Baby Colds and Cleaning out their Noses: Handout


Cleaning out phlegm and mucus from a baby’s nose.  


Nasal Suction with Saline

Babies and small children can’t blow their nose.  They can’t clear their throat and chest of mucus very well either.   The best way to reduce mucus in the nose and airway of a small child is to clean it out with salt water, called saline.  Like when you go to the beach and your nose drips, the salt water helps thin out the mucus making it easier to suction or swallow.
Aggressively cleaning out the mucus, whenever your child is stuffy, makes it much easier for them to breathe (and eat).  The reclining position shown in the link below, makes it easy for one person to clean out the nose alone.  In this position, gravity helps pull the saline into the sinuses where the mucus is hardest to get to.  What ever you cannot suck out with the suction bulb, will be thinner, and easier for your child to swallow (since your baby cannot blow it’s nose by itself).  In the reclining position, the water will go down towards the sinuses, but they breathe up to the chest, so they wont choke.
A little blood in the mucus is normal, like when someone picks their nose.  There should not be a lot of bleeding though.
It can be done as often as needed when the child is stuffy.

 We don’t treat babies’ colds with medicine.

Cough and cold medicines were made for adults.  They tend to dry out the mucus, and make it thicker and harder to remove.  The saline will dissolve the mucus and make it easier to remove. 
Plain acetaminophen (Tylenol, FeverAll suppositories, etc.) or ibuprofen (Motrin, Advil, etc.) is ok for fevers or general pain/discomfort your child may be feeling from their cold or flu. 
There still is no cure for colds and flu’s, we do what we can to be comfortable until it goes away naturally on it’s own.  A cold and cough will last a couple of weeks.  It is usually the worst on about the 3rd through 7th day. 
It is normal to have a fever the first few days of a cold.  Antibiotics will not help it get better quicker, or prevent it from getting worse.  Antibiotics do NOT cure colds.  They will only add side effects like diarrhea or yeast infections, or even life threatening allergic reactions.
You should see a doctor if:

  • if the child is breathing faster than 60 times in 60 seconds.
  • if even after suctioning you notice your childs nostrils are flaring when they breathe.  (The nostrils are moving when they breathe).
  • if the skin at the bottom of the neck above the breast bone is sucking in when they breathe, or the skin is pulling in between the ribs when they breathe.
  • if the cold has gone on longer than 2 weeks without getting better.
  • if the cold seems to be getting worse after a week, or they get a fever after the first few days. 


Sucking Mucus out of the Nose

  1. Suction bulb
  2. Saline, Salt water, infant nasal saline, nasal saline  (Ocean Spray, Ayr, Simply Saline Baby, Little Noses)
  3. Paper towels
  4. Towel or blanket to wrap baby
  5. Tissue paper to wipe any mucus off of baby’s face

Wrapping the baby

  1. place to the side of the towel or blanket.  If the blanket is not very long, lay in a diamond shape instead of a rectangle.
  2. wrap the closest corner over the arm, then put it under the child’s body.  This way their body weight will hold down their arm.
  3. Then wrap the other side around the baby like a burrito.

The most effective way to suck out mucus:
Lay the baby with it’s head braced between your knees, so the baby is looking up at you with it’s head lower than it’s body.

  1. Put several drops of saline in each nostril.
  2. Squeeze the suction bulb, then put it in the nose until it stops against the edges of the nostrils, creating a seal.
  3. While still holding the suction bulb in the nose, let the bulb go so that it sucks out the mucus.
  4. Squirt it onto a paper towel.
  5. Repeat until you are not getting much mucus.

You may repeat this procedure whenever the baby seems congested.   You wont be able to get out all the mucus, like when you blow your own nose.  You may still hear mucus in there, but it should sound looser.  Your baby will be able to swallow the thinner mucus more easily now.
Cleaning the bulb
    Boil the bulb once a day or clean it out with soapy water.  Make sure to suck the soapy water into the inside.  Then rinse it out by sucking in regular water.  Otherwise, even more germs will grow inside your bulb.
-©  Shaun S. Berger, MD  Feel free to reproduce for patient education.  

Spanish Version:

Want to see pictures of how to swaddle, and how to suction?

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