Stuffy or runny nose - children
Nose - congested; Congested nose; Runny nose; Postnasal drip; Rhinorrhea
A stuffy or congested nose occurs when the tissues lining the nose become swollen. The swelling is due to inflamed blood vessels.
The problem may also include nasal discharge or "runny nose." If excess mucus runs down the back of the throat (postnasal drip), it may cause a cough or sore throat.
You've got that feeling again: Your nose is stuffy, your head seems heavy, and your sinuses feel swollen and on fire. You once again, have Nasal Congestion. Many people think that their nose gets congested from too much thick mucus. But, usually, your nose gets stuffy when the tissues lining it become swollen. The swelling is from inflamed blood vessels. Your nose can become stuffy because of a cold, the flu, and allergies. Sometimes the congestion goes away in a week, sometimes you have it nearly every day or during certain times a year, especially if you're allergic or sensitive to something like pollen, tobacco smoke, or pet dander. If your baby is congested, you can make your own saline drops, adding a quarter teaspoon of salt to a half-cup of lukewarm water. Lay your child on his or her back, put a rolled up towel beneath their shoulders, and put two or three drops into each nostril. After 30 seconds, turn the child on their belly to help the fluids drain. You can also use an infant nasal bulb, called an aspirator, to help remove some of the mucous in their nose. Other tips for helping kids include raising the head of your child's bed; Have your child drink plenty of fluids; Use a cool-mist vaporizer in your child's room at night; DO NOT use over-the-counter cough and cold medicines for any child under the age of 6. They don't help much anyway, and they can cause serious health problems in kids. Older kids and adults can take over-the-counter medicines to help relieve their stuff nose. Oral decongestants can shrink the blood vessels throughout the body, including in the lining of your nose. Nasal decongestants are more targeted, but shouldn't be used more than 3 days in a row. Antihistamines may reduce the amount of mucus in your nose. But these medicines don't treat the problem, just the symptoms. You can also try gentler solutions, like a Neti pot, saline irrigation, saline nasal drops, using a vaporizer or humidifier when you sleep, and drinking plenty of fluids such as hot tea or chicken soup. A stuffy nose will usually go away in about a week. But if it doesn't, or you get congested at certain times of year or when you're around pets or smokers, your doctor can help you find out if you have allergies and get you the right treatment to make any allergies less of an annoyance.
Most of the time, nasal congestion in older children and adolescents is not serious by itself, but can cause other problems.
When nasal stuffiness is just on one side, the child may have inserted something into the nose.
Nasal congestion can interfere with the ears, hearing, and speech development. Congestion that is very bad may interfere with sleep.
The mucous drainage may plug up the eustachian tube between the nose and the ear, causing an ear infection and pain. The mucous drip may also plug the sinus passages, causing sinus infection and pain.
A stuffy or runny nose may be caused by:
- Common cold
- Sinus infection
The congestion typically goes away by itself within a week.
Congestion also can be caused by:
- Hay fever or other allergies
- Use of some nasal sprays or drops bought without a prescription for more than 3 days (may make nasal stuffiness worse)
- Nasal polyps, sac-like growths of inflamed tissue lining the nose or sinuses
- Vasomotor rhinitis
- Small objects in the nostril
Tips to help infants and younger children include:
- Raise the head of your child's bed. Put a pillow underneath the head of the mattress. Or, place books or boards under the legs at the head of the bed.
- Older children may drink extra fluids, but those fluids should be sugar-free.
- You can try a cool-mist vaporizer, but avoid putting too much moisture in the room. Clean the vaporizer every day with bleach or a disinfectant cleaning product.
- You can also steam up the bathroom shower and bring your child in there before bed.
A nasal wash can help remove mucus from your child's nose.
- You can buy a saline spray at a drugstore or make one at home. To make one, use 1 cup (240 milliliters) of warm water, 1/2 teaspoon (3 grams) of salt, and a pinch of baking soda.
- Use gentle saline nasal sprays 3 to 4 times per day.
If your child has allergies:
- Your health care provider may also prescribe nasal sprays that treat allergy symptoms.
- Learn how to avoid triggers that make allergies worse.
Nasal sprays are not recommended for children under age 2. Don't use over-the-counter nasal sprays more often than 3 days on and 3 days off, unless told to by your provider.
You can buy cough and cold medicines without a prescription. They do not seem to be effective in children.
How do you treat congestion in babies? I'm Dr. Alan Greene and particularly when over-the-counter decongestants became clear they're not good for babies, parents have been wondering all the more how do you deal with it then? There are a few things. First of all, there's the bulb syringe which you probably went home from the hospital with. And it actually can be effective at helping to pull some of the mucous out - some of the viral load out as well of the nose. They're very easy to use. The trick is you just squeeze everything as much air as you can out of the bulb syringe to start, then gently push it as far as it will go up into the nose and release. Then it will pull both virus and mucous out. You can get more out if you put a few drops of saline nose drops in first. That'll help make it more difficult for the virus to reproduce. It'll help loosen things up so you can pull more out. They can act a bit as a natural decongestant as well. Do the nasal drops, wait maybe 10 minutes, and then do the bulb syringe. Other things that help - gravity can be your friend. All of us tend to be more congested when we're lying flat when our head is about the same level as our heart. And that's even more true for babies. They're more responsive to gravity. So if you're holding the baby upright against your shoulder with their head above their heart, they will naturally and quickly be less congested. Another thing that can be very helpful is a vaporizer. And the way that works a vaporizer humidifier by putting extra moisture in the air will help to thin the mucous so the mucous will draw that extra moisture in and will be thinner and easier to get out either by the bulb syringe, by sneezing, or just the baby's own mechanisms. So there are gentle and natural ways you can help relieve congestion in your young baby.
When to Contact a Medical Professional
Contact the provider if your child has any of the following:
- A stuffy nose with swelling of the forehead, eyes, side of the nose, or cheek, or that occurs with blurred vision
- More throat pain, or white or yellow spots on the tonsils or other parts of the throat
- Discharge from the nose that has a bad smell, comes from only one side, or is a color other than white or yellow
- Cough that lasts longer than 10 days, or produces yellow-green or gray mucus
- Symptoms that last more than 3 weeks
- Nasal discharge with fever
What to Expect at Your Office Visit
Your child's provider may perform a physical exam that focuses on the ears, nose, throat, and airways.
Tests that may be done include:
- Allergy tests on skin and blood tests
- Blood tests (such as CBC or blood differential)
- Sputum culture and throat culture
- X-rays of the sinuses and chest x-ray
- CT scan of the head
Lopez SMC, Williams JV. Rhinoviruses. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier;2020:chap 290.
McGann KA, Long SS. Respiratory tract symptom complexes. In: Long SS, Prober CG, Fischer M, eds. Principles and Practice of Pediatric Infectious Diseases. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 21.
Milgrom H, Sicherer SH. Allergic rhinitis. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier;2020:chap 168.
Last reviewed on: 7/19/2021
Reviewed by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.