A baby’s runny nose is almost always caused by a common cold, and since there’s no cure for cold viruses, your job is to keep your baby comfortable while their immune system does the work. Most runny noses clear up on their own within 7 to 10 days. The main things you can do are keep the nose clear with saline and suction, add moisture to the air, and make sure your baby stays well hydrated.
Clear the Nose With Saline and Suction
Babies can’t blow their own noses, so saline drops and a bulb syringe (or another nasal aspirator) are your best tools. Lay your baby on their back and put 3 to 4 drops of saline into each nostril. Hold their head back for about a minute to give the saline time to thin the mucus.
Then squeeze all the air out of the bulb syringe before gently placing the tip into one nostril. Release the bulb slowly so it pulls the loosened mucus out. Squeeze the mucus onto a tissue, then repeat on the other side. Gently wipe around the nose afterward to prevent skin irritation from the constant moisture.
Timing matters here. Always suction before feedings, not after. Suctioning on a full stomach can trigger vomiting. And limit suctioning to no more than four times a day, because overdoing it can irritate the delicate lining inside your baby’s nose and actually make congestion worse.
Add Moisture to the Air
A humidifier helps keep nasal passages from drying out, which makes it easier for mucus to drain naturally. You have a few options, and each comes with trade-offs.
- Ultrasonic (cool mist): Quiet, affordable, and no burn risk. The downside is that they spray everything in the water into the air, including bacteria and minerals. Use only distilled water to avoid releasing mineral dust.
- Evaporative: Also cool and safe from burns. A recent Consumer Reports study found this type releases neither bacteria nor minerals. The filter needs frequent changing, though.
- Steam-based: Produces germ-free vapor because it boils the water first, but the hot surfaces can burn a curious toddler or older sibling. Not ideal for unattended use in a child’s room.
Whichever type you use, clean it weekly by filling the tank with enough distilled white vinegar to cover all water-contact surfaces. Let it soak for 20 minutes, scrub the cracks with a toothbrush, rinse well, and air dry. Never add essential oils or vapor rubs to any humidifier. If you notice white dust collecting on surfaces near the humidifier, stop using it immediately. Keep the bedroom door open so the room doesn’t become overly humid.
Keep Your Baby Hydrated
Congestion can make feeding difficult because babies breathe through their noses while they eat. Shorter, more frequent feedings often work better than trying to get through a full session. For babies under one year, stick with breast milk or properly mixed formula as their primary fluids. An oral rehydration solution is also safe if your baby is losing fluids from a fever or refusing normal feeds.
If your baby is struggling to take fluids, try offering 1 to 2 teaspoons (5 to 10 mL) of breast milk, formula, or oral rehydration solution every 5 to 10 minutes using a spoon or syringe. Watch for signs of dehydration: fewer wet diapers than usual, no tears when crying, a dry mouth, or unusual sleepiness.
Safe Sleep With a Stuffy Nose
It’s tempting to prop your baby up on pillows or incline the mattress to help them breathe, but this is genuinely dangerous. When a baby’s head is propped up, their neck can bend forward or fall to one side, creating a kink in the airway that makes breathing harder, not easier. The Consumer Product Safety Commission has banned inclined sleepers (anything with more than a 10-degree angle) for this reason.
The American Academy of Pediatrics recommends babies always sleep flat on their backs on a firm, even surface with nothing else in the sleep space: no pillows, wedges, rolled towels, blankets, or stuffed animals. Don’t let a congested baby fall asleep in a swing, rocker, or bouncy seat either, because they can’t keep their head upright and their airway straight in those positions. Instead, use saline and suction right before bedtime to clear the nose, and run a humidifier in the room with the door open.
Skip the Cold Medicine
Over-the-counter cough and cold medicines are not safe for young children. The FDA warns against giving them to any child younger than two because of the risk of serious, potentially life-threatening side effects. Manufacturers go further and voluntarily label these products as not for use in children under four.
Homeopathic cough and cold products aren’t a safer alternative. The FDA has no evidence that they work, and children under four who have taken them have experienced seizures, allergic reactions, difficulty breathing, and dangerously low blood sugar. The safest approach for a baby’s cold is the combination of saline, suction, humidity, and fluids described above.
Teething vs. a Cold
Teething can produce a runny nose, but there are clear differences. Teething-related discharge is typically clear and lasts only two to three days, centered around the day a tooth actually breaks through. Any temperature bump from teething is tiny (around 0.2°F) and stays within the normal range. If your baby’s temperature hits 100.4°F or higher rectally, teething isn’t the explanation.
A cold is more likely if the runny nose comes with a cough, if your baby seems progressively more fussy, or if the discharge lasts longer than a few days. Mucus color alone isn’t very telling. White, yellow, and green discharge are all normal during a cold and don’t automatically mean your baby needs antibiotics.
Signs of Something More Serious
Most runny noses are harmless, but a cold can sometimes lead to an ear infection. Bacteria take advantage of the fluid and swelling from a viral infection to set up shop in the middle ear. Since your baby can’t tell you their ear hurts, watch for tugging or pulling at the ears, new or worsening fussiness and crying, trouble sleeping beyond what the congestion explains, fluid draining from the ear, or problems with balance.
Contact your pediatrician if nasal discharge lasts longer than 10 to 14 days, if yellow or green mucus persists beyond that window, or if a cough hangs on for more than 10 days. A fever lasting more than three days also warrants a call.
Some breathing changes need immediate attention. If you see your baby’s nostrils flaring wide with each breath, the skin pulling inward below the neck, under the breastbone, or between the ribs (called retractions), or your baby is breathing noticeably fast, these are signs of respiratory distress.