My Newborn has a stuffy nose!

The dreaded Newborn/infant congestion. This is one of the top concerns brought to clinic by new parents. Around 2-3 weeks old (sometimes sooner) your sweet newborn will inevitably sound congested. Are they sick? Is it allergies already? What do I do? Why is this happening? I can still remember bringing my first baby home. As a first time mom I was determined that no germs were going to be getting to my newborn! I had done my due diligence. Hand sanitizer on every floor, limiting visitors, making sure every close family member had the necessary boosted vaccines (the Tdap). I had even gone as far as purchasing an infant seat cover up that had pretty cursive writing with flower/leaf boarder saying "STOP! Your germs are too big for me. Please do not touch, only look." as if that was going to stop the little ol' grandmas at the grocery store from pinching my chunky babies cheeks. Either way I was ready. So why on earth was my baby congested after only a couple weeks of being home? What had I missed?!

Is this really Normal?

Newborn congestion usually is NORMAL, and they will eventually grow out of it. Majority of the time this is not due to them being sick and once this can put your mama heart at ease, their little congested snort may even become endearing. Newborns can sound congested from the start, but often time isn't noticed until a couple weeks in. But why is this?

• Babies have very SMALL nasal passageways, this is not to be confused with nostrils. The opening of your babies nose may appear a good size, some babies even have wide nostrils but still have the dreaded congestion. That is because the nostril is not a good determinate of the size of the nasal passageways far above leading into the sinus cavity. These passageways are very narrow, causing a congested sound solely due to the small nature of the passageway. Think when you blow or suck air through a straw.... it will always make some sort of noise due to the sound of the air through the small entrance of the straw.

• Babies are NOSE breathers. Have you ever noticed a baby's mouth is always closed? Especially a newborn! Unless they are crying, their mouths remain closed which forces them to breath through their nose. Therefore they are forcing all their required breathing to fill their lungs is entering through the sometimes "pencil tip" sized passageway. Now imagine forcefully breathing through the straw. The sound it creates is even louder.

Can I fix it?

Okay, "sigh of relief", my baby's congestion is likely normal. But is there anything I can do to improve the congestion? There are a few things to do that can make sure we don't increase your babies already baseline congestion. Again, keeping in mind that the generalized congestion sound is normal, and likely effecting you much more than it is your perfect sleeping peaceful baby.

• Suction and Saline. Using a good ol' nose sucker to assure there are no extra secretions of baby boogers causing the nasal passageways to be even smaller than they already are. My favorite nose suction is the Nose Frida, but really any suction (manual, bulb, or electric) will do. Using saline is important to loosen up those sticky pesky boogers. Newborns can handle saline, although we prefer you to use the saline drops and not the aerosol can like sprays, as these can be a little too forceful at times. 1-2 drops in each nostril with some suction is the perfect clean out.

• Humidifiers. Adding moisture into the room your infant is in most of the time can help sometimes too. Imagine a humidifier as a sort of "invisible lube", now that's quite the image. But providing a small amount of moisture to an overall dry environment can cause the air to move a little more easily through a small dry passageway.

• Positioning. Certain positions can help reduce the pressure of the airflow through the small passageways. Keeping your baby in a more upright position. You can achieve this by; propping them up on a boppy pillow, holding upright on your shoulder (get those cuddles in!), increasing the head of the crib/bassinet to 30 degrees. It is also important to make sure your baby's head is in a neutral position, meaning their head should not be falling back or too far forward causing the neck to stretch either way.

Warning signs it may not be normal

Still not convinced it's normal? Your right.... it is important to rule out anything that may make your baby's congestion abnormal. If your baby (especially newborn) has any of the following symptoms call your doctor for evaluation;

• Fever

• Mucous (snot) continually running out of nose

• Frequent cough

• Retractions (does your babies breathing look different? Sucking in under the ribs and around the belly?)

• Decreased/poor feeding

• Excessive/increased spitting up

• Any blue discoloration around the mouth, nose or fingers and toes

In rare occasions baby's nasal passageways can be so small they do cause issues with patient properly feeding and gaining weight. If this occurs your medical provider may send you to ENT where they can complete a scope and visualize your infants nasal passageways to assure there are no areas that are too tight (strictures) or swelling that may benefit from nasal steroid drops. Unless your baby's oxygen is abnormal (low) or they are not gaining weight this likely is not need.

But Remember

Babies, particularly Newborns make a variety of interesting noises that cause us as parents to question the normalcy of the particular sound. "Nasal congestion is one of the main noises babies make", I can't tell you how many times a day I say that statement in clinic. Your baby will eventually grow bigger (faster than we are ready for them too) and the nasal congestion will resolve on its own. As for my third baby.... well, he didn't have the special infant carrier telling the little sweet grandmas at the grocery stores to back off. There was likely only one hand sanitizer in the house, and visitors didn't have a check list they had to pass before visiting. And just like my first son's nasal congestion, which never caused him any issues and self resolved over time, his little snorting nasal congestion came, and left quicker than I even had time to worry about this time around.

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I always recommend if you are unsure or concerned about your baby to always call or go see your PCP to assure there are no other underlying conditions. No PCP will every be mad at your for bringing your baby in for a concern you have as their parent. I assure you of this. And if they do..... find a new one.