Stuffy Nose How to Break Up Nasal Gridlock

How to Break Up Nasal Gridlock

Your four-year-old is throwing another footstomping tantrum. This time, however, her defiant ''no'' comes out like ''doe.''

At one time or another, it seems, every kid gets a stuffed-up nose that makes her sound like Snuffleupagus, Sesame Street's elephantine character with the nasally voice. Most often, it's because a cold virus has moved into the nose, says Bob Lanier, M.D., a pediatric allergist and immunologist in private practice in Fort Worth, Texas, and host of the nationally syndicated radio and TV program ''60 Second House Call.'' The intruding virus irritates the delicate mucous membranes lining the nasal passages, causing blood vessels to swell. Fluid pools in the surrounding tissue. This triggers more mucus production until, finally, the result is nasal gridlock. Air can't move in and air can't move out.

For kids who are allergy prone, other irritants besides viruses may have the same effect. Feather pillows, dust or pollen can also swell nasal membranes. But whatever the cause, a child with jammed nasal passages is likely to be cranky, uncomfortable and unable to sleep. That means Mom and Dad don't get much sleep either.

And a baby's grouchiness can lead to all-night wakenings. ''A stuffy nose can make a baby feel like she's suffocating,'' says Dr. Lanier. If her nose is blocked, she can't nurse, so she'll be even more frantic.

Here's what experts recommend to get mucus moving and breathing passages open again, no matter what your child's age.

For moister air, turn on the shower. ''In Seattle, where we have misty weather, I often tell parents who have porches to rock their stuffy babies to sleep out in the moist air,'' says Helen Baker, M.D., clinical professor of pediatrics at the University of Washington in Seattle. But Dr. Baker also recommends an even better remedy that's available to anyone year-round: ''First, run the shower tap on hot for several minutes to steam up your bathroom. Then go in and sit with your child for 15 to 20 minutes. That should help loosen nasal secretions,'' she says.

Try a mist machine at night. If your child often wakes up stuffy, it may be because the air in your house is too dry. If so, you can use a cool-mist vaporizer or ultrasonic humidifier. These are safer in kids' rooms than the old-fashioned steam-type vaporizers, according to Michael Macknin, M.D., head of the Section of General Pediatrics at the Cleveland Clinic Foundation in Ohio, clinical professor at Pennsylvania State University Medical School in Hershey and associate professor of pediatrics at Ohio State University Medical School in Columbus. But you have to clean them often to avoid fungus and bacteria buildup (follow manufacturer's instructions).

''These misters spew minute particles that can end up deep inside the airways. If there's contamination, it may trigger bronchitis or other breathing problems,'' says Dr. Macknin. He recommends rinsing the machine daily with hot water. Every third day, scrub the tank with a diluted bleach solution and rinse thoroughly.

Keep filling her favorite cup. When your child has to breathe through her mouth for long periods, it can have a dehydrating effect, says Dr. Lanier. Drinking lots of water, juice or other liquids helps guard against that, and also promotes mucus flow and drainage, he says. Milk is fine, too. ''It's a myth that milk thickens mucus,'' says Dr. Lanier.

Try a tender touch. ''For children who panic when they get stuffy, reassurance is important,'' says Dr. Baker. ''A calming rock in a rocking chair, for example, may help settle your child so she can fall asleep.''

Dr. Baker doesn't advise rubbing your child's chest with a strong-smelling over-the-counter ointment containing menthol, oil of wintergreen or eucalyptus. ''These give parents something to do, but they really don't improve air flow,'' she says. And in babies and very young children, these ingredients can be absorbed into the bloodstream, where they might have toxic effects.

Suction out the stuffiness. If you have an infant with a stuffy nose, a handy suction device called an ear bulb can be a great help. Available at drugstores, the ear bulb makes a great mucus extractor, says Dr. Baker. ( She prefers it to a nasal aspirator because it has a longer, easier-to-use tip.)

To use one, hold your baby's head still with one hand. With the other hand, squeeze the bulb, then insert the tip in one nostril. Quickly release the bulb to suction up secretions. Remove the tip and squirt the contents in a tissue. Repeat with the other nostril. ''After use, be sure to sterilize the bulb by boiling it,'' adds Dr. Lanier.

Try homemade saltwater nose drops. ''I've been recommending these drops for 30 years to loosen stubborn secretions in infants,'' says Dr. Baker. Her recipe: Mix ¼ teaspoon of salt in a ½ cup of warm water, and store it in a clean jar--but not for more than a few days. Make up a new jar if needed.

To get the drops to baby's upper nasal passages, you'll need gravity's help, she says. Sit on the edge of a chair, with your legs straight out and your feet flat on the floor. Position your baby's head down the incline of your legs so her nose points to the sky. Hold her still with one arm. Using an eyedropper, place one drop of saltwater in each nostril. Wait a few minutes. ( If necessary, you can sing to her to calm her.) Then, using an ear bulb, suction out the secretions. Both the eyedropper and the ear bulb should be boiled, to sterilize them, before you use them again.

To insert drops in an older child's nose, have him lie face up on the bed with his head over the edge. Place two drops in each nostril. Let them seep in for about two minutes. Then have him gently blow his nose.

Or buy the ready-made kind. Saline (saltwater) drops are available at drugstores. But you'll need to administer them with a steady hand. If the tip should touch your child's nose, the dropper could become contaminated, cautions Steven D. Handler, M.D., associate director of otolaryngology at Children's Hospital of Philadelphia. ''If contact is made, don't replace the dropper in the bottle,'' he cautions. Sterilize the dropper before you use it again.

Be cautious with medicated syrups. Over-the-counter decongestant syrups shrink swollen blood vessels and open up the airways, says Dr. Handler. Different children react in different ways to the individual products. Some kids get jittery, says Dr. Handler, while for other kids, the same product puts them out like a light. ''It's a matter of trial and error,'' he says.

These products aren't meant for kids under one year old, cautions Dr. Baker. For older children, carefully follow the directions on the bottle or consult your physician for the correct dosage for your child.