Helping young children with nasal congestion

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.

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Pediatrician DR.PAUL Roumeliotis is certified by the American Board of Pediatrics and Royal College of Physicians and Surgeons of Canada. The information provided above 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.