by Marzia Mandelli
It is necessary to help the little one, who is not yet able to blow his nose adequately, by using nasal washes with physiological solution or, in moments of exacerbation, a hypertonic solution
My 18 month old grandson, who attends daycare, has had a cold with a runny nose for months. He snores a lot and breathes with his mouth open, despite nasal washes. He also suffered from reflux. What do you recommend?
Answered by Marzia Mandelli, Medical Director, Pediatric Clinic, Asst Santi Paolo e Carlo, San Paolo Hospital, Milan (GO TO THE FORUM)
The persistence of rhinitis and cold syndrome is a frequent cause of concern for many parents and often causes episodes of acute otitis media. This condition is often attributable to the beginning of attendance of the children’s community, which often coincides with the autumn season. The acquisition of a mature immune system and the growth of the bony structures of the upper airways should physiologically reduce the problem, but in the meantime families must find the most appropriate therapies to reduce symptoms which often, although not serious, involve poor appetite and disturbed sleep.
The advices
It is therefore necessary to help the child, who is not yet able to blow his nose adequately, by using nasal washes with physiological solution (even 5-6 times a day in the acute phase) or, in moments of exacerbation, a 2.2% hypertonic solution or 3% (there are several, also associated with hyaluronic acid which prevents dryness of the mucous membranes). a very useful tool that allows you to perform a micronized nasal douche, in which it is also possible to use cortisone-based drugs. Another possibility is the daily performance of nasal showers which allow real irrigation of the nasal passages. It is often useful to humidify the room in which the child sleeps, in order to prevent heating or air conditioning from causing dryness of the upper airways and therefore nighttime coughing.
Useful exams
In some cases it may be necessary, despite all these precautions, to carry out an ENT examination with fiberoscopy to evaluate the adenoid tissue and an allergy examination with prick tests to exclude allergies to inhalants which, especially in the case of perennial allergens such as dust mites and moulds, they can cause chronic obstructive rhinitis that overlaps with common viral colds and requires adequate systemic anti-histamine or topical nasal steroid treatment. The latter is often also necessary for the medical treatment of adenoid hypertrophy not yet a candidate for surgery. In conclusion, the role of the pediatrician of free choice in guiding parents in the best diagnostic-therapeutic path for the child, based on personal and family history, is fundamental.
Corriere della Sera also on Whatsapp. sufficient click here to subscribe to the channel and always be updated.
February 6, 2024 (modified February 6, 2024 | 3:58 pm)
© ALL RIGHTS RESERVED