Nasal Congestion (Infant/Child)

Home care

Follow these guidelines when caring for your baby's or child's nasal congestion at home:

• Use saline nose spray to loosen mucus. Saline spray is salt water in a spray bottle. It's available without a prescription. Use 1 to 2 sprays in each nostril.

  • For babies, use a rubber bulb syringe (nasal aspirator) to pull out the mucus after using the saline spray. This may work best when your baby is less than 6 months old. Sit your baby upright. (Don’t use the bulb syringe with the child on their back.) Squeeze the bulb before putting it in your baby's nose. Gently put the tip into your baby's nostril, and slowly let go of the bulb to create suction. Do the same for the other nostril. Clear your baby’s nose before each feeding.

• Use a cool mist vaporizer near your baby’s crib or in your child's room. You can also run a hot shower with the doors and windows of the bathroom closed. Sit in the bathroom with your baby or child on your lap for 10 or 15 minutes.

• Keep your baby or child hydrated. For younger babies this means breastfeeding or bottle feeding. Children should drink water or other fluids. Staying hydrated helps thin mucus.

• Don’t give over-the-counter cough and cold medicines to your baby or child unless their healthcare provider has specifically told you to do so. OTC cough and cold medicines have not been proved to work any better than a placebo (sweet syrup with no medicine in it). And they can cause serious side effects, especially in children younger than 2 years of age.

• Don’t smoke around your baby or child and don't allow other people to do so. This includes smoking in your home and car. Cigarette smoke can make the congestion and cough worse.

Follow-up care

Follow up with your child’s healthcare provider, or as directed.

When to get medical advice

Call your child's provider right away if any of these occur:

• Fever (see Fever and children, below)

• Symptoms get worse or new symptoms develop

• Nasal discharge persists for more than 10 to 14 days

• Fast breathing. In a newborn up to 6 weeks old: more than 60 breaths per minute. In a child 6 weeks to 2 years old: more than 45 breaths per minute.

• Your baby or child is eating or drinking less or seems to be having trouble with feedings

• Your baby or child is peeing less than normal.

• Your baby or child pulls at or touches their ear often, or seems to be in pain 

• Your baby or child is not acting normal or appears very tired

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below is when to call the healthcare provider if your child has a fever. Your child’s healthcare provider may give you different numbers. Follow their instructions.

When to call a healthcare provider about your child’s fever

For a baby under 3 months old:

• First, ask your child’s healthcare provider how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

• A fever of ___________as advised by the provider

For a child age 3 months to 36 months (3 years):

• Rectal or forehead: 102°F (38.9°C) or higher

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher

• A fever of ___________ as advised by the provider

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age

• Temperature of 104°F (40°C) or higher in a child of any age

• A fever of ___________ as advised by the provider