A runny nose is common in babies and can be distressing for both infants and caregivers. This article offers guidance on safe home care strategies, medications to avoid, and situations requiring professional medical attention.
Safe Home Remedies
Keeping a baby well-hydrated is a primary step in managing a runny nose, as adequate fluid intake helps thin mucus, making it easier to clear nasal passages. For infants, consistent breastfeeding or formula feeding is important. For babies six months or older, water, diluted juice, or warm broths can supplement their fluid intake.
Saline nasal drops or spray safely loosen mucus and moisten nasal passages, which can improve breathing. After applying saline drops, a bulb syringe or nasal aspirator can be used to gently suction out the loosened mucus. When using a bulb syringe, squeeze the bulb to expel air, then gently insert the tip into the nostril to create a seal before slowly releasing the bulb to suction out mucus. For nasal aspirators, which often involve mouth suction, a filter prevents the transfer of mucus and germs. Suctioning should be limited to about two to four times a day to avoid irritating the nasal lining.
A cool-mist humidifier in the baby’s room adds moisture to the air, helping alleviate congestion and prevent nasal passages from drying out. It is important to clean the humidifier regularly to prevent the growth of mold and bacteria. Elevating a baby’s head slightly during sleep can also help mucus drain and reduce congestion, which can be achieved by placing a towel or small wedge under the mattress to create a gentle incline.
Medications to Avoid
Over-the-counter (OTC) cold and cough medications are not recommended for babies and young children due to potential serious side effects. The Food and Drug Administration (FDA) advises against using these products in children younger than two years, and manufacturers often label them with warnings against use in children under four years. These medications have not consistently shown effectiveness in young children and can pose risks such as slowed breathing, which can be severe for infants.
Decongestants and antihistamines should be avoided for children under two years, as they can cause side effects including convulsions, rapid heart rates, and hyperactivity. Some antihistamines, like diphenhydramine (found in Children’s Benadryl), are not suitable for children under two years unless specifically directed by a doctor due to potential severe side effects. Oral decongestants like pseudoephedrine should not be given to children younger than 12 years.
Aspirin should not be given to children under 16 years of age unless specifically advised by a doctor for certain medical conditions. This is due to a rare but severe condition called Reye’s syndrome, which can cause brain damage and liver problems, particularly when aspirin is given during a viral illness like the flu or chickenpox. There are alternative medications, such as acetaminophen or ibuprofen, that are considered safer for pain and fever relief in children, provided they are used according to age and weight guidelines.
When to Seek Medical Advice
While many runny noses resolve with home care, certain signs indicate the need for professional medical evaluation. Contact a doctor if a baby under three months has any cold symptoms, including a runny nose. A persistent high fever, especially 100.4°F (38°C) or higher in babies under 12 weeks, warrants medical attention. For babies over 12 weeks, a fever above 104°F (40°C) is concerning.
Difficulty breathing requires immediate medical attention. This includes fast breathing, wheezing, flaring nostrils, or retractions (skin pulling in around ribs or neck with each breath). Signs of dehydration, such as fewer wet diapers, dry lips, lack of tears, or a sunken soft spot, also necessitate contacting a pediatrician.
Other indicators for seeking medical advice include a runny nose lasting over 10 days without improvement, persistent fussiness or lethargy, refusal to feed, or worsening symptoms. Ear pain or pulling at the ears, a rash, or any concerning changes in the baby’s behavior or condition should also prompt a call to the healthcare provider.