Sienna Rhodes
Newborns often sound congested due to their miniature nasal passages, leftover fluid in their nose from the womb, or mucus buildup. This condition, called nasal congestion of the newborn, is common and usually resolves within a few days to a week. Treatment options include saline nose drops, sprays, or bulb syringes to clear mucus, and placing the baby in an upright position to aid drainage. In rare cases, congestion may indicate respiratory distress, so parents should monitor their baby's breathing and seek medical attention if concerned.
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What You'll Learn
Newborns are obligate nose breathers
Newborns are often described as "obligate nose breathers", a term that refers to the physiological instinct to breathe through the nose rather than the mouth. This is because their nostrils and airways are extra small, and even a small amount of mucus or dryness can cause congestion.
However, this term may be misleading, as it implies that the newborn has no choice but to breathe through its nose. In fact, most infants are able to breathe through their mouths if their noses are blocked. One study found that a sample of 19 infants, ranging in age from 1 day to 7.5 months, reliably transitioned from nose to mouth breathing after nasal occlusion. This suggests that infants possess the physiological capability to breathe through their mouths.
Another study, which monitored the respiratory response of ten infants to nasal obstruction, found that five of the ten infants were able to initiate and sustain effective oral breathing without arousal during 36±32% of occlusions. The remaining five infants did not exhibit oral breathing, with arousal occurring in 42±34% of occlusions. These results indicate that not all infants are obligate nose breathers, and that effective oral ventilation can be a life-saving response to nasal obstruction.
While nasal breathing is generally preferred, as it filters particles, humidifies and warms the air, and produces nitric oxide, mouth breathing can be an effective alternative when the nose is congested. This is why newborns with stuffy noses may breathe through their mouths, although this can make feeding more difficult.
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Congestion is common in newborns
If your baby seems content and is eating, sleeping, and dirtying nappies regularly, the congestion will likely pass without treatment. However, if your baby is having difficulty breathing or feeding, contact your healthcare provider. You can also try home remedies, such as a cool mist humidifier in the room, nasal saline spray, or gentle suction with a bulb syringe or infant nasal aspirator.
If you are breastfeeding, try an upright position, such as the biological or laid-back breastfeeding position. These positions use gravity to assist with drainage, making breathing easier and potentially improving the latch. Over-the-counter cough and cold medications should never be given to a newborn without consulting a doctor.
If you are concerned, take a short video of the sound to show your paediatrician, as this can help them make a more accurate assessment.
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Home remedies for congestion
It's common for newborns to sound stuffy due to their small and developing nasal passages, which can make them sound congested even when they are perfectly healthy. However, if you're concerned about your baby's congestion, there are several home remedies you can try to help provide relief:
Use a humidifier: Adding moisture to the air with a cool-mist humidifier can help loosen congestion and make it easier for your baby to breathe. Place the humidifier in your baby's room, ensuring it is clean and well-maintained to prevent the growth of bacteria or mould.
Saline drops and suction: Gently instill saline drops into each of your baby's nostrils to help loosen any dried mucus. Wait a few minutes, and then use a bulb syringe to gently suction the mucus out. This can be done several times a day to provide relief.
Elevated sleeping position: When your baby sleeps, slightly elevate their head and chest to help ease congestion. You can do this by placing a thin towel or blanket under the head of their mattress, ensuring it remains secure and doesn't slip. Never use pillows or thick blankets as these can be unsafe for newborns.
Steam: Taking your baby into the bathroom while running a hot shower can help to clear their congestion. The steam will loosen the mucus, making it easier for them to breathe. Ensure the room is well-ventilated, and don't leave your baby alone in the bathroom.
Chest physiotherapy: You can help your baby clear their chest by gently patting their back while they are in a sitting or slightly inclined position. This can help loosen and move the mucus, making it easier for them to cough it out or blow it through their nose.
Keep your baby hydrated: Ensure your baby is getting enough breastmilk or formula, as proper hydration can help thin out mucus and make it easier to clear.
It is important to remember that newborns have sensitive respiratory systems, and if their congestion is accompanied by other symptoms like fever, difficulty breathing, or a persistent cough, you should seek medical advice from your healthcare provider.
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When to seek medical attention
Nasal congestion is common in newborns and often resolves without treatment. However, it is important to monitor your baby's symptoms and be vigilant about seeking medical attention if necessary. Here are some guidelines on when to seek medical attention for a newborn with a stuffy nose:
If your baby is having difficulty breathing or trouble feeding:
Nasal congestion can sometimes lead to breathing or feeding problems. If your baby is struggling to breathe or feed due to a stuffy nose, it is important to check with their healthcare provider.
If your baby exhibits other symptoms:
Look for other signs of illness, such as a persistent cough, fever, or changes in mucus color (clear mucus is normal, while green or yellow mucus may indicate an infection). Contact your doctor if you notice any of these symptoms to determine the appropriate treatment.
If congestion persists or worsens:
While nasal congestion often clears up within a few days to a week, if it persists or gets worse, it may indicate an underlying condition. Consult your baby's healthcare provider to rule out other causes and ensure your baby receives proper care.
If your baby has a dry or irritated nose:
A dry or irritated nose can be bothersome for your baby. Try using saline drops to moisturize the nasal passages, and if the irritation persists, consult your healthcare provider for further guidance.
If your baby is premature:
Preemie babies have even smaller air passages than average newborns, making them more prone to noisy breathing. Consult your baby's doctor for specific guidance on managing congestion in a premature infant.
If you are concerned:
As a parent, you know your baby best. If you are concerned about your newborn's stuffy nose or are unsure about the severity of their congestion, don't hesitate to contact your healthcare provider for advice and reassurance.
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Breastfeeding positions for congested babies
Newborns often sound congested because they are \"obligate nose breathers", meaning they primarily breathe through their noses. Their miniature nasal passages can easily be affected by minor dryness or a bit of clear mucus. This congestion is usually harmless and goes away on its own within a few days. However, if your baby is facing feeding or breathing problems, you should consult a healthcare provider.
Breastfeeding a congested baby can be challenging, but certain positions may help alleviate the issue. Here are some breastfeeding positions that might be suitable for congested babies:
Hands and Knees or Dangling
This position involves laying the baby on their back while you hang your breast over them and let them latch. This position can be helpful for congested breasts or babies as it can help with milk flow. It may be tricky to get comfortable in this position, so it is recommended to have a helper assist you with props. This position is not intended for everyday use.
Upright or Koala
This position can be effective for babies with reflux, ear infections, tongue tie, low muscle tone, fast milk ejection, or oversupply. You straddle the baby's legs over your thigh or hip while holding their head upright as they feed. This position can be discreet in public and comfortable for both mother and baby.
Cradle Hold
The cradle hold is the most common position and is useful when first learning to breastfeed. It provides an enjoyable feeding and bonding experience for both mother and baby. To use this position, sit somewhere with support for your arm, such as an armchair or couch. Position your baby in your lap with their head in the crook of your arm, keeping their chest against yours. You can use pillows to support your baby's head if needed. This position allows you to have good control of your baby's head and helps them latch on.
Biological Nurturing
If your baby has difficulty latching or is restless and crying, this calming position may help. Support yourself with pillows and lean back enough so that your baby is fully supported on your reclined body, not completely flat. Lay your naked baby prone on your chest for skin-to-skin contact and bonding. Remember that getting comfortable with breastfeeding takes time!
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Frequently asked questions
Newborns often sound congested because their nostrils and airways are extra small, so it doesn't take much for these pathways to be affected by minor dryness or a bit of mucus. This is usually normal and is called "nasal congestion of the newborn".
Nasal congestion in newborns usually goes away on its own within a few days. To help clear mucus, you can use saline nose drops or spray, or a bulb syringe. You can also try placing your baby in a warm, steamy room or using a cool-mist humidifier.
If your baby is having difficulty breathing or feeding, check with their healthcare provider. Signs of respiratory distress include rapid breathing, nasal flaring, or retractions (pulling in of the chest between the ribs). If your baby has a fever, is sneezing often, is less energetic than usual, or is not eating as much, contact your doctor.
Sneezing is a natural reflex to clear germs, particles, and leftover fluid from the nose. Occasional sneezing is normal and does not necessarily mean that your baby has a cold.
Newborns make a variety of sounds, including grunting (usually related to digestion), hiccups (caused by an immature diaphragm), and snoring (mild snoring is common). Most newborn baby noises are completely normal.
