A caregiver states that their 2-month-old has had trouble breathing. What is the best next step in management?

In the scenario involving a 2-month-old with breathing difficulties, the most appropriate next step is to suction the nasal passages using a bulb syringe. Infants can develop nasal congestion that significantly impairs their ability to breathe effectively, resulting in increased work of breathing and potential respiratory distress. Suctioning helps clear the nasal passages and improves airflow, allowing for more effective breathing.

Suctioning is a non-invasive and quick intervention that can be performed safely, and it often provides immediate relief for infants who may struggle with nasal congestion. This action is particularly relevant given an infant's dependency on nasal breathing, especially at such a young age.

While gathering a history, particularly regarding the child’s immunization status, is valuable in assessing their overall health and exposure to infections, it does not provide an immediate solution to the current respiratory distress the infant is experiencing. Similarly, administering oxygen might be necessary if the situation does not improve, but it is typically indicated after initial assessment and interventions. Conducting a respiratory assessment would also be crucial; however, the immediate need to address potential airway obstruction takes precedence. Therefore, suctioning the nasal passages is the best immediate management step.