How to treat your baby's congestion

It doesn't take much to stuff up your baby's tiny nasal passages and airways. Congestion in babies is very common and usually not serious, but it can make eating , playing , and sleeping more difficult for your little one.

"Congestion is common in babies, but it isn't always worrisome and usually resolves on its own," says Michelle Rockwell, M.D., who is double board-certified in Family Medicine and Sports Medicine and is a member of the BabyCenter Medical Advisory Board . "It's helpful for parents to be educated and prepared for when it does happen – because it certainly will!"

What is congestion in babies?

Babies can have nasal congestion and/or chest congestion.

If your baby has nasal congestion (a stuffy nose), it means that their nasal passages are narrowed, either from mucus buildup or from inflammation of the tissues and blood vessels in the nose. They may have a runny nose, too. Irritation and swelling in the nose is also called rhinitis.

If your baby has chest congestion, it means that mucus has accumulated in their air passages and lungs, partially blocking the airways in their chest. They may also have a cough.

Why do babies get congested?

The most common cause of nasal congestion is a viral infection such as a cold , flu , respiratory syncytial virus (RSV), or COVID .

Children younger than 6 years old tend to get between six and 12 colds each year, says Dr. Rockwell. Babies haven't yet built up their immunity, so they're especially vulnerable to infections.

Babies can also be congested without an infection. Pollutants, allergens , cigarette smoke , and even dry air can cause their nasal passages to swell. Babies who spit up a lot may be more prone to nasal congestion because the spit up can come through their nose and mouth and irritate and inflame their nasal tissues.

If your baby has chest congestion, a lower-respiratory-tract infection such as bronchiolitis or pneumonia may be to blame.

Congestion is common in babies, but it isn't always worrisome and usually resolves on its own. - Michelle Rockwell, M.D., BabyCenter Medical Advisor

Signs that your newborn or older baby has congestion

Your baby may have nasal congestion if they:

• Sound stuffy or plugged up
• Have trouble bottle feeding or breastfeeding because they can't get air through their nose
• Are sneezing
• Snore when they sleep, or are having trouble sleeping
• Have a runny nose from too much mucus
• Have a sore throat (they may sound hoarse when they cry or babble)

Your baby may have chest congestion if they:

• Have a wet cough . (If they have a dry, barking cough it's more likely to be croup or whooping cough .)
• Make a sound when they breathe

Practical tips to relieve baby congestion

Whether your baby's congestion is caused by an infection or irritants, there are things you can do at home to help them breathe more easily.

Clear their mucus

Your baby can't blow their nose, so you need to do it for them. Put a few drops of saline in your baby's nostrils to loosen mucus, then use a snot-sucking bulb syringe or nasal aspirator .

You can buy saline drops or spray at the pharmacy, or make your own. To make your own saline drops, the American Academy of Pediatrics recommends combining 1/2 teaspoon of non-iodized salt, 1/4 teaspoon baking soda, and 1 cup (8 ounces) of warm water. (Use water that's sterile, distilled, or previously boiled and then cooled.) Stir to dissolve.

Around the time your baby is about 9 months old (once they can sit up and lean forward), you can try a nasal wash using a neti pot. Be sure to use clean equipment and sterile water. Find directions for using a neti pot in our article on safe home remedies for colds in babies, toddlers, and kids.

Moisten the air

Keep the air in your baby's sleeping area moist by running a cool-mist humidifier . Carefully position the humidifier so the mist can reach your baby, but your baby can't reach the humidifier and pull it over. Always keep the equipment clean (check the manufacturer's directions) so you don't introduce germs into the air.

You can also provide warm, moist air by giving your baby a warm bath or by taking your baby into a warm, steamy bathroom for 15 to 20 minutes.

Keep your baby hydrated

Keeping your baby hydrated by breastfeeding or bottle feeding as usual will help make their mucus thinner, so easier to remove and cough up. You don't need to push more liquids than usual. But it's okay to offer your baby a little bit of water – about 4 to 8 ounces daily – once they're 6 months old.

Avoid cough and cold medicines

It's not safe to give a baby cough and cold medicines. It won't make your baby get better faster. Most importantly, these medications aren't safe for babies. Says the U.S. Food & Drug Administration : "Some cough and cold medicines can have serious side effects, such as slowed breathing, which can be life-threatening, especially in infants and young children."

When to worry about congestion in your baby

Because congestion can be a sign of illness, it's important to know when to call your pediatrician . If your baby is younger than 3 months old , always take them to the doctor at the first sign of illness – including any fever of 100.4 degrees or above. Newborns are vulnerable, and a serious infection such as pneumonia or croup can be dangerous.

For babies 3 months or older, call their doctor if they:

• Are running a high fever , over 102.2 degrees
• Are breathing faster than usual
• Are pausing for ten seconds or longer when they breathe
• Are making sounds when they breathe in and out (wheezing, whistling, crackling)
• Have a dry, persistent cough
• Are vomiting when they cough
• Are pulling at their ears
• Are unusually irritable
• Have thick, green nasal discharge
• Are lethargic, difficult to wake up, or less alert than usual
• Have red eyes or eye discharge
• Aren't eating well
• Are coughing up blood-tinged mucus
• Have signs of mild to moderate dehydration , such as fewer wet diapers, strong-smelling urine, reduced tears, and/or a sticky mouth and lips

Call 911 if your baby has any of these signs:

• They're struggling to breathe. Their nostrils may flare, they might grunt or bob their heads when they breathe, or you may see retractions – pulling in between the ribs or lower neck when they breathe.
• Their lips, face, or fingernails look bluish or gray
• They can barely cry or make any sounds
• They seem to have something stuck in their throat
• They have signs of severe dehydration, such as sunken eyes, excessive sleepiness, a dry mouth and lips, sunken fontanels (soft spots), and only one or two wet diapers in a day