Infant Series: Eye Discharge, Nasal Congestion & Breathing
One of the most common problems with infants are a blocked tear duct, also called the nasolacrimal duct. The duct is a small opening on the inside of the eye which drains tears into the inner nasal area. When it is narrowed or blocked, tears build up forming a yellow, crusty discharge. Typically, this discharge is intermittent, lasting days to weeks at a time, usually building up during sleep and controlled with a warm washcloth to wipe away the tear build up.
One can also massage the duct by gently rubbing your finger down the bridge of the nose. The natural course is that as baby grows, the duct grows too and opens up usually by 6- 9 months.
Rarely, the tears get superinfected and form a thicker, green, stringy discharge which does not resolve within 2-3 days and often associated with conjunctivitis, which needs antibiotics. If recurrent infection occurs, sometimes ophthalmology consultation is warranted for mechanical opening of the tear duct.
In addition to narrow tear ducts, many babies also have narrow nasal passageways at birth causing nasal congestion. Babies are obligate nasal breathers which means they preferentially breath through their nose. This means that small nasal canals can make a lot of noise but usually pose no threat to your baby. As long as your baby is feeding well and has no increase work of breathing, no treatment other than nasal bulb syringe aspiration is necessary. This usually resolves by 3-6 months.
Infants can have an irregular breathing pattern during sleep called periodic breathing where rapid breathing for 10-20 seconds is followed by a pause. This is considered normal and resolves as the breathing center in the brain matures. If you notice color changes (blue color around the lips) or pauses lasting longer than 10 seconds, this is not normal and needs evaluation to other causes.