Nasal Congestion in Newborns
Content reviewed against published AAP, Mayo Clinic guidelines
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If your baby has been diagnosed with or you suspect nasal congestion in newborns, here is what the evidence says.
The short answer
Nasal congestion is extremely common in newborns and young babies because their nasal passages are very narrow. Babies are obligate nose breathers for the first several months, which means nasal congestion can be particularly distressing for them and their parents. Most congestion in newborns is caused by normal mucus production and narrow passages, not illness. Saline drops and gentle suctioning are the safest and most effective treatments.
Key takeaways
- Nasal congestion is extremely common in newborns and young babies because their nasal passages are very narrow. Babies are obligate nose breathers for the first several months, which means nasal congestion can be particularly distressing for them and their parents. Most congestion in newborns is caused by normal mucus production and narrow passages, not illness. Saline drops and gentle suctioning are the safest and most effective treatments.
- Usually normal when: Newborn sounds congested but is feeding well, making wet diapers, and breathing comfortably
- Call your doctor if: Baby under 3 months has congestion with fever (100.4 F or higher) -- call your pediatrician immediately
- Varies by age — see the age-by-age breakdown below
“Fever itself is not an illness — rather, it is a sign or symptom that the body is fighting an infection. Fever stimulates certain defenses, such as the white blood cells, which attack and destroy invading bacteria.”
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By Age
What to expect by age
0-3 months
Newborns have very small nasal passages (about the diameter of a pencil eraser), so even a small amount of mucus can make them sound very congested. This is usually normal. Babies may snort, sneeze frequently, and sound noisy when breathing, all of which help clear their tiny nasal passages. If your baby is feeding well and not in distress, congestion alone is usually not concerning. Use saline drops and a bulb syringe or nasal aspirator before feeds as needed.
3-6 months
By this age, nasal passages have grown slightly but congestion from colds becomes more common as maternal antibodies wane. A cold causing congestion typically lasts 7-10 days. Use saline drops before suctioning to thin mucus. Running a cool-mist humidifier in the baby's room can help. Do NOT use medicated nasal sprays, decongestants, or menthol products in babies. Elevating the head of the crib slightly may also help.
6-12 months
Babies at this age may get many colds (8-12 per year is normal), especially if in daycare. Congestion during colds can interfere with feeding and sleep. Continue using saline and gentle suctioning but avoid over-suctioning, which can cause nasal swelling. If congestion persists between colds or is always one-sided, mention it to your pediatrician as it could indicate a structural issue or, rarely, an object in the nose.
12 months+
Toddlers can begin to develop allergic rhinitis (nasal allergies), which causes chronic congestion, runny nose, and sneezing. If your toddler has persistent congestion that does not follow the pattern of a cold, allergies may be a factor. Enlarged adenoids can also cause chronic nasal congestion and mouth breathing in toddlers. If your child snores, breathes through the mouth, or has disturbed sleep from congestion, discuss this with your pediatrician.
What Should You Do?
When to take action
- Newborn sounds congested but is feeding well, making wet diapers, and breathing comfortably
- Baby sneezes frequently and has occasional noisy breathing without fever or other symptoms
- Baby has nasal congestion during a cold that gradually improves over 7-10 days
- Baby's congestion improves after saline drops and gentle suctioning
- Baby has persistent congestion that lasts more than 2 weeks without improvement
- Congestion seems to always be on one side of the nose
- Toddler has chronic congestion, mouth breathing, or snoring that is not related to colds
- Baby under 3 months has congestion with fever (100.4 F or higher) -- call your pediatrician immediately
- Baby is struggling to breathe, has nasal flaring, chest retractions, or refuses to feed due to congestion -- seek urgent care
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Nasal Congestion in Newborns.
Things to mention
- Baby has persistent congestion that lasts more than 2 weeks without improvement
- Congestion seems to always be on one side of the nose
- Toddler has chronic congestion, mouth breathing, or snoring that is not related to colds
Observations to share
- Baby has persistent congestion that lasts more than 2 weeks without improvement
- Congestion seems to always be on one side of the nose
- Toddler has chronic congestion, mouth breathing, or snoring that is not related to colds
Urgent signs to report immediately
- Baby under 3 months has congestion with fever (100.4 F or higher) -- call your pediatrician immediately
- Baby is struggling to breathe, has nasal flaring, chest retractions, or refuses to feed due to congestion -- seek urgent care
My notes
From ismybabyalright.com — free, evidence-based baby health guides
Related Resources
Frequently asked questions
Is nasal congestion in newborns normal?
When should I call the doctor about nasal congestion in newborns?
When is nasal congestion in newborns normal?
What causes nasal congestion in newborns?
What should I mention to my pediatrician about nasal congestion in newborns?
Is nasal congestion in newborns normal at 0-3 months?
Is nasal congestion in newborns normal at 3-6 months?
Should I go to the ER for nasal congestion in newborns?
Does nasal congestion in newborns go away on its own?
References
- [1]American Academy of Pediatrics. Stuffy Nose in Babies. HealthyChildren.org. AAP
- [2]Mayo Clinic. Nasal Congestion in Infants. Mayo Clinic
All content follows our editorial policy and is reviewed against published clinical guidelines.
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Bottom line
Most cases of nasal congestion in newborns are normal. Talk to your pediatrician if baby under 3 months has congestion with fever (100.4 f or higher) -- call your pediatrician immediately.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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