Nasal rinsing for babies: how to do it safely and when to seek help

A stuffy nose in a baby can be very worrying — especially because little ones can’t blow their noses on their own yet.

When there is mucus or nasal congestion, the baby may have a harder time sleeping and even trouble feeding.

In these situations, nasal hygiene with saline solution can help thin and remove mucus, making it easier to breathe through the nose.

Although it seems like a simple task, it’s worth knowing a few important precautions to do it safely.

What is nasal rinsing for?

Saline solution helps moisten the inside of the nose and loosen dry or thick mucus.

This can be especially helpful when the baby has:

• a stuffy nose;
• nasal discharge;
• trouble feeding because of congestion;
• discomfort while sleeping caused by a blocked nose.

In young babies, clearing the nose before feeds can make feeding easier when congestion is getting in the way.

What should you use to rinse a baby’s nose?

For babies and young children, choose saline solution without medication, such as normal saline suitable for nasal use.

Do not use medicated nasal decongestants in babies without medical advice.

Decongestant medications can cause side effects and should not be treated as equivalent to saline.

How to do nasal hygiene?

The technique may vary depending on the child’s age and the pediatrician’s guidance.

In young babies, the approach should generally be gentle.

A simple way is to:

1. Wash your hands well.

2. Position the baby comfortably and safely.

3. Carefully apply the saline solution into one nostril.

4. Let the mucus come out naturally or remove the excess when needed.

5. Repeat on the other side.

When there is a lot of mucus, a suitable nasal aspirator can be used gently after applying the saline solution.

The goal is not to put a lot of pressure inside the nose, but to help soften and remove the mucus.

Do you need to use a syringe?

There are different ways to do nasal hygiene, including drops, age-appropriate sprays and syringes.

But more pressure doesn’t mean better cleaning.

In newborns and young babies, the technique and volume used need to be appropriate for their age.

If you have never done a nasal rinse or aren’t sure how to do it, ask the pediatrician or another health professional to demonstrate the technique during an appointment.

What about the nasal aspirator?

A nasal aspirator can help when there is mucus the baby can’t clear on their own.

There are manual and electric models.

Suction should be gentle and doesn’t need to be done repeatedly when there isn’t significant mucus.

Excessive or overly aggressive use can irritate the lining of the nose, leaving the area more sensitive or swollen.

When is the best time to do it?

When congestion is getting in the way, some moments can be especially useful.

For example:

• before feeds;
• before sleep;
• when mucus is making it hard to breathe through the nose.

Doing nasal hygiene before feeding can help because babies need to breathe through their nose while they feed.

Do you need to do nasal rinsing every day?

Not every baby needs their nose rinsed several times a day.

Whether it’s needed depends on the amount of mucus, whether there is congestion and the pediatrician’s individual guidance.

If the baby is breathing normally, feeding well and comfortable, there’s no need to insist on frequent procedures just because they are part of a routine.

The Brazilian Society of Pediatrics (SBP) points out that nasal rinsing has become very common and that there are different devices and ways to do it. Care should be individualized.

Can I make saline at home?

For babies, a ready-made solution suitable for nasal use is usually the simplest option to reduce preparation errors and contamination.

If a solution is prepared at home on professional advice, it is essential to use safe water — sterilized, distilled or previously boiled, according to the recommendation you received.

Avoid improvising solutions with water straight from the tap.

Can I use a cotton swab inside the nose?

Avoid putting cotton swabs or other objects inside the nostrils.

The lining of the nose is delicate and can be easily injured.

If there is visible dried mucus on the outside of the nose, gently clean only the area you can reach.

The baby cried during the rinse. Did I do something wrong?

Not necessarily.

Some babies don’t like the feeling of the solution going into their nose or being positioned for nasal hygiene.

Crying during the procedure doesn’t necessarily mean something went wrong.

Even so, the procedure should be gentle.

If the baby has repeated choking, bleeding, significant difficulty breathing or is very uncomfortable after the rinse, stop and seek professional advice.

Does nasal rinsing treat the flu or a cold?

No.

Saline solution can help relieve congestion and remove mucus, but it doesn’t eliminate the virus that causes a cold or other respiratory infection.

So it works mainly as a comfort measure.

Be careful with decongestants

Do not put decongestant medications in a baby’s nose on your own.

Medicated products are not equivalent to saline and can cause side effects.

If you are unsure about any nasal spray, drops or product, check with the pediatrician before using it.

When to seek care?

A stuffy nose on its own is usually different from difficulty breathing.

Seek care immediately if the baby shows signs such as:

• effort to breathe;
• ribs or the area below the ribs sinking in with each breath;
• very fast or clearly labored breathing;
• lips or skin turning bluish or purple;
• significant trouble feeding due to shortness of breath;
• pauses in breathing;
• drowsiness or a significant drop in their usual responsiveness.

Retractions — when the skin seems to “sink in” between or below the ribs with each breath — are a sign of breathing difficulty and need to be evaluated.

Also seek medical advice if the congestion persists, gets worse or comes with other symptoms that are worrying the family.

Newborns need special attention

In the first months of life, it’s important to be extra careful with respiratory symptoms.

If a newborn seems to be having trouble breathing, don’t try to fix it just by rinsing the nose more often.

Seek an evaluation from a health professional.

Nasal rinsing should bring comfort, not become a battle

Nasal hygiene can be a simple ally on stuffy-nose days.

The most important thing is to use a suitable solution, do it gently and watch how the baby is breathing, feeding and behaving.

Not every bout of congestion calls for several rinses throughout the day — and difficulty breathing should never be treated as just a “stuffy nose.”

Nilu tip: if congestion tends to get in the way of feeding, try doing nasal hygiene a few minutes before feeding the baby. When mucus is the problem, clearing the nose can make feeding more comfortable. 💛

Reference sources

• Brazilian Society of Pediatrics — Nasal rinsing.
• American Academy of Pediatrics / HealthyChildren.org — guidance on nasal congestion, saline solution and nasal suction in babies and children.

This content is for educational and informational purposes and does not replace consultations, evaluations, diagnosis or individualized guidance from health professionals.