Lillian M. Beard, M.D, a Fellow of the American Academy of Pediatrics, is an associate clinical professor at the George Washington University School of Medicine and Health Sciences in Washington, D.C. She is a frequent guest expert and spokesperson on national television programs, discussing issues related to children's health. Dr. Beard practices pediatrics in Washington, D.C.

Q: Our 6-week-old baby suffers from chest congestion mainly at night. With him unable to spit or blow his nose, how do we clear his phlegm?

A: At 6 weeks, many infants have an overabundance of secretions that may congest the back portion of their nose, making their breath sounds quite noisy. The result, frequently loud snoring like breath sounds, is responsible for what we call "transmitted" breath sounds, sometimes mistaken for chest congestion. For his comfort and your peace of mind, it is important to try to clear his nasal passages. To accomplish this, I suggest that you put 2 drops of normal saline (salt water...available and packaged as "NaSal"), an over the counter preparation, into each nostril. This liquefies secretions that may have dried and blocked the pathway for air. Then use an infant nasal aspirator to suction each nostril. Squeeze the bulb of the aspirator before placing it into baby's nose...then release the bulb once it is in place as far back in the nose as it will comfortably reach.

This will function as a "nose blower" for your baby. Also try to elevate the baby's head and chest when he is on his back. I advise parents to place 2 phone books under the head section of the baby's mattress. This angle of elevation will help the baby to breathe with greater ease.

Caution: do not use pillows or bolsters in the baby's bassinet or crib in an attempt to achieve an elevation; they may pose a safety hazard.