Nasal congestion is simply nasal mucus that is partially obstruction the nasal passages. Nasal congestion is not a runny nose, but rather is a stuffy nose. A stuffy nose will sound "stuffy" or nasally, but will not be runny.
Nasal mucus is produced to moisten the air entering the lungs to prevent drying out the lungs. Nasal mucus is also produced in response to a nasal irritation such as with cigarette smoke, hair spray, perfume, house dust, stove smoke (wood and coal) or when someone suctions the nose too vigorously. When the child can't remove the dried secretions on their own, then the mucus will partially obstruct the airway and the parents will hear congestion.
Nasal congestion is not an infection and therefore cannot be spread.
Nasal congestion is almost universal among infants below 6 months of age and among all of us in the winter. Even without treatment, most congestion will subside about 6 to 8 months of age. Some children will have abnormally small nasal passages, allergies or continued exposure to irritants and the symptoms could continue indefinitely.
First, try to remove the irritants listed above that may be causing the congestion.
Second and most importantly, run a vaporizer in the child's room. A cool mist vaporizer is much better for croup, while a warm mist vaporizer may be slightly better for colds and a humidifier is quieter, otherwise there is no difference in which device you use. If you don't have one yet and money is short buy a cool mist vaporizer so you won't have to buy one later for croup.
Third, use saline nose drops to loosen the nasal mucus. You can buy over the counter saline nose drops (Ocean spray, Ayre, Nasal, etc.) or make your own. Make fresh saline nasal drops daily by mixing 1/4 tsp. of table salt in a cup of water. Put a drop or two of the saline into one nostril. Leave it in a minute while massaging the side of the nose (optional), then suction out the nose if you can see something there. What you don't get out, your child will just swallow naturally. Do only one side at a time.
Fourth, don't suction the nose too vigorously or you will irritate the nose and cause it to produce more mucus.
Fifth, don't use the suction bulb the hospital gave you with the long pointy end. This is actually an ear syringe and when place too far in the nose will make the mucus worse. Try sticking a q-tip up you nose to see how it feels and see if you get stuffy. Use instead the kind with the blunt clear screw in piece.
Sixth, make sure to suction before feeding and bedtime.
Seventh, do not use cold medicines or decongestants. As appealing as they sound, they really don't help and I have seen too many patients hit the emergency room with seizures, irritability and hallucinations from cold medicines.
Eighth, elevate the head of the child's bed to help the secretions drain.
Ninth and lastly, recognize that nasal congestion is normal and will be a part of your life for the next few months. A baby that's comfortable and resting but is congested does not have a problem until someone tries to stick something up their nose.
WHAT LOOKS LIKE NORMAL CONGESTION?
Nasal congestion is fairly distinct, but some other problems can be similar:
Allergies: This gives a runny nose, not generally a stuffy one. There often will be pinkness to the eye lids and clear runny itchy eyes. Allergies also do not really start until 6 months of age.
Choanal Atresia: The is a membrane that blocks one or both nasal passages. A infant with both passages blocked would not get out of the hospital without us finding it. If one of the passages was blocked, the baby would only be able to breathe out of one nostril. You can test for this by simply blocking one nostril and listening to see if the baby breathes out the other. This will not resolve on its own and cannot just show up later, therefore, if your child had been able to breathe through that nostril before then this is not the cause.
Colds: a cold gives a runny nose not a stuffy one, but you can treat a cold the same way. Colds also give low grade fevers and a cough, which nasal congestion never has with it.
Nasal polyp: These are quite unusual in this age range, in fact I have never seen one in a infant. This would be essentially like a choanal atresia except that it is not present at first and grows later.
Sinus infection: This is usually a profusely runny nasal discharge that is green and associated with a "face ache" and low grade fevers. Infant’s sinuses are so small, they really can’t get a sinus infection for the first few years.
Nasal congestion is easy to diagnose and treat on your own. If you see something not mentioned here or something changes, then you may want to let your physician know:
During business hours if: the mucus become profuse and green (green nasal mucus is a normal healing process provided it only lasts a few days) or worsens over a couple of days, there is a low fever (<102), you have tried all of the above without success (nothing cures it you can just make your child comfortable for awhile), your child has moderate difficulty with eating (after you have suctioned them out of course).
Immediately if: your child develops great difficulty breathing even after suctioning.
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