Dealing with congestion and post-nasal drip in babies and toddlers

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Dealing with congestion and post-nasal drip in babies and toddlers

Nasal congestion can cause your little one a great deal of discomfort. Here’s how to deal with it. 


Nasal congestion can cause your little one a great deal of discomfort. Here’s how to deal with it. 

By PaedIQ paediatrician Dr Iqbal Karbanee


Babies and toddlers experience great difficulty when they have nasal congestion. The younger the child, the more difficult it is for them to clear their nasal passages properly. In infants, especially those under four months of age, breathing through the nose is preferred. When the nose is blocked they cannot sleep well, cannot feed normally, and generally get quite distressed.

Most infants spend lots of time lying down, especially on their backs. As nasal congestion develops and gets worse, the mucus drifts down the back of the nose into the throat, forming a post-nasal drip. From here they may develop a wet sounding cough, and may even vomit after coughing.

Treating nasal congestion

In most cases, nasal congestion is caused by a virus such as the Rhinovirus (common cold), the more serious Adenovirus, RSV (Respiratory Syncytial Virus) or the flu virus. If the infection is viral, antibiotics will not help. Saline drops or sprays for the nose are your best bet for helping to ease congestion and should be used often, especially before feeds and before your baby goes to sleep.

If your baby has large amounts of mucus that will not clear, you may need to use medication. Ask your Clicks pharmacist for an age-appropriate over-the-counter treatment to help dry up the mucus. If your baby is sleeping and feeding well, but just has a runny nose, it is preferable to allow the immune system to deal with this in its own time. Keep this up unless complications arise.

Complications arise when the virus spreads from the upper airways to the chest. This can lead to breathing problems ranging from mild wheezing to bronchiolitis and bronchopneumonia. Any child who develops difficulty breathing, wheezing or rapid breathing should be taken to a medical facility for treatment. The very big and hotly debated question is when to use antibiotics. There is no easy answer, but as a general guide it is advisable not to rush and treat a runny nose with antibiotics; rather allow at least three to five days for the nose to start clearing first. A runny nose that persists for longer than five days is not necessarily a cause for medical assistance, however you should consult with your pharmacist or paediatrician if your child’s symptoms are getting worse, or if they have breathing difficulties or a fever.

A chronic runny nose or congestion that persists for weeks may be part of an underlying problem such as allergic rhinitis. In such cases, allergy tests are advised to try and establish the exact cause.  


The first prize is to prevent the spread of infections in the first place, and this can be done with frequent hand washing – which is especially useful to limit the spread of RSV – and ensuring children are cared for in environments that are not too crowded and are well ventilated.

More information on child health issues is available on the website Paed-IQ. Simply use your ClubCard number to login. Paed-IQ Services are exclusive to Clicks BabyClub – with expert advice from a paediatrician and interactive chats on our Facebook page every week. Every Wednesday from 12 to 2pm, the Clicks BabyClub Facebook page hosts a live Q&A session with a PaedIQ paediatrician. If you have a question about your baby's development, “like” the BabyClub page and join the chat




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