Sleep during a cold
They cannot breathe through their nose, they cannot feed properly, and nobody is sleeping. For the next few days sleep is not the problem to solve - it is the thing that improves once the other two do.
3 min read
Babies under about six months breathe mainly through their noses, so a blocked nose is a much bigger problem for them than for an adult. It interferes with feeding, it wakes them repeatedly, and it is worse lying flat because mucus pools.
Nothing about the routine will fix that. Put the schedule aside for the duration, do whatever gets everyone through, and pick it back up afterwards.
What actually helps
Saline drops before feeds and sleep. The most effective thing available, and safe at any age. Two drops per nostril, then a nasal aspirator if they will tolerate it.
Fluids, frequently. Smaller, more frequent feeds. A blocked baby cannot manage a long feed and will take less each time. This matters more than sleep does.
Humidity. A humidifier, or sitting in a steamy bathroom for ten minutes before bed. Keep the room at the normal sixteen to twenty degrees.
Upright while awake. Holding them upright helps drainage. But they still sleep flat on their back - do not tilt the cot or use a wedge or positioner.
Paracetamol or ibuprofen if needed. At the dose appropriate for their age, for fever or obvious discomfort. Check with a pharmacist if unsure.
What not to do
Do not raise the head of the cot, use a sleep positioner, or let them sleep in a car seat or bouncer. The temptation is strong when a baby is congested and the risk is real - safe sleep guidance does not change during a cold.
Over-the-counter cough and cold medicines are not recommended for young children, and vapour rubs are not suitable for babies. Honey must not be given under twelve months.
A blocked nose is a feeding problem before it is a sleeping problem. Fix the nose and the feeds first.
Getting back afterwards
Colds run five to ten days, with the cough often lingering longer. Once the daytime mood has recovered, go straight back to the usual routine rather than easing into it - three or four nights is normally enough to reset if you do not delay.
How long it lasts, and the cough afterwards
Colds run five to ten days, with the congestion usually worst on days two to four. The cough outlasts everything, often by two or three weeks, and a night-time cough in an otherwise well and cheerful child is not a reason to keep the routine on hold.
The signal to go back to normal is the daytime mood rather than the absence of symptoms. Once your baby is themselves during the day, feeding properly and has had no fever for a day, return to the usual arrangements the same night. Waiting for the cough to disappear entirely typically means waiting an extra fortnight, and by then the illness habits have become the arrangement.
Using saline properly
Saline drops are the most useful thing available and most people use them too sparingly. Two drops per nostril, with your baby lying back, a couple of minutes before a feed and before sleep. Then a nasal aspirator if they tolerate it, though many do not and the drops alone help.
It is safe at any age and can be repeated several times a day. The timing matters more than the quantity: a blocked baby who cannot feed will take less milk and wake more, so clearing the nose before feeds does more for the night than clearing it at bedtime.
When to stop troubleshooting
Seek urgent medical help for fast or laboured breathing, the skin pulling in under the ribs or at the neck, grunting with each breath, blue or very pale skin, a baby who is difficult to rouse or unusually floppy, or one who is refusing feeds and having fewer wet nappies. Any fever in a baby under three months needs same-day advice. Bronchiolitis is common in infants and can deteriorate quickly - trust your instinct and call 111 or your GP.
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