Saline drops, gentle suctioning, extra fluids, and humid air are the most effective and safest ways to relieve congestion in children. Most congestion clears on its own within a week or two, but these simple interventions can make your child noticeably more comfortable in the meantime. What works best depends partly on your child’s age, since many common remedies have strict age cutoffs.
Saline Drops and Sprays
Saline is the single most reliable tool for congestion in kids of any age, including newborns. Salt water loosens thick mucus so it can drain or be suctioned out more easily. A systematic review of studies on children with upper respiratory infections found that saline irrigation reduced symptom severity, and one study of children under three showed that 67% had clear nasal sounds after saline irrigation compared to just 32% of children who received no treatment.
For infants, tilt the head back slightly and place two to three drops of saline in each nostril. Wait a few seconds for the solution to loosen the mucus, then use a bulb syringe or nasal aspirator to suction it out. Older toddlers and kids can use a saline spray bottle or even a gentle rinse. You can repeat this several times a day, especially before feedings and sleep. Both regular (isotonic) and slightly saltier (hypertonic) saline work. A study of 125 children under two found that both types improved symptoms and sleep quality compared to no irrigation at all.
Nasal Suctioning for Babies
Babies can’t blow their noses, so suctioning is often necessary after saline drops. You have three main options: bulb syringes, tube-style aspirators where you provide suction through a mouthpiece, and battery-powered electric aspirators.
Bulb syringes are cheap and widely available, but technique matters. Always squeeze the bulb before placing it at the nostril, then release to create suction. Squeezing after the tip is already in position can push mucus deeper. Tube aspirators give you more control over suction strength but can be inconsistent. Electric aspirators offer the most even, controlled suction and tend to be easiest for new parents to use correctly.
Whichever tool you choose, limit suctioning to two or three times a day. Overdoing it can irritate the delicate lining of your baby’s nose and actually cause more swelling.
Fluids and Humidity
Keeping your child well hydrated helps the body maintain thinner, more fluid mucus. The airways lining naturally regulates mucus hydration through a balance of fluid secretion and absorption, but when a child is sick and possibly eating or drinking less than usual, that balance can tip toward thicker, stickier mucus. For breastfed or formula-fed babies, offer feedings more frequently. For older children, water, diluted juice, broth, and warm soups all count.
A cool mist humidifier in your child’s room adds moisture to the air and can ease coughing and congestion. The Mayo Clinic recommends cool mist humidifiers specifically for children because warm mist humidifiers and steam vaporizers pose a burn risk if a child tips them over or gets too close. By the time the water vapor reaches your child’s lower airways, it’s the same temperature regardless of whether it started warm or cool, so there’s no therapeutic advantage to heated steam. Clean the humidifier daily to prevent mold and bacteria buildup.
Honey for Children Over One
Honey can soothe a cough that often accompanies congestion, but it is only safe for children 12 months and older. Younger babies are at risk for infant botulism, a rare but serious form of food poisoning caused by bacterial spores that honey can contain. For children ages one and up, half a teaspoon to one teaspoon (2.5 to 5 milliliters) before bed can calm nighttime coughing. Multiple studies have found it performs as well as or better than common over-the-counter cough suppressants in children.
Vapor Rubs: Age Limits and Side Effects
Mentholated chest rubs are a go-to for many parents, but they’re not appropriate for young children. Most products containing camphor and menthol are labeled for ages two and up, and camphor has been linked to seizures in young infants. Even in older children (ages 2 to 11), a clinical study found that 46% of kids treated with vapor rub experienced at least one side effect. The most common was a burning sensation on the skin (28% of children), followed by burning in the eyes (16%) and nose (14%). These effects were mild, but worth knowing about. If you use a vapor rub on an older child, apply a thin layer to the chest only, never under or inside the nose.
Over-the-Counter Medications to Avoid
The FDA warns that children under two should never be given over-the-counter cough and cold products containing decongestants or antihistamines, because serious and potentially life-threatening side effects can occur. Manufacturers have voluntarily extended that warning, labeling these products “do not use in children under 4 years of age.” This includes common oral decongestants and combination cold medicines found in any pharmacy aisle. For children under four, stick with saline, suctioning, fluids, and humidity. For children four and older, talk to your pediatrician about whether a specific product is appropriate and what dose to use based on your child’s weight.
Safe Sleep With a Stuffy Nose
It’s tempting to prop up a congested baby so they can breathe more easily, but this is not safe. The American Academy of Pediatrics recommends that babies always sleep flat on their backs on a firm, even surface with no pillows, props, or blankets. Think of your baby’s airway like a straw: it works best when it’s straight. Propping a baby’s head up or inclining the mattress can cause the neck to bend forward or to the side, actually making breathing harder. The Consumer Product Safety Commission has banned inclined sleepers (anything that raises the head more than 10 degrees above flat) after a series of infant deaths.
Instead of elevating, clear your baby’s nose with saline and suctioning right before laying them down. Running a cool mist humidifier nearby can also help them breathe more comfortably through the night. For toddlers and older children who sleep with a pillow, a slight elevation is fine and can help mucus drain.
Signs of Breathing Trouble
Most congestion is harmless and clears within seven to ten days. But certain physical signs mean your child is working too hard to breathe and needs medical attention. Watch for nasal flaring, where the nostrils spread wide with each breath. Look at the chest for retractions, where the skin pulls inward below the neck, under the breastbone, or between the ribs during breathing. Listen for wheezing, a tight whistling or musical sound especially when breathing out, which signals that the airways are narrowing. Rapid breathing, a bluish tint around the lips or fingernails, or an inability to drink or feed are also reasons to seek care promptly.