Expert: David Olson, MD - 6/5/2004

Question
Dear Doctor:

I understand that you can't diagnose anything over the internet.  I am just looking for some advise or information.

My wife and I have a 4 week old baby girl.  My wife's due date was June 6th.  The baby was born via c-section on May 7th because of preeclampsia. The baby was 3lbs and 4oz at birth.  She stayed in the hospital for one week until she was 3 lbs and 12oz and then they discharged her.  She has been home with us and is doing well.  She is gaining weight and is up to 4lbs 11oz at this time.  

The problem / question I have is that she is always VERY congested.  We have told her pediatrician this numerous times and he doesn't seem too concerned about it.  All he said to do was use something called "ocean" or "little tears" nasal spray.  I guess they are both saline based nasal sprays.  Anyway, we purchased the ocean nasal spray.  When I spray it up her nose, tons of discharge comes pouring out both sides of her nose.  I then use a nasal aspirator to suck out as much mucous as possible.  The problems is, when I am done her nose if fine but she has a ton more mucous in the back of her throat that we can still hear. It sounds like she is gargling.  We can tell that it is bothering her.  She is unable to take her bottle and swallow normally because of this.  Do you have any advise or ideas?  Isn't there any over the counter medications that we can give her to "dry" her mucus membranes out for a little while to give her a break?  This has been ongoing for the past two weeks..at least.

Thank You,

Paul

Answer
Hi, Paul,

Congratulations on your new baby.

Generally I give the same advice as your pediatrician would.  We are very hesitant to give medicines to babies this age for this condition.  She is at an age until about 4-5 months where she is an obligate nose breather.  She has to breath through her nose, and if it is blocked, she has a difficult time breathing.  She can't use her mouth effectively to breath until about 4-5 months.

What to do?  The saline drops are safe, effective but really a pain for a baby.  You might ask your doctor about the occassional use of 1/8% neosynephrine drops.  These are effective, but can cause a rebound effect if used more than 4-5 days in a row.

Good luck, Dr. Olson