Congestion in Children

Congestion is a common symptom in children. Sometimes congestion is an acute, or short-term, condition, such as in the case of a cold or the flu.

Other times nasal congestion is a chronic problem, such as in the case of allergies. In order to fully resolve nasal congestion in children, it is important to identify the underlying cause, as well as to treat the symptoms. Nasal congestion is often caused by the swelling of the tissue lining the nose due to irritated and inflamed blood vessels.

Causes of Short-term Congestion

Common causes of short-lasting congestion in children include a viral infection, such as a cold or flu, or a sinus infection, which can be either viral or bacterial. According to MedlinePlus, there are over one billion colds in the United States each year and children average three to eight colds per year. At the onset of a viral infection, nasal secretions are typically thin, becoming thicker and sometimes colored yellow or green as the infection progresses. A sinus infection, also called sinusitis, can occur after a viral infection, such as a cold, or as the result of allergies. Sinusitis often starts as acute, but if untreated can become chronic.

In sinusitis, the sinuses swell and become irritated, often as the result of mucus trapped in the sinuses. The trapped mucus provides a place for bacteria, viruses and fungi to grow. Sinusitis can cause persistent congestion, not only in the nose itself, but also in the face.

Causes of Chronic Congestion

Little girl with the flu

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Allergies affecting the nose are referred to as allergic rhinitis. According to the American Academy of Allergy, Asthma, and Immunology, allergies are the most common cause of chronic congestion in children.

When a child with allergic rhinitis breathes in an allergen, the body releases histamine as part of the immune response, which in turn causes swelling and mucus production that results in congestion. Left untreated, chronic nasal congestion in children can cause abnormalities in the growth of the bones of the face and the teeth.


Common nasal symptoms of a viral infection include a runny nose, congestion and sneezing. In a cold, the most common symptoms occur in the nose, so nasal congestion is almost a given.

In younger children, sinusitis often causes cold-like symptoms, including nasal congestion and fever. Many parents associate cold-related headaches with sinusitis. However, according to the KidsHealth website, the sinuses in the forehead aren't developed enough to get infected until the teen years.

In contrast, facial pain and headaches are common symptoms of sinusitis in teens. Common allergy symptoms include a runny and itchy nose, sneezing, postnasal drip, and congestion.


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An important component of treating congestion, especially congestion that is severe enough to disrupt your child from her normal routine or that is chronic in nature, is identifying the underlying cause of the congestion. Your child's doctor will first obtain a history and ask questions about the duration of the congestion, other symptoms and attempted treatments. Diagnostic tests that may be ordered to identify the cause of your child's congestion include allergy skin tests, X-rays of the sinuses and chest, blood tests and sputum culture.


If a cold is the cause of congestion, making sure that your child gets plenty of rest and drinks a lot of fluids will help his body to recover and will help to thin nasal secretions. Chicken soup can also be helpful in relieving cold symptoms. According to MedlinePlus, medical experts have recommended against using cold medications in children under the age of six. For older children, over-the-counter medications may lessen congestion. Decongestants can be helpful for treating all causes of congestion. They work by shrinking the blood vessels lining the nose. Antihistamines can also be effective by reducing the amount of mucus, especially in the case of allergies.

Saline nose drops can be used in children of all ages.

In a baby, the use of a nasal bulb to remove mucus can help. For children of all ages, a cool-mist vaporizer in their room at night and hot steam from the shower may aid in relieving congestion.