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All Stopped Up

Nasal Congestion in Infants

By Lisa A. Goldstein

es and loosen thick nasal discharge, making it easier to remove with bulb suction. Saline can be purchased at a store or made at home by mixing 1/2 teaspoon of salt in 8 ounces of water, says Dr. Brown, who also recommends putting a wedge under the baby's mattress for elevation.

"Never use old-parent remedies like blowing into one of the baby's nostrils to clear the other nostril," says Dr. Conway. "This is potentially dangerous and should not be done." She also emphasizes never using over-the-counter medicine without consulting a physician first. For example, never use acetaminophen (Tylenol) for reducing fever in an infant less than 2 months of age, she warns, because fever in this age group can be secondary to neonatal-acquired infections that can be of late onset and potentially devastating. "As a result, any fever greater than 100.4 should not be treated by parents at home and the baby should be evaluated immediately (if less than 2 months of age) by a physician," she adds.

If you're thinking your cold remedy would work for your child, think twice. "Most pediatricians do not feel comfortable giving antihistamines/decongestants to children less than a year old," says Dr. Conway. "Studies suggest that while these medicines help dry nasal passages in adults, their only benefit in the young child is that of sedation. Further, the effects of pseudoephedrine for nasal congestion have not been widely studied in very young children. It is known to cause increased heart rate and raise the diastolic blood pressure of adults who take it. It is therefore not recommended or children less than 1 year of age."

Medication, such as nasal decongestants, often "wires the babies up and then you have a snotty awake baby instead of a snotty sleeping one," adds Dr. Brown.

Nasal congestion frequency may also depend on the baby's exposure to others. Wilkins' son, for example, started daycare in September when he was almost 9 months old. He gets colds more often now. He probably only had one or two colds before daycare, says his mother, but now they seem to pass them around so he gets them once a month. "The doctor isn't concerned and seems to think it's par for the course," she says.

The important thing to remember is that "most nasal congestion will cause nothing more than a little aggravation for the baby as well as the parents," says Dr. Conway. She says what's most important is for parents to make sure that the baby is not:

• Feverish
• Having persistent difficulty with feeding
• Unable to sleep
• Having any respiratory distress (breathing fast with flaring of the nostrils or deep, rapid retractions of the chest muscles with breathing)

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