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© Mat Daniel 2019       

Blocked and Snotty Noses

 

A blocked nose can be miserable for any of us. In babies it is even more serious, because for the first few months babies only breathe through the nose, and the brain hasn't yet learnt to breathe through the mouth.

There are many reasons why a blocked nose occurs. Other pages on this website describe specific causes.

Snotty noses are also very common, particularly in toddlers. At this age, the immune system often isn't fully functioning. In addition, the toddler is exposed to a mass of new bacteria and viruses for the first time in his or her life, often at the nursery. This means that upper respiratory infections are common, and snotty noses are the result.

Parents often ask about antibiotics for snotty noses. Infections that cause snotty noses are usually caused by viruses, and antibiotics therefore don't have much of a role unless there are complications. Remember that antibiotic over-use can lead to development of antibiotic-resistant superbugs, so antibiotics should only be used when really required.

Parents also often ask about adenoid removal. Snotty noses settle with age, and the adenoids also shrink down. Therefore, we do not recommend adenoidectomy for snotty noses alone. In fact, high quality research studies have found that whether you remove the adenoids or not, the eventual outcome in terms of snottiness and upper respiratory infections is the same. So we do not recommend adenoidectomy for snotty noses, unless there are other associated problems.

Blocked noses in babies

When born and for the first few months of life, babies can only breathe through the nose as the brain hasn't yet learnt to breathe through the mouth. To us adults this seems odd, because if we have a blocked nose we just breathe through the mouth. We may be miserable because we have a blocked nose, but a baby doesn't know that there is another option, so a blocked nose in a baby is a much larger problem.

There can be a variety of reasons why a baby would have a blocked nose, including infections and secretions, as well as two problems that ENT surgeons deal with: choanal atresia and pyriform aperture stenosis.

If your baby has a problem blocked nose, your GP, paediatrician or ENT surgeon may be undertaking investigations to find out why the nose is blocked, or they may have already done those and be satisfied that there is no underlying problem, or have made the diagnosis and you are waiting for treatment to take effect. Either way, there are some things that you can do to help.

We would recommend that you use saline nose drops help loosen the secretions in the nose. About a minute after the drops have been applied, you can use a nasal aspirator to remove the secretions. Hopefully, doing this several times per day will provide symptomatic relief to your baby, irrespective of what the actual cause is. Humidifiers can be helpful also. Make sure that any irritants to the nose are avoided: in particular, cigarette smoke, and remember that even if you smoke away from your baby the baby will still get exposed to smoke on your clothes and hair.

What IS the cause of my child's blocked nose?

It's often very difficult to be certain. Part of the problem is that the symptoms of a blocked snotty nose arise due to lots of different reasons, and often multiple problems coexist. For example, many 2 year olds will have large adenoids, will get frequent upper respirator infections, and probably have sinusitis as a result of those infections. (A sinus infection may follow a simple viral upper respiratory tract infection, and usually requires no specific treatment). Another example would be a 5 year old, who may well have large adenoids, as well as nasal allergy, and may have developed sinus problems as a result of the allergy and adenoid enlargement. And all these problems before we even get to sleep apnoea.

Although separating the problems from one another may be tricky, in practice it often doesn't matter too much exactly what is the cause. We know that all these problems often happen together, and the treatments that we use are likely to help a variety of different underlying problems. Your doctor will explain to you what the treatments are likely to achieve, and what they can't.

Have a look at the rest of the website for information about adenoids and also look at specific nose problems.