Pediatrics: Lillian Beard, M.D.

My 5-month-old has her first cold. She's so stuffed up it's hard for to eat, and she wakes up a few times a night because she's so uncomfortable. What can I do to alleviate her symptoms?

By Lillian Beard, M.D.

Most infants are miserable when they are not able to breathe through their noses. To clear her nose, you can try saline (salt water) nose drops. They are readily available over the counter at your local drug store. There are several different brand names; just ask the pharmacist to assist you. (And make sure you buy only saline nasal drops; many nose spray contain decongestants not suitable for an infant.) Just two drops into each nostril will help to thin any mucus secretions which may be causing stuffiness in her tiny nasal passageways.

Also, to clear away the secretions, you can use an infant "ear" syringe, (a rubber bulb syringe with a long snout). These are ideal to fit into babies' tiny noses. Instill two saline drops into one nostril, squeeze the bulb syringe before placing the tip in baby's nose, then release the bulb and this negative pressure will pull the now thinned secretions from the nostril. Repeat this maneuver in the other nostril. It functions as a 'nose blower' for babies. This can be done up to four times per day (more than this can be irritating to the nasal passages). Before feedings and sleep are ideal. Be careful not to squeeze the bulb of the syringe into the nose; that would painfully push air and mucus further into the back of the nose.

In addition, just elevating the baby's head and chest to at least a 45-degree angle during feedings and when sleeping will increase her comfort level. Adding moisture to her bedroom or playroom using a cool-mist humidifier will also enhance her comfort. If she stills seems uncomfortable despite these steps, ask your pediatrician if she can recommend one of the over-the-counter oral decongestant medications specially formulated for infant use.

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