Why does my baby often have a stuffy nose at night?

Generally, when a baby frequently experiences nasal congestion at night, it refers to recurrent nighttime stuffiness. This may be caused by changes in body position, narrow nasal passages, colds, allergic rhinitis, or sinusitis. Management can include general measures or medication under a doctor's guidance. Specific causes are analyzed as follows:

1. Changes in Body Position

When babies lie flat, the flow of nasal secretions is obstructed and tends to accumulate in the back of the nasal cavity, leading to nasal congestion—especially noticeable during deep sleep at night. Try slightly elevating the baby’s head during sleep by using an infant-specific pillow or raising one end of the mattress to help drain secretions and reduce congestion.

2. Narrow Nasal Passages

Babies’ nasal structures are not yet fully developed and their nasal passages are narrower than those of adults. When indoor air is dry at night or contains dust, pollen, or other particles, the nasal mucosa may react, producing excess secretions that lead to congestion. Using saline nasal drops can help clear nasal secretions. Maintaining appropriate indoor humidity and avoiding allergens can also help prevent symptoms.

3. Colds

Colds are usually caused by pathogens entering the body. Viruses trigger inflammation of the nasal mucosa, increasing secretions and narrowing the nasal passages, resulting in frequent nighttime nasal congestion. Symptoms may include fever, cough, sneezing, and runny nose. Under medical guidance, medications such as Lanqin Oral Liquid, Fenghan Cold Granules, or Ganmaoling Granules may be used for treatment.

4. Allergic Rhinitis

Allergic rhinitis occurs when the nasal passages are exposed to allergens. These allergens stimulate the nasal mucosa, triggering an allergic reaction that may cause nasal mucosal congestion, swelling, increased secretions, and nasal blockage—often occurring at night. Symptoms may include sneezing, runny nose, and nasal itching. Under a doctor’s supervision, treatments may include azelastine fluticasone nasal spray, budesonide nasal spray, or triamcinolone acetonide acetic acid cream.

5. Sinusitis

Sinusitis is a sinus infection caused by viruses, bacteria, or fungi. Inflammation and swelling of the sinus mucosa increase secretions, blocking the sinus openings and impairing nasal airflow, causing the aforementioned symptoms. It may also be accompanied by headaches and facial tenderness. Under medical guidance, medications such as amoxicillin-clavulanate potassium tablets, acetaminophen tablets, or amoxicillin capsules may be prescribed for treatment.

Parents are advised to closely monitor their baby's nasal condition and seek prompt medical attention if any abnormalities occur.