Home » Baby with a common cold - how to comfort and help

Baby with a common cold - how to comfort and help

Första gången man som förälder ska ta hand om en förkyld bebis kommer många frågor. Vad ska man göra? Kommer bebisen klara av det här? Och det är väl inte RS-virus… Som barnläkare är jag inte alls lika intresserad av om det är RS-virus eller inte, jag är intresserad av två saker: orkar bebisen äta och har den svårt att andas. Och jag vet att med mycket enkel vård så klarar i övrigt friska spädbarn av förkylningar alldeles utmärkt.

Can your baby breathe easily? Can they eat?

Förkylda bebisar  som har svårt att andas och inte kan äta kommer ofta till barnakuten. Det är förstås helt riktigt, om din bebis inte kan äta och du inte vet vad du ska göra åt det är det helt riktigt att söka vård. Men som tur är behövs det ofta inte så mycket för att hjälpa bebisen, och det som oftast behövs kan du göra hemma.

Det är i själva verket så att både andningsproblem och matningsproblem ofta beror på något så banalt som nästäppa. Det första som händer om ni kommer till barnakuten (förutom väntetiden…)  är att sjuksköterskan gör en “nästoalett”. I de allra flesta fall kan spädbarnet både äta och andas därefter och många kan gå hem utan att träffa läkare. Det vill säga, om du läser färdigt det här inlägget finns det stor chans att du slipper söka barnakuten med din bebis!

Why then does nasal congestion badly affect babies?

1. Babies’ noses are very narrow, and therefore they are easily blocked by snot, mucus and swollen mucus membranes when a cold occurs, both RS viruses and other viruses.


2. Infants, until they are around 6 months old, will primarily breathe through their nose rather than their mouth.

3. While they are eating (breast or bottle feeding) infants can and need to breathe. If the nose becomes blocked, they will release the breast or bottle and will not take in food.

The last point is truly fascinating, that they can drink and breathe at the same time! The downside however is that a congested baby cannot breathe or eat!

To clean an infant's nose

There are nasal aspirators which are readily available to buy which work very well. However, in paediatric care we tend to do the opposite. Instead of sucking out the mucus, it is flushed down the throat, most commonly with sterile saline, but a saltwater spray also works well.

Nasal aspiration is good when the baby is suffering from congestion.

Spädbarns näshåla är ganska stor (även om den är trång). Därför räcker det inte att droppa bröstmjölk eller kolksaltlösning i näsan.  Du behöver rinse the nose. Usually, one or two millilitres per nostril is sufficient. A useful tool is a plastic syringe without the needle cap, which is available to buy from a pharmacy. If you are right-handed, hold the baby’s head with your left hand (and vice versa) and flush the solution straight in, not up, the nose with your free hand. The baby will sputter and cough up a lot of dissolved mucus, some will be swallowed. It may feel scary, but this is not a dangerous procedure. Continue this way until the nasal cavity is clear.

It is vital to note that the nasal septum is sensitive to pain, but not the nose. Therefore, you should avoid the nasal septum (the inner wall of the nose, against the other nostril) when you are inserting the syringe or spray bottle against the nostril (the outermost part of the nose) to avoid hurting the baby.

When should I go to the ER for a baby with a cold?

Om en förkyld bebis även efter näsrengöring får kämpa för att orka andas och har svårt att äta är det dags att åka till närmaste barnakutmottagning. Ta med några smörgåsar till dig själv och en bok om bebisen somnar för många har långa väntetider. Och var toknoga med handhygienen där, för där finns mycket magsjuka…

When should I seek out a health centre if my baby has a cold?

If the baby has a cold, but can breathe and eat, but is a little fussy with a slight fever, it may be suffering with an ear infection. In infants, these are always treated with antibiotics. Try giving pain relief with Avedon and try to help the baby sleep by propping them slightly upright, maybe in the baby carrier. Then take them to the nearest health centre the following day to see if there is an ear inflammation present.

If a baby under three months old has a fever over 38.5 degrees, the health centre is the place to find medical assistance. In the past, it had been advised to see a paediatrician, at least in Stockholm anyway, but now it is stated the nearest health centre should be able to assist infants suffering with fever.

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81 thoughts on “Förkyld bebis – snorig och täppt i näsan – hur hjälpa?”

  1. Pingback: Fever in babies and children - what to do and at what point is the fever too high?

  2. Thank you Doctor Cecilia for this incredibly important information! The fact that there are people like you who take the time to write like this, I think is fantastic!
    I thought babies can breathe through the mouth and that it works to drip saline. BUT, I am glad I googled babies with stuffed noses and found your text! What a difference it made for my two month old. From laboured breathing to "plop" and then the worst lump came out after which he began to moan happily and could sleep on. As you advised, I took a dosing syringe that I had at home and threw together some sterile saline. Later today I will go and buy some Nezeril for my two year old.

  3. Hey! Now I have tried the "resolute nose flush", but afterwards worried about whether I was too resolute, ie flushed too fast / hard. How do you know that no water goes into the airways / lungs? She did not cough and cough as it says in the article but looked most shocked. Afraid to ask for something…

    1. You do not need to be worried. The child has a cough reflex which prevents water from entering the lower respiratory tract. You probably did not give so much that it went down the throat.

  4. Should the baby lie on his back or sit while injecting the rinse for best effect? Thanks for the tips, the nasal rinse has worked great so far if needed. But now I do not get the snot / mucus, it seems to sit further back and clog so that she does not want / can breastfeed. She is 9 months old.

    One tip is to consistently say “here it comes” or similar just before injecting it. Before, my baby refused, but now it works better, now that she is used to it.

  5. Haha, I don't care about syringes and stuff and I just put my mouth on the little baby's nose ... But now my 5-week old has so much snot that it is almost running. The husband also uses his mouth but he blows it down instead (which you do in the health care, maybe therefore it is logical but to me it feels illogical but of course I understand that my feelings for it are not .. Logical!)

    1. Yes, that method I also tend to use. Sometimes you are out and do not have the whole kit with gadgets, just need to get hold of a nostril and suck out as much snot as you can. Rock'n'roll method 🙂

  6. Hey! My daughter, almost six months old, has a cold and struggles to breathe. As you wrote, we have tried to clean the nose by "dropping / spraying" the saline in the nostrils. We use 1 pipette every time and it works ok. You wrote that you should rinse for real instead so I was going to try it on. Saw that at the pharmacy now there is something called Physiomer Baby Mist. There seems to be some bottle that rinses the nose a little more, can you recommend it? Feels smoother if it works as well as spraying sterile saline.

  7. Do you need tips that you can order Rhinox 0.1 directly from Norway? Apotekdirekte.no delivers to Sweden. Remove this comment if it is not ok.

  8. Hello
    our little boy is 2 weeks old now and was 1 month premature and now he is quite stuffy in the nose as it seems like he sneezes very much but no mucus or anything comes out. There is some dried a bit on the edge of the nostrils, do they usually get so stuffy when they're so small? And what should I do about such a little guy? Mvh Daniel

  9. Thanks for an incredibly good blog that I read alot of in recent weeks (since I started reading about rotavirus vaccination that our little boy, 11 weeks old, will soon get).

    A little snotty nose is the only thing we have had so far, but as a friend of drugs, I want to be prepared for worse, and therefore thank you for the Rhinox tip - I sought a suitable dosage when I unofficially intended to do as Marlene.
    So now I'm ready to blend in when needed! / another pharmacist

  10. Haven't read all the posts so apologize if anyone has already commented on this. I have tried nasal aspirations and drips in breast milk and saline drops that worked poorly. Then I tested PHYSOMER BABY which I bought at the Crown's pharmacy, it's a bottle with a nozzle at the top. You press the bottle lightly and have the nozzle in the child's nose, then there will be a nice shower or almost like dew rain and cleanse. Can't get any better and it works fast. Have three children and the smallest is only 4 months. Sounds like I'm bribed to write about them but it's a great product!

  11. Had a tough night tonight with our stuffy baby who was struggling to breathe. Rinsed with the saline (a lot) and then completed the cure with a tip I got from my friend, namely to lie a little on one side, this because the remaining snot then flows a little to one side inside the nose and "exposes" the other side. Can anyone know / confirm that this works?

  12. It's a shame that the product disappeared. It is the only nasal spray (0.1mg / ml) that I as an adult 38-year-old man had helped without waking up with drying feeling at night and without burning like satan in the nose when used. Used 3 times a year it takes 1-2 days off a cold.

    Might as well do as suggested above and buy the 0.25 mixture and dilute with saline.

  13. Thanks for a very good blog! Like so many other little ones, my baby (three months) is suffering with long-lasting nasal congestion (with no visible mucus). I would like to know more about the nasal congestion doctors think will grow away. The child is very frustrated, especially when sleeping, pulling with arms, kicking and moaning, even in an upright position. No home remedies work, nor nezeril. Breastfeeding is what works (oddly enough !?) and it works best. Have read about parents whose children have similar problems, but cyberspace lacks information from the medically knowledgeable. Is there any help for these little kids with stuffy noses?

    1. You just have to wait until they grow and the trachea gets bigger! Avoid Nezeril in case of prolonged nasal congestion, otherwise the mucous membrane may become dependent on it.

  14. Hey!
    Thanks for a great blog! Hope you can answer an anxious mom.
    Have used Otrovin Baby 5 ml pipettes. The dosage is 2-4 times a day.
    Since my 3 month baby is extremely snotty I have emptied a pipette distributed between her 2 nostrils to flush clean. Despite this, I hear how it rattles and bubbles. Until the cold got attached, she has had a lot of snot plugs and more minor problems. Have then cleaned the nose in the same way, 1 pipette about every 4-5 days or if needed.
    Asking for tips from my BVC who now warns that she ingests too much salt in the intestines.
    So now I sit here and am very worried that for 2 months I have given her too much salt.
    13 pipettes are consumed in 8 weeks.
    If the saline solution is dangerous for the intestines, why is it not on the package?

    1. Hey! There is no warning on the packaging as the saline solution is not dangerous for the intestines.

  15. Hey! Thank you for a very interesting and educational blog! I was thinking about asking about nosebleeds in babies, our daughter has had nosebleeds since a cold in June and now it is September! We run the nasal flush in principle every day, absolutely not unnecessarily and very rarely with the drawstring. She is 4.5 months. The problem is that she cannot sleep on her back, after about 40 minutes her nose is clogged and sleep disturbed so she sleeps on my stomach (can then sleep all night except she wakes and eats). It feels risky considering sudden infant death but she sleeps, however, I do not sleep very well. Is this something to do with growing up that we can expect or can it be an allergy or similar? Any tips on how the daughter can sleep on her back when there are no nasal drops for babies? Many questions and are grateful for tips!

    1. Wait it out I would say. Maybe a little higher position on the head end of the bed, for example with bed lifts under the legs at the head end?

    1. No, I wouldn't. Breast milk is more completely absorbed when it ends up in wrong places like airways while breast milk replacement is not absorbed in the same way.

  16. Typical that I did just that a quarter of an hour ago then found this blog !!! What can happen then if anything can happen ... purely officially;) ???

  17. How long can a baby (child under one year) be congested ?! Is there any kind of limit on when to contact the health care even if the general condition is good?

    1. If the general condition is good, you do not need to contact the health care at all. With the exception of just one nostril that is congested all the time. Then you can suspect that there is something there and investigate, an old pea or pearl or something.

  18. Can I dilute the nasal drops for children from 2 years with saline, pull up in the dosing syringe and drop a drop in each nostril? Yes, to my child under 2 years I mean.

    1. Hi Marlene!
      Good posts I think. I usually recommend this, to pour Nezeril 0.25mg / ml in a spoon and dilute with the same amount of saline, put in syringe and give 1-2 drops in each nostril to young infants. My experience is that it works well and can in many cases be the difference between managing their baby properly at home and having to visit health care. One must be careful that it contains at least as much saline as Nezeril alone, and that one follows the dosing recommendations in general.

      Sincerely
      Jimmy Celind, Doctor, Pediatrics
      Queen Silvia Children's and Youth Hospital, Gothenburg

  19. Hey!
    I wonder if you can take the "resolute nasal flush" at each breastfeeding occasion. If you need to rinse with up to 2 ml of saline solution in each nostril, every two hours, it will be quite a lot of saline that the baby ingests, I think. My baby is 8 weeks old and stuffy in the nose, not at all fun 🙁

  20. My Noah, 6 months, has been snotty and stuffy on and off since he was born. Starting to wonder if he is allergic to cats. Have taken it up on bvc because he has been sniffing on almost every occasion but it seems they aren't listening .. How is it, really, can they become allergic already as infants?

    Regarding saline, I made my own tonight. 1 part salt to 1dl water, can be boiled and let cool but no need to.

    1. As far as we know, it is very rare for newborns to be allergic to cats. But I say as far as we know, this is not something we usually investigate. And I would also be VERY skeptical of interpreting “allergy tests” from such young children when they are not designed for babies.

      If he grows well and feels good otherwise, I would let the cat allergy theory remain uninvestigated. The only thing you can do to know is to get rid of the cats and clean out all the cat hair and see if it gets better. Had the son had severe asthma I would definitely have recommended it. But getting rid of the cats due to sniffing on and off - no. I would not.

      Have now calculated a little on the density and concentrations of saline. Your saline solution seems a little too strong. It should be 9 mg / mL, ie 900 mg / 100 mL (1dL). Saline weighs 1.3 g / mL, which means the right dose is 0.7 mL (0.7 spice measure) of saline per 100 mL (1 dL)

    2. Hello
      now it is an old thread but i hope to get answers anyway. I have tried to rinse her nose clean on my one month baby but she seems to drown as the water enters her mouth. It's awful to see. She has it so hard. What kind of mistake am I making? She is often stuffy in the nose and then swollen too but is not cold. What is it and how can I help her? Grateful for answers!

    3. Maybe you can give a little less water? If she is not cold then you may be able to rinse a little less rarely.

  21. Hey!
    Thanks for a very nice and educational blog! I have a question about the nasal aspiration you can buy for babies. I have a 4 week old baby with a stuffy nose that I have used this on and is there any risk that I may have sucked too hard when using it? Have in retrospect read that they can damage their noses, but wonder what it is that happens in case they are mucous or something else that is dangerous.
    Mvh, Emelie

    1. The nasal aspirators you can buy are so big that you can hardly get into the nose and access the mucous membrane with them. Which is good and safe. I consider them safe. If she feels good, she feels good. Count on it.

  22. I can confirm that breast milk works just fine if you do not have saline at home. Has given our little one a couple of real flushes when she was tight in her nose during her first half year and nothing else has ever been needed.

  23. Hey! My 8-week baby (he weighs 6kg) has a cold and I have cleaned the nose with saline pipettes (have been careful and not pushed it far in the nose). The problem is that there are some blood streaks in the snot and the saline he coughed out has been a little pink (blood mixed) once. I understand that the mucous membranes may have been damaged / become irritated but now I am so worried that this can lead to a serious infection ... What can I do (or what should I pay attention to) to reduce the risk of an infection occurring? He eats, poops, has no fever and is happy when he is awake. Grateful for answers! Sincerely, / Emma

  24. Hello,

    Since I read the original post a few months ago, I have rinsed my baby (almost 10 months) nose in the suggested way. Am very grateful for the tip as she hated the nose suck and it was basically impossible to get to and get clean in the nose with it. Anyway.

    I have used ACO's sore wash (ampoules, large pack). When I was going to buy it again, I was told by several visiting pharmacies that they had been discontinued. Gah! The small nasal sprays are not worthwhile for this purpose (and get expensive!) - do you have any tips on the corresponding saline solution at a reasonable price?

    The pharmacist at my local pharmacy suggested a bottle of Sodium Chloride that I bought (because he confirmed that it would be usable for this purpose), but returned it the following day (after looking it up anyway). It was normal saline (not sterile), which is not possible to use (it is kind of the same as the salt we have in the food and should preferably only give in limited amounts to babies)? Stated that it would only be used for flushing / cleaning externally. In addition, the shelf life of this large bottle was only 48 hours. Mass rinsing then. 😉 Too bad, because otherwise it was an economic alternative.

    So here I am. Would be very grateful if you or any reader by any means had any suggestion similar to ACO's Sore Wash - thank you in advance! 🙂

    1. It is the same saline as in the food. Physiologically in concentration means 0.9% ie the same as in the body. Babies are not harmed by it or to normal salted food.

      Too bad the wound wash has stopped. You do not need to rinse your nose if it is not clogged and snotty by the way.

  25. it makes no sense to flush the nose with unsalted tap water. rinse your nose yourself with a cold and then you have to have salt in. Don't know why but, maybe the ph value?

  26. Hey! What does the salt do in the saline solution? Is it harmful to sometimes use tap water (for otherwise healthy and not so small children) for the nose?

    1. Interesting question! It is dangerous not to flush with tap water. Possibly, however, if water remains on the mucous membranes of the nose, there may be another type of fluid balance across the mucosal cells. But what that would mean in practice I dare not say. Also do not know if anyone has investigated whether there is any difference.

  27. Hey!
    Me and a friend who is studying to be a doctor have discussed this several times with the fact that babies cannot breathe through the mouth.
    Is it due to reflexes or anatomy?
    After all, I know that children's anatomy allows them to eat and breathe at the same time as adults. But at the same time, I have a hard time understanding how a baby couldn't breathe through the mouth because of the anatomy. They obviously manage to scream so the air can go out through their mouths. Then what happens at the inhalation? Is there a reflex closure of the soft palate against the back tongue base by inhalation? How does it work then baby bile screams? Does your baby pause screaming to draw air through your nose?
    Mvh Stina, speech therapist (who does not work with infants)

  28. Now that I have asked at the pharmacy I have just received the answer that you should use the Renaissance, for fun I now thought that I would email and ask and got the following answer

    Hello,

    Renaissance nasal drops are a sterile, buffered physiological saline solution.
    For adults, children and infants. Infants / small children apply a few drops in each nostril, and the dissolved secretion is dried or chipped away
    Otri- Baby saline solution is a sterile isotonic (same salt concentration found naturally in the body) solution without preservative, with moisturizing properties. The saline solution restores moisture when the nasal mucosa is dry and full of crusts. With stuffy nose, it contributes to the removal of snot and improves breathing.It is especially suitable for cleaning the nose of infants and children,
    *****************************************************************************

    But is it just a LOT of water that is applied? We have bought such sterile wound washing (saline 0.9%) however they are not resealable which is a clear minus.

    1. I also usually buy the wound cleaner. It is clearly the most economical. And for my immunocompetent children at home, I use them for a few days. Unlike at work, and what I would do if my kids had a bad immune system and could get sick of any growing bacteria in the open packages.

  29. The Renaissance nasal drops are a sterile saline solution? In that case, they can be bought at any pharmacy, both as disposable pipettes and as a spray.

    1. Otribaby has a good size of its pipettes (a pipette is enough for both nostrils) and because using the pipette you do not need to keep the syringe clean (they become sluggish after a while use). My girls were born prematurely and we had to learn this with nose cleaning already at Neo-natal if I don't remember wrong! Not because it was needed (healthy small babies) but for preventive purposes!
      If you want to be a little environmentally conscious then you struggle with the syringe and wash and have and then you can buy ampoules with Wound Wash (eg Aco's), cut off the top so that the syringe just goes down the ampoule, then you can turn the ampoule up and down and thus get the last drops!

  30. How bad should it be before taking action? My 5-week baby often seems to have mucus in the back of the nasal cavity (ie against the throat), especially in the morning. He takes the breast a little slowly and sounds a bit snotty but gets started breastfeeding after a while and then breathes normally. Have been wondering if I should do something, but since he both eats and breathes I have let go…

  31. Received tips from another pediatrician that the baby can sleep in the baby carrier when they are congested. However, this does not work if you have a baby who must be close even when they sleep, then you can instead put extra pillow under the bed mattress so that baby comes higher up with his head.

  32. Thanks for a great post. It does raise some questions for me though:

    How to get “sterile saline”? Or should you use something else at home? (Breast milk I get no abundance of).

    What do you mean by flushing straight in, not upwards - it depends well on whether the baby "sits" or lies which one is upwards? (excuse me if I seem ridiculously incomprehensible). Do you mean inward towards the body and not up towards the forehead?

  33. Thanks for great posts! Currently have a cold 6 month old at home. Just wondering what you mean by injecting straight in and not up? So should the baby's head be lying down?
    My little girl gets annoyed by mucus in her throat and I wonder if there is something except mucus, but it is perhaps another "post". I'll try this with the syringe so maybe she coughs up from her throat too 🙂

    1. The only "mucus" that works is a lot of fluid. There are no working drugs that affect the texture of the mucus.

    2. Dangerous to small young children? I have been advised to give warm juice, because the sugar becomes mucous. It has worked on all my three children, one of whom had RS virus and was hospitalized for 10 days… Have no medical facts behind, nor any other scientific concepts but only my gut feeling as a mother of three. High position, for really small children in the car seat, also worked well. Now surely all dentists and dentists will go crazy over the sugar, but it works very well at half past three at night when you start getting desperate ...

  34. If I go to a pharmacy and ask for "sterile physiological saline" and a plastic syringe without tip - will they know what I'm talking about and bring out the stuff?

    1. Absolutely! Ask for a regular dosing syringe (most pharmacies never even charge for it). Sterile saline is usually in the baby shelf but ask otherwise.
      / pharmacist 🙂

  35. Must also say that many midwives think sucking is something you should not use and communicate it as a truth to new moms. It takes quite a lot of backbone to resist when you have a small baby and the midwife conveys exactly what you described above, that you should use breast milk to get stuffy stuffy nose and that lubrication is not recommended because it was easy to hurt the baby in the nose with it. I don't know if this still applies as it is now five years since I had a small scrap, but then it was.
    I myself thought that the sucking was very good (although the baby hated it) and did what worked for us - ie sucked the snot. But you felt like a bad mother for letting your child get a cold and then you felt like a bad mother for cleaning the snot for it to make life easier.

    With your post, I feel a little prepared though! 🙂

  36. Hey!
    Nezeril should remove its drops / spray 0.1mg / ml at the end of the year! Did you know? You do not know or can find out if it should be prescribed instead? Do you think it is worth gold sometimes when it is really needed!

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