Newborns often have noisy breathing, which can cause significant worry for parents, especially when it sounds like deep congestion or phlegm in the throat. This concern is understandable because infants are obligate nasal breathers, meaning they breathe almost entirely through their nose. The narrowness of their nasal passages means that even a small amount of mucus can be highly disruptive, creating loud sounds that seem more severe than they truly are. This guide provides practical and safe methods to manage and clear congestion, helping your baby breathe, feed, and sleep more comfortably.
Differentiating Normal Sounds from True Congestion
Many of the sounds that worry parents are actually typical noises produced by a newborn’s tiny anatomy rather than a deep chest infection. The classic “snorting” or “whistling” sound often comes from mucus high up in the nasal passages or simply from the small size of the nostrils themselves. These sounds tend to be intermittent and do not usually interfere with the baby’s feeding or overall demeanor.
A gurgling or coarse sound may also be caused by retained fluid or saliva in the upper airway, which is common in the first few weeks of life. This superficial congestion is not typically a cause for alarm and often resolves naturally as the baby grows. Normal noisy breathing does not require an increased effort from the baby to move air.
True congestion is characterized by a consistent, wet sound that indicates a buildup of thicker mucus that is harder to clear. If the noise is accompanied by visible difficulty during feeding or sleeping, it suggests the congestion is significant enough to warrant intervention. Observing your baby’s comfort level and breathing effort is a more reliable measure than the volume of the sound alone.
Loosening Mucus with Saline and Moisture
Before attempting to remove mucus directly, it is beneficial to thin the secretions to make them easier to clear and reduce the risk of irritating the nasal lining. Sterile saline drops are effective because they are a non-medicated mixture of water and salt. The saline solution works by drawing moisture into the nasal passages, which helps to liquefy thick, sticky mucus.
For newborns, use sterile saline drops, not a forceful spray, to avoid driving the mucus further into the passages. Typically, two to three drops are administered into each nostril while the baby is lying on their back with their head slightly tilted back. Allowing a minute or two for the saline to work before suctioning can improve the effectiveness of the clearance.
Environmental moisture also plays a role in managing thick phlegm and congestion. Operating a cool-mist humidifier in the baby’s room adds moisture to the air, helping to prevent secretions from drying out and hardening. Alternatively, sitting with your baby in a steamy bathroom for about 10 to 15 minutes, with the hot shower running, can provide temporary relief by thinning the mucus in the upper respiratory tract.
Direct Clearance Methods
Once the mucus has been loosened, a nasal aspirator can be used to physically remove the secretions from the nasal passages. The bulb syringe is the most common tool, and proper technique is necessary to ensure safety and effectiveness. To use a bulb syringe, first compress the bulb completely to expel the air before gently inserting the tip into the baby’s nostril.
While keeping the bulb compressed, insert only the very tip into the nostril to create a seal, then slowly release the bulb to create suction that draws the mucus out. After suctioning one nostril, squeeze the collected mucus into a tissue and then repeat the process for the other side if needed. Clean the bulb thoroughly with soap and water after each use and allow it to air-dry to prevent bacterial growth.
Other options include oral suction aspirators, which use a filter to protect the user, or battery-operated electric aspirators. Regardless of the device, suctioning should be limited to only a few times a day, primarily before feedings and sleep. Excessive or vigorous suctioning can cause swelling and irritation of the nasal tissue, which may worsen the congestion.
Recognizing Signs of Respiratory Distress
While most newborn congestion is manageable at home, certain signs indicate that the baby is struggling to breathe and requires immediate medical attention. One of the most serious red flags is retractions, which is a visible sucking-in of the skin and muscles between the ribs, under the rib cage, or at the neck when the baby inhales. Retractions show that the baby is using accessory muscles to force air into their lungs.
Another danger sign is cyanosis, which is a bluish tint to the lips, tongue, or nail beds, indicating a low oxygen level in the blood. A consistently high respiratory rate, typically over 60 breaths per minute when calm, is also a sign of distress. If the baby is making a persistent grunting noise with every exhale, this can be a mechanism to keep the small air sacs in the lungs open and is a serious indication of breathing difficulty.
Any sign of lethargy, refusal to feed, or a fever in a newborn should prompt an immediate call to a pediatrician or a visit to an emergency room. Trusting your parental intuition is important; if your baby appears to be working hard to breathe or their behavior seems significantly off, seek professional medical evaluation without delay.