Congestion in infants

Nasal congestion is a frequent complaint for children in the first 4 months of life. The major causes of congestion are:

1.) Anatomic/Physiologic - Infants have both small nasal size and an inability to breathe through their mouths. Fortunately, congestion caused by these problems resolves by 4 months in most children.

2.) URIs (upper respiratory tract infection AKA “a cold”) - Even mild “cold” symptoms will make children in the first few months miserable. They often cause decreased appetite, decreased sleep and increased fussiness.

3.) GERD - Gastroesophogeal reflux disease is often a cause of congestion in the first several months. Children who spit up through their nose or merely reflux into their nasal passages often will have congestion for days. Thicken feeds, frequent burping and holding a child upright can reduce the congestion caused by GERD.

**note I do not believe allergies can cause symptoms until 6 months of age

There are few effective options to treat congestion:
1.) Holding a child upright and elevating the head of their bed (30 degrees).
2.) Saline and the bulb syringe.
3.) Running a humidifier in the child’s room.

** note over the counter cold medicines are not approved at these ages

If your child’s congestion seems severe or there are additional symptoms please see your doctor.

Written March 2010 by
Dr. Gordon, Orlando Pediatrician