An infant with a stuffy nose can be a difficult problem. Unlike older children an infant does not know how to breathe through their mouth. They must breathe through their nose no matter how stuffy. Most stuffy noses and colds are caused by viruses – small germs that are not killed by antibiotics. Viruses are passed from person to person by kissing, sneezing, breathing into another’s faces or most importantly by failure to wash hands. Certain things will make a person more likely to develop a cold such as hay fever, fatigue, air pollution (cigarette exposure) or anything that causes irritation to the lining of the nose. Some feel that vitamin C does not prevent a cold, but it may be helpful in alleviating symptoms of a cold, at least in adults. A small supplement of vitamin C will not be harmful to your infant or child but is not necessary.

When your baby begins to develop a cold, they will be fussy and irritable. They may run a fever during the early stages. Usually, the runny nose or stuffy nose will start shortly afterwards. Occasionally, there will be a cough. Seldom will the fever last over 48 hours or be high. The baby’s appetite for solid foods will usually decrease more sharply than for the bottle or other liquids. The symptoms of the cold may last seven to ten days with occasional continued runny nose for two to three weeks. The other symptoms usually go away within a few days.

The color of the mucus does not indicate a more serious form of cold. Most colds start with a clear discharge that turns gray, yellow or green. Occasionally, a small amount of bloody discharge will be seen representing irritation of vessels near the surface. Do not be overly concerned. Using a vaporizer and a small application of Vaseline or antibacterial ointment to the inside of the nose will relieve the irritation.

Unfortunately, there is nothing to make the cold go away or to cure it. You can however, make the child more comfortable by following these directions:

1. Use acetaminophen (Tylenol®) for fever over 100.5°F. this will help only the fever, not the cold. You may give acetaminophen or ibuprofen according to the instructions on fever (see Fever section).
2. Vaporizers are helpful in keeping the mucus loose and runny. The safest is the cool air vaporizer (producing a cool, visible mist) and it should be used next to the crib, pointing directly at the child from three to four feet away (see Vaporizer section).
3. A nasal bulb syringe, sometimes called and ear syringe, is useful in clearing the mucus by suction. When using a syringe, it should be placed firmly against the child’s nostril and gentle suction should be repeated three to six times in each nostril.
4. Elevate the head of the bed/mattress or put the baby to sleep in the infant seat. This promotes drainage.
5. Saline nose drops may be useful for short-term treatment. Ayr, NaSal, Ocean and other infant saline nasal drops may be obtained at the drug store. Use 2-3 drops in each nostril every 2-4 hours as needed for congestion and to promote drainage, followed by suction. Do not use the nose drops just because the baby “sounds stuffy” or is making a lot of noise with breathing.
6. Continue to offer regular diet even if the appetite is decreased.
7. Cold medications are discouraged due to the potential for side effects. Do not use without specific instructions on dosage based on weight. Refer to the section on cold medications on our website or call the office.

Arrange an appointment in the office if:

• Fever lasts more than 48 hours (if 48 hours is up in the evening, please call before 5 pm or during office hours)
• Fever develops after the cold has been established for several days
• The child seems to be in pain
• You hear wheezing or crackling in their cough
• The child is experiencing chest pain, or is breathing rapidly and deeply as if they have been running or exercising vigorously
• The child seems more ill than is described here. Ear infections are a common complication of colds in many infants and young children. Fever, extreme fussiness, poor sleep, mattering of the eyes, or pulling the ears may be a sign of ear infection. Children with these symptoms should be examined.