Definition

• Nasal congestion can be the worst part of a cold for young children
• It can keep your baby from feeding and sleeping well
• Nasal suction with a little saline or water can save the day

Health Information

General

• Nose secretions are a normal part of the common cold. Most come from the sinuses. Reason: Viral sinusitis is a part of all colds.
• The discharge stays clear for a few days and then becomes cloudy. Sometimes, it becomes yellow or green colored for a few days. This is still normal.
• Thicker discharge is more common with sleep or low humidity. Allergy medicines also make the nose discharge thicker. Reason: All of these reduce the amount of normal nasal secretions. So, the discharge dries out.
• Reality: Cough and cold medicines can’t remove dried nasal discharge from the nose. Neither can antibiotics.
• What to doƒ Nasal saline (salt water) and suction to the rescue.

Symptoms of Nasal Congestion: Is Nasal Suction Neededƒ

• Nasal congestion varies in severity.
• Most nasal congestion just causes a little noisy breathing. Your baby or child is not even aware of it. This kind doesn’t need any treatment.
• Nasal congestion needs treatment if it interferes with function.
• The main example in infants is trouble during breast or bottle feeding. When the mouth is closed the baby can’t breathe through the nose. Therefore, the baby has to stop feeding to breathe. This degree of blockage can be seen by putting a pacifier in the mouth.
• Nasal congestion can also cause loud noisy breathing. The child is usually fussy when the breathing reaches this level. Sometimes with noisy breathing, you can’t see blockage in the front of the nose. This usually means the dried mucus is farther back.
• These infants need nasal saline drops or spray to loosen up the dried mucus. If you don’t have, you can use bottled water or boiled tap water. Sometimes, the saline alone will cause the child to sneeze out the mucus. Other times, the saline will wash the mucus to the back of the nose. Then, it can be swallowed. Others will need nasal suction to get out the mucus.
• Rule 1: Never suction without first loosening up the mucus with saline. If you don’t have any, you can use a few drops of clean tap water. (If under 1 year old, use bottled water or boiled tap water.) Reason: Suction or nose blowing alone can’t remove dried or sticky mucus. Use 3 drops in each nostril.
• Rule 2: If the saline opens up the nose, suctioning is not needed. Goal: Avoid needless suctioning.
• Another option: Use a warm shower to loosen mucus.
• For young children, can also use a wet cotton swab to remove sticky mucus.
• Caution: Never use the suction bulb to put the saline in the nose. Reason: Suction bulbs are usually dirty with germs.

Care Advice

1. Nasal Suction - How to Do It If Your Child Needs It:
   • Nasal suction must be done gently.
   • Put in a few drops of saline.
   • Compress the suction bulb.
   • Then put the tip inside the nasal opening, but not very far.
   • Create a seal by pressing the outer nose against the tip.
   • Then release the bulb so it will pull in secretions.
2. Prevention of Side Effects:
   • Putting the bulb in too far will cause trauma to the nose lining. It will hurt and can cause swelling.
   • Sometimes, it causes bleeding. A nosebleed after nasal suction means it was done too forceful.
   • Suction gently and try to limit to 4 or less times per day. Suctioning too often can cause increased swelling and congestion.
3. Best Suction Device:
   • Buy a suction bulb with a blunt tip. Buy one that completely covers the nasal opening.
   • Better yet, buy a NoseFrida or Baby Comfy Nose. They are special nasal aspirators that makes a seal without entering the nose. They are 10 times more powerful than a suction bulb. They cost around $15, but reviews suggest it’s worth it.
4. Older Children and Blowing the Nose:
   • Older children can blow their nose once they are 3-4 years old. Then, they no longer need nasal suction.
   • But, in winters with low humidity and forced heat, they still need nasal saline. This will loosen up mucus before blowing. Otherwise, the mucus often holds tight.
5. Nasal Flushes and Teens:
   • This is when saline is squirted in one nostril and comes out the other.
   • Most kids hate nasal flushes, so they are not advised until the teen years.

Call Your Doctor If

• Your child is having trouble breathing
• You think your child needs to be seen
• You have other questions or concerns

Author: Barton Schmitt MD, FAAP

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.