Pediatrics

Runny nose in baby

introduction

While an adult suffers from a cold on average two to three times a year, small children are affected around twelve times a year due to their immature immune system. The cold then usually occurs. as part of a common cold, which, as in adults, is almost exclusively caused by viruses.

In this respect, colds are more common in children. This is not a concern, rather the immune system is further strengthened by every contact with viruses, it learns, so to speak.
But allergies can also be the trigger for persistent or recurring cold symptoms. In addition, there are other, less common causes.

causes

The most common cause of runny nose in children - as in adults - is infection with a virus that is transmitted by droplet or smear infection and also has an easier time with the immature immune system. In principle, the same pathogens come into question as for adults, of which more than 200 different types are known.

In addition to the rhinovirus as the most common trigger, i.a. Respiratory syncytial, human metapneumo-, corona, parainfluenza and adenoviruses, especially in summer Coxsackie, entero and echo viruses may be responsible. There are some special features in severity and frequency distribution; For example, children are much more likely to contract the human metapneumovirus and an infection with the respiratory syncytial virus usually affects them. result in a more severe course.

The influenza virus, the causative agent of the "real" flu, is also to be considered. has a significantly more severe course and can particularly endanger babies under one year of age. Teething troubles such as Measles, chickenpox, scarlet fever (bacterial) or whooping cough (bacterial) can trigger a runny nose, but these usually have other symptoms in the foreground. Otherwise, bacteria such as staph, streptococci or pneumococci can cause or intensify runny nose as part of a so-called bacterial superinfection, if the nasal mucous membrane is already damaged and the immune system is weakened as a result of a viral infection. The general positive effects on infection include nasal mucous membrane damaged by dry room air or poorly supplied with blood due to hypothermia, but also underlying diseases (e.g. cystic fibrosis) or narrowed nasal cavities (due to polyps or a crooked nasal septum).

Read more on the topic: flu

Special cases are e.g. the bacterial infectious disease diphtherialeading to a bloody, liquid cold (Pseudomembranous rhinitis), or the congenital syphilis which can lead to a bloody, purulent runny nose. Chronic runny nose in children, on the other hand, is usually caused by allergies. On the one hand, a wide variety of grass and flower pollen can play a role, which then turns out to be seasonally limited hay fever makes noticeable. On the other hand, an allergic runny nose can exist all year round if allergens such as Animal hair or dust mites are the trigger. It is also possible for such a runny nose to occur with no demonstrable cause.

In this context one speaks of a vasomotor rhinitisapparently based on a dysregulation of blood vessels; above all Irritants such as Cleaning agents or perfumes can cause or exacerbate this problem in small children. Other causes like one Hypertrophic rhinitis, in which an increase in the volume of the lower and middle turbinates leads to discomfort or a Atrophic rhinitis (Ozaena), which favor the colonization of germs due to the tissue shrinkage of the nasal mucous membrane, are conceivable, but much less common.

In addition, especially with small children, it should be remembered that introduced foreign bodies (e.g. a marble) can also be responsible, which then cause unilateral, purulent rhinitis. For colds that do not heal in winter, an enlarged almond is another possible cause. Breasted breast milk that has got into the nasal passages can also cause cold-like symptoms or a "runny nose" in babies.

Symptoms

The symptoms of the runny nose can vary slightly depending on the cause, but typically the main symptom is always an increased secretion production of the nose, which leads to a "runny" or blocked nose. The classic cold usually begins with a burning or tickling sensation in the nose and increased urge to sneeze. In the days that followed, this turned into a so-called Runny nose about, where especially a watery, often colorless secretion is released from the nasal mucosa. The skin of the face in the direct vicinity of the nose, in particular the tip of the nose and upper lip, can be so affected by frequent blowing and constant contact with the secretion that it becomes red and rough.

In addition, there are often watery eyes, a restricted sense of smell and taste as well as a general feeling of illness. As the secretion thickens in the further course (and may also turn yellowish to green) and the mucous membranes swell, the nose becomes increasingly clogged and breathing becomes more difficult. If bacteria also settle on the previously damaged mucous membrane as part of a bacterial superinfection, a yellow-green purulent secretion appears. Of course, the cold can also be caused by all other typical cold symptoms, such as Fever, cough, fatigue, sore throat, headache and body aches are accompanied.

In addition, complications such as sinus or middle ear infections are possible, which are often caused or favored by a build-up of secretions. The symptoms usually sound within seven to ten days, but small children in particular can suffer from a cold, which can also prevent them from getting the necessary sleep.

When babies get a cold, breathing difficulties are usually the main problem, as babies breathe almost exclusively through their nose. However, this is quickly blocked due to the still narrow nasal cavities and one possible consequence is that the baby completely refuses to drink. Allergic or vasomotor rhinitis is more characterized by sudden, seizure-like occurrence with sneezing attacks, production of watery nasal secretions and itching, especially in the nose and eyes.

This can also be noticeable by reddening of the conjunctiva. Foreign bodies introduced into the nose can cause unilateral, purulent runny nose, which can also be accompanied by odor formation. An ozaena (so-called “stink nose”) can also be responsible for unpleasant smells (and a dry nose). Blood admixtures are often the result of severe irritation of the mucous membrane, but can also occur as a specific symptom in the context of certain infectious diseases, for example in diphtheria or congenital syphilis.

Eye sticky / pus in the eye

Purulent or sticky eyes are not automatically associated with a runny nose or a cold. Nevertheless, conjunctivitis can be triggered in bacterial or viral infections. Triggered by bacteria, the eye secretes purulent secretion and is yellowish in color. If the eye is infected with viruses, which cause conjunctivitis, the eye secretes a colorless secretion.

In the case of viral conjunctivitis, the conjunctivitis should heal itself within a week. An antibacterial ointment may be necessary in the case of bacterial infections. Basically, purulent eyes should be viewed by an ophthalmologist.

Read more on the topic: Conjunctivitis

Runny nose and mucus formation

Mucus is caused by hypersecretion of the nasal glands, which sit in the mucous membrane and keep the nose permanently moist. If a virus causes excessive secretion of secretion, this can "clog" the nose.

In the case of viral infections, the secretion is watery and clear, and after a while it can become cloudy. If bacteria settle on the viral infection, a so-called superinfection occurs and the secretion turns yellow. Runny nose / colds are rarely caused by bacteria. The mucus should be aspirated when the airway is obstructed.

diagnosis

The diagnosis of a cold is usually carried out. purely clinical, i.e. based on symptoms reported by the child and physical examination. If children are too young or too silent to describe their symptoms, it is particularly important to look closely at the child in order to identify possible causes such as a foreign body in the nose. If the runny nose does not come from a simple cold, is particularly strong or persistent, various differential diagnoses should be considered, which is why further clarification is useful.

For this purpose, certain pathogens can be detected in laboratory methods, which e.g. for the influenza virus (causative agent of the "real" flu) or viruses that cause childhood diseases such as the measles virus can be applied. An allergy test can be useful, especially with a chronic cold. For this purpose, a blood test, in which specific IgE antibodies can be detected (so-called radio-allergy sorbent test), is usually preferred to the usual skin test (so-called prick test) in small children.

Therapy - what to do?

Depending on the cause of the cold, different treatment approaches can be useful. It is important to note that not all funds that are used for adults are also suitable for small children. The classic cold can not be fought specifically with medication, but at best treated symptomatically. He can usually be cured at home without further complications. General measures such as Physical rest, enough sleep and adequate room temperatures. Various home remedies can be used, for example drinking chamomile or elderflower tea or inhaling, among other things. Camomile teahave a supportive effect.

However, essential oils should not be inhaled by young children as this can cause shortness of breath. Also certain Homeopathics or Natural remedies can alleviate symptoms and possibly have a positive effect on the course of the disease. In more stubborn cases or more serious accompanying symptoms (e.g. fever), other medications can also prove to be useful. Since small children can particularly suffer from symptoms such as a blocked nose, the administration of decongestants can also be used Nasal sprays be helpful to ensure improved well-being in the short term. However, these should only be used for a few days, otherwise a habitual effect occurs, which continues to lead to a blocked nose after stopping the spray.

Gentler, but still helpful - and therefore more recommendable if the cold is not too strong - are simple ones Salt water sprays. In the case of a sore nose, the use of i.a. containing dexpanthenol Ointments or sprays possible. Antibiotics are only effective against bacteria and should therefore only be considered in the event of a bacterial infection. Slight allergic or vasomotor rhinitis can also be treated with general measures, home remedies and homeopathics, where it is particularly important to find the allergen or the trigger and to protect the child from contact with it. In more severe cases, it may be necessary to use special antiallergic agents (e.g. cortisone or Antihistamines), from the age of five, specific immunotherapy may be possible and useful.

Nasal drops used to treat runny nose

If the nasal mucous membranes are swollen and block the airway, this can be particularly uncomfortable for babies, as they breathe exclusively through the nose up to the 6th month. Nasal drops (or nasal sprays) containing the active ingredient xylometazoline can be given to reduce swelling of the mucous membranes and facilitate the drainage of secretions. However, this must be clarified in advance with the attending physician.

The active ingredient content should not contain more than 0.25 mg or 0.5 mg / ml, depending on the month of life. This corresponds to a solution of 0.025% or 0.05%. Treatment with 0.9% sodium chloride solution can also help. Basically, nasal drops (unless otherwise prescribed by your doctor) should not be given for longer than 7 days in order to prevent the mucous membranes from drying out.

homeopathy

Sambucus nigra (black elder), Euphrasia (eyebright), Nux vomica (crow's eye) can be given.

If the secretion is yellowish / purulent, Hepar sulfuris (calcium sulphurous liver) and potassium bichromicum should provide relief.

Aconitum napellus (blue monkshood) can be administered if the cold symptoms also occur. The dosage depends on the ingredient and the month of life of the baby.

Always consult your doctor beforehand!

Home remedies

Home remedies, under the heading medicine / natural healing methods / phytopharmaceuticals, teas, inhalants and baths are understood which are of plant origin. In principle, with these ingredients (also) purchased in supermarkets and drugstores, the amount administered must be adapted to the child's organism. Information is based on experience and is usually neither scientifically nor through studies. As a general, non-evidence-based rule, children between the ages of 1-4 Age one-fifth to one-half the adult dose. In the case of an acute cold, only small children from 12 months should be treated with home remedies.

In the case of an acute cold as part of a cold, drinking cowslip tea and primrose root tea can liquefy the nasal secretions more quickly and thus drain them off better. Inhaling essential oils such as peppermint, eucalyptus and mint can disinfect the mucous membranes and have antimicrobial effects.

The onion used to treat colds

There is no evidence that the onion extract helps with colds. According to reports, shredded onions can be wrapped in a cloth and placed close to the baby, and inhaling the exhaled substances can result in a clearer nose. If there is also an otitis media as part of a cold, an onion bag can be placed on the affected ear. By bringing a finely chopped onion in a sachet to the boil for two minutes and letting it cool. It can then be attached to the ear as an ear wrap.

Read more on the topic: Otitis media

Breast milk to prevent runny nose

Breast milk is once again considered the best source of nutrition for an infant.

It has a low protein and mineral content (compared to cow's milk). Casein and alpha-lactalbumin make up most of the proteins. Lactose is the main carbohydrate in breast milk and provides 40% of the energy it contains. Another 40% of the energy comes from the fat in breast milk. Other sugar compounds support defense mechanisms in the intestine. Breast milk contains important antibodies, such as immunoglobulin A and white blood cells, that protect the child from infections. The antibodies it contains can help with a runny nose by dripping a few drops of breast milk into the baby's nostrils

How long does the cold last?

In the case of a cold, a distinction must be made as to whether it is an acute or chronically recurring cold. The duration can vary depending on the findings. In the case of an acute infection of the nasal mucous membranes, usually as part of a cold, the runny nose occurs 2-8 days after infection. After 3 days to a week, the runny nose should have improved spontaneously with other accompanying symptoms and should have disappeared after 2 weeks.

If the inflammation of the nasal mucous membranes extends to the paranasal sinuses and the resulting mucus can no longer drain away, a cold can last for a week to months and then usually no longer heals spontaneously. The same applies to colds from other causes, such as an allergic cold or a cold caused by irritating substances. If a runny nose is induced by taking medication, it should go away after the drug is stopped.

When should one suck off the baby's secretion?

If the baby's breathing is so strongly prevented that it can no longer breathe through the nose, it will try to balance its oxygen demand by screaming. Because babies up to 6 months old can only breathe through their nose. If decongestant nasal drops do not help and the nose still remains blocked or produces so much mucus that breathing is no longer adequately possible, the nose can be freed of annoying mucus with the help of a nasal aspirator. Both manual and electric vacuum cleaners can be used. It is important that these are germ-free (it is better to rinse out with water once more) and that they do not have any sharp edges that could damage the sensitive mucous membrane.

forecast

In most cases, rhinitis is a harmless symptom of a simple cold and subsides after a few days without any consequential damage. However, it can also arise in connection with various other diseases, which in turn can cause more severe disease processes and require further treatment.

prophylaxis

The most effective way to prevent a runny nose caused by a viral or bacterial infection is to avoid contact with the relevant pathogens (through hygienic measures) and above all. is avoided with those who are already sick. This should explain to the children how they can protect themselves from infection (e.g. do not share drinking bottles with other children). However, since a certain amount of colds is also very important for the healthy development of the immune system, children should not be shielded from possible contact with pathogens to an excessive extent. It is more important to keep away from more serious infectious diseases, such as the flu or various childhood illnesses, against which vaccines are mostly available.

While against the flu in healthy children usually is not vaccinated against some typical childhood diseases such as Measles, rubella or whooping cough, vaccinations recommended. In addition, a short-term, so-called passive immunization against the respiratory syncytial virus possible, but this is only used in particularly vulnerable babies (e.g. those with a congenital heart defect). A vaccination against the numerous classic cold viruses or against common colds can not. Apart from that, general measures are of course useful to strengthen the immune system or keep it healthy, including a balanced diet, enough sleep, little stress and exercise outdoors. As a prophylaxis against allergic rhinitis, small children should avoid harmful environmental stimuli (e.g. high levels of dust), and breastfeeding for a long time and the early introduction of varied complementary foods can reduce the risk of developing an allergy.