Stuffy Nose and Colds in Newborns and Babies Under 3 Months

Stuffy, or sick?

• Many newborns sound stuffy with no illness at all: small nasal passages, milk, and dry air (see the breathing sounds guide). Sneezing alone is usually not a cold.
• A cold looks different: runny or thick nasal mucus, a cough, maybe fussiness, often with someone else in the home sick too.
• Young babies catch colds from siblings, visitors and childcare. Most are mild, but under 3 months babies can get sicker quickly and fever means something different. For older babies, see the colds and fevers guide.

Easing congestion

1. A few drops of saline in each nostril.
2. Wait 30-60 seconds, then suction gently with a bulb syringe or nasal aspirator.
3. Do this before feeds and sleep. More often irritates the nose.
4. Run a cool-mist humidifier in the room. No hot-steam vaporizers, which can burn.
5. Hold the baby upright for some awake time. For sleep, always flat on the back: no wedges, pillows or tilted mattresses.
6. Wipe the nose and the skin underneath with a soft cloth; a thin layer of petroleum jelly protects sore skin.

Feeding through a cold

• Babies breathe through their noses while feeding, so congestion makes feeds harder. Clear the nose first, and offer shorter, more frequent feeds.
• Keep breastfeeding or chestfeeding if you're the one who's sick; your milk carries antibodies.
• Count wet diapers. Fewer than usual is an early sign of not getting enough.
• No water, juice or homemade remedies under 6 months.

What not to give

• No cough and cold medicines; they aren't safe for babies. No honey under 12 months. No vapor rubs on young babies, and no essential oils or nasal sprays other than saline.
• Under about 12 weeks, check with the pediatrician before giving any medicine, including fever medicine.

Checking for fever

• Take a rectal temperature if your baby feels warm, seems unwell, or is feeding poorly. See the temperature guide for how.
• Under 3 months, a rectal temperature of 100.4°F (38°C) or higher is never a wait-and-see fever.

Protecting young babies

• Handwashing for everyone who holds the baby; ask sick visitors to wait (see the visitors guide).
• RSV protection: a vaccine given in late pregnancy, or an antibody shot for the baby, both lower the chance of serious RSV. Ask which applies to your family and season.
• Keep the home smoke- and vape-free.

Signs a cold is getting more serious

• Breathing faster than about 60 breaths a minute, ribs or neck pulling in, nostrils flaring, grunting.
• Pauses in breathing, or too breathless to feed.
• Fewer wet diapers, much sleepier than usual, or a cough that causes color change.

When to check in

• Let the pediatrician's office know about any cold in a baby under 3 months, especially if it is affecting feeding.
• Call right away, day or night, for a rectal temperature of 100.4°F (38°C) or higher, or for any of the signs above.
• If lips or face look blue or gray, or the baby stops breathing, call 911.