Colds and Stuffy Noses in Babies: Care at Home

Watching a baby with a stuffy nose who is fussy and struggling to feed is hard. A cold is an infection caused by viruses, so antibiotics do not work. According to the American Academy of Pediatrics (AAP), the goal is to keep your baby comfortable and make sure they get plenty of rest and enough fluids. This guide is based on AAP and NHS recommendations and explains especially when you should not wait.

Symptoms and how long they last: According to the AAP, a cold can cause:

• A runny nose, clear at first, then thicker and often colored
• Sneezing
• A mild fever, especially at night
• A sore throat and trouble swallowing
• Coughing
• Fussiness on and off

In a cold that runs its course without problems, symptoms slowly ease within 7-10 days. According to the NHS, a cold can be contagious for 1-2 weeks, and in young children this can last even longer.

Under 3 months? Doctor first: The AAP recommends calling your pediatrician at the first sign of illness in a baby 3 months old or younger. According to the NHS, get medical help without waiting if a baby under 3 months has a fever of 38°C (100.4°F) or higher, or a baby aged 3-6 months has a fever of 39°C (102.2°F) or higher. At this age, a "let's wait a few days" approach is not right.

Not every symptom needs treating: There is no cure for a cold; the body fights off the virus itself. The AAP says many children with a cold keep playing and sleeping normally, and only symptoms that really cause discomfort need easing. According to the AAP, safe home remedies can sometimes work better than medicines in young children.

Stuffy nose: saline and an aspirator: Babies cannot blow their own noses, so congestion can make feeding and sleep harder. The AAP recommends:

• Putting 2-3 drops of saline (salt water) into each nostril, or using it as a spray. It is available over the counter.
• Then gently suctioning out the drops and loosened mucus with a rubber bulb syringe or nasal aspirator.

This simple method is one of the safest ways to bring relief without medicine.
Humid air also helps: the AAP recommends using a humidifier if the air at home is dry. But remember the NHS warning: never have young children breathe steam from a bowl of hot water, because of the risk of scalding.

Feeding and fluids: Keep giving breast milk or formula; getting enough fluids is important for your baby's recovery. The NHS also recommends giving fluids often in bronchiolitis, which starts out like a cold. If your baby is feeding noticeably less than usual, you should tell your doctor.

Be careful with medicines:

• The AAP does not recommend over-the-counter cough and cold medicines for children under 4; between ages 4 and 6, they should be used only if a doctor recommends them.
• According to the NHS, decongestant medicines should not be used in children under 6.
• Talk to your doctor or pharmacist before giving your baby any medicine.
• Aspirin is not given to children; the NHS sets this limit at age 16.
• According to the AAP, menthol chest rubs are only suitable from age 2 and up.
• Antibiotics do not work against viruses.

Honey: never before age 1: You will often hear honey suggested for coughs, but the AAP and NHS are clear that honey should not be given to babies under 12 months. According to the AAP, the reason is the risk of botulism in babies. Honey can only become an option after age 1.

A cold or bronchiolitis? According to the NHS, bronchiolitis looks very much like a cold at first. Symptoms are usually at their worst on days 3-5, and the cough usually goes away within 3 weeks. If, after a runny nose, you notice noisy breathing that wheezes or crackles, breathing faster than normal and less feeding, watch your baby closely and talk to your doctor.

Call your local emergency number right away: According to the NHS, these symptoms are emergencies:

• Trouble breathing: grunting sounds, or the belly sucking in under the ribs with each breath
• Pauses in breathing
• Skin, tongue or lips turning blue or gray
• Not responding or not being able to stay awake
• A first-ever seizure
• A rash that does not fade when you press a glass against it

When should you see a doctor? According to the NHS and the AAP, talk to your doctor without waiting if:

• The cold is getting worse instead of better
• Your baby is feeding noticeably less than usual
• Their diaper has been dry for 12 hours or longer
• Their breathing is wheezy or faster than normal
• Their nostrils flare with every breath
• Your baby is more sluggish or fussier than usual
• The runny nose lasts longer than 10-14 days, or the cough longer than 10 days

When something does not feel right, asking your doctor is always the right call.

Dear mom, watching a baby with a stuffy nose is tiring, but most colds ease within a few days with saline, plenty of fluids and your loving care. Pay attention to your baby's age and breathing; when in doubt, do not hesitate to ask.