
of blowing up a balloon or blowing into a straw can be instructed
to blow in the same way) through their nose. By practicing this
they will eventually learn to blow their nose on their own.
The information provided in this site is
designed to be an educational aid only. It is not intended to
replace the advice and care of your child's physician, nor is
it intended to be used for medical diagnosis or treatment. If
you suspect that your child has a medical condition, always
consult a physician.
