Blocked nose in babies: how to do a nasal rinse

A very common question when it comes to newborns is how to carry out a nasal rinse for your baby. There is plenty of general knowledge on the subject, and it is well known that you can rinse your baby's nose, but the truth is that it is not always done well.

That is why our midwives at Happymami have written the following post especially for you on a blocked nose in babies and nasal rinsing.

My baby is breathing strangely, they may have a blocked nose

First of all, you should know that your baby, like all newborns, is an obligate nasal breather. In fact, they breathe through their nose until the first 4-6 weeks of life.

This is because their larynx sits in a higher position than in a child or an adult, with the epiglottis almost in contact with the soft palate, which makes it harder for air to pass through the mouth, except when crying.

On the other hand, it is normal for newborns to sneeze (it helps them clear their nasal passages), cough or get hiccups. It may sound silly, but many first-time mums and dads ask about sneezing.

Infant rhinitis

It is considered the main cause of nasal obstruction at this age. It consists of inflammation of the nasal mucosa of the baby, and it is often due to a viral or non-specific cause.

Symptoms of infant rhinitis

The characteristic symptoms are noisy breathing and breathing difficulty, which get worse during sucking while you breastfeed. One of the most characteristic signs and symptoms of nasal obstruction is snuffling.

It is a characteristic noise caused by air passing in a “turbulent” way through the nasal passages of your baby when they are narrowed.

Your baby will not have a fever but will be irritable, with no other major change. And if you lift your baby's nose and with good lighting, you can see nasal mucus.

Which nasal rinse system for a newborn is best?

If you are going to clean your baby's nose with saline solution, you will find many different systems in pharmacies. They are all equally valid if you use them correctly.

The advice AEPED gives us is to opt for small containers, so that we avoid using the same bottle over and over with every cold, which encourages contamination by germs.

It is also important that each baby has their own device, so that viruses are not passed from one to another.

How do you carry out a nasal rinse for babies?

Below we leave you a couple of recommendations that can help you a great deal to carry out these nasal rinses and to make them as effective as possible.

• Carry out the nasal rinses for your baby before bedtime and before feeds.
• 1.5-2 ml in each nasal passage for babies will be enough. If it is for an older child, 5 ml is enough.
• Use the saline solution at room temperature, so that the sensation for your baby is less unpleasant.
• You can lay your baby face down or face up, depending on how you can hold them best. Try to turn their head to one side and try to make sure it does not tip backwards.
• Once you have them well positioned and held, squirt the saline solution into the nostril that is on top, “with determination”.
• If they are lying face up, to make it easier for them to expel the secretions, you can sit your baby up.
• Afterwards, repeat the manoeuvre in the other nostril, turning your baby's head to the other side.
• If their nose is very blocked, you can put in a little saline solution, give it a massage to soften the mucus and then put in more saline solution.
• Some of the mucus may be expelled and some of it may be swallowed, and that is normal.

In addition, we leave you a video on cleaning your baby's nose where you can see how to carry out the nasal rinse and which will be a great help to you.

Can you suction a baby's nose?

There are different types of nasal aspirators for babies, on the market, as well as hospital suction catheters. And their use is recommended once or twice a day, only if there is a lot of mucus to suction (you will see it) and without doing it roughly.

This is because if we used these suction catheters continuously, we could cause greater inflammation in our baby and damage the mucosa.

Which would make the clinical picture worse, with the formation of synechiae (adhesions).

Complete nasal obstruction

A complete obstruction of your baby's nose can lead to significant consequences, such as breathing difficulty or delayed growth. But these are due to medical causes that we will now describe and which are different from the normal mucus of a newborn.

Signs and symptoms of complete nasal obstruction

In more serious cases, such as complete nasal obstructions, we can find rhinorrhoea, breathing difficulty (with nasal flaring, chest retraction and cyclical cyanosis). Also obstructive apnoea, as well as altered feeding, epiphora and delayed growth, aerophagia with abdominal distension (a tummy full of air), are characteristic of a pathological obstruction. The diagnosis should be made by means of an exhaustive medical history and a physical examination.

Causes that lead to a complete nasal obstruction

Generally speaking, and without alarming ourselves, there are a multitude of causes that can lead to nasal ventilatory impairment in your baby, which would be detected, where applicable, by the hospital paediatrician.

To tell them apart, we have congenital causes (from birth), notably choanal atresia, congenital stenosis of the piriform aperture, the dermoid cyst, the glioma and the encephalocele.

This bilateral nasal obstruction usually appears in the neonatal period, whereas unilateral obstruction may appear later in life.

Conclusion: blocked nose in babies and nasal rinsing

Nasal obstruction in newborns and infants varies in severity, from mild breathing difficulty when feeding to severe airway obstruction. Learning how to carry out a correct cleaning of your baby's nose is not difficult, and mastering it is just a matter of practice.

In addition, if you are unsure whether it is more than just mucus, see your paediatrician, who will be delighted to help you.

Remember that this information should not be used as a substitute for your relationship with your paediatrician, who, depending on the individual circumstances of each child or adolescent, may give recommendations that differ from the general ones set out here.

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