What do you use for a four year old who has bad congestion and runny nose?

Saline drops. Medications like antihistamines and decongestants are no longer recommended because of lack of efficacy and potential adverse effects. Salt water drops provide safe but temporary relief. Your child will tell you if they help. Don't keep doing it if they resist.
Nasal saline. Try a nasal saline spray and if this is a chronic or seasonal condition, let him be evaluated by an allergist, there are better prescription medications that can relieve his symptoms.

Related Questions

4 year old was on nasonex (mometasone) for 3 weeks and runny nose/congestion improved. Tried to stop and it's back! Is nasonex (mometasone) or astepro safer for long term use?

Rhinitis and steroid. Some kids have a bad allergic rhinitis and steroids do help. Although theoretically steroids used thru the nasal mucosa do not cause systemic side effects, I have seen patients get nasal bleeding and weight gain though rarely seen is possible. It may be wise to see an allergy and immunology specialist. There are blood tests now available to check for allergens in ur specific geographic area as wel. Read more...
Runny Nose. Yes Nasonex (mometasone) would be safe and affective long term for your child's symptoms. Hope this helps. Read more...
Saline/Avoidtriggers. I usually recommend nasal saline spray use before the dosage of nasonex (mometasone). In addition, avoiding and controlling the triggers of the allergic reaction is important. A virtual consult can help to further evaluate. Read more...