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?
He replies Marzia MandelliMedical director, Pediatric Clinic, Asst Santi Paolo e Carlo, San Paolo Hospital, Milan (GO TO THE FORUM)
The persistence of rhinitis and syndrome cooling down a frequent cause of concern for many parents and often the cause of episodes of ear infection medium acute. 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 problembut in the meantime families must find the most appropriate therapies to reduce symptoms which often, although not serious, lead to poor appetite and disturbed sleep.
We must therefore help the child, who is not yet able to blow his nose adequately, by employing it nasal washes with physiological solution (even 5-6 times a day in the acute phase) or, in moments of exacerbation, a 2.2% or 3% hypertonic solution (there are several, also associated with hyaluronic acid which prevents dryness of the mucous membranes). very useful tool that allows the execution of a micronized nasal douche, in which it is also possible to use cortisone-based drugs. Another possibility performing daily nasal showers which allow real irrigation of the nasal passages. Often useful humidify the room where the child sleeps, in order to prevent heating or air conditioning from causing dryness of the upper airways and therefore nighttime coughing.
In some cases it may be necessary, despite all these precautions, to carry out an ENT examination with fibroscopy to evaluate the adenoid tissue e an allergy visit with prick test to exclude allergies to inhalants which, especially in the case of perennial allergens such as dust mites and moulds, can cause chronic-obstructive rhinitis which overlaps with common viral colds and which requires adequate anti-histamine treatment systemic or of nasal topical steroid. The latter is often also necessary for the medical treatment ofadenoid hypertrophy not yet a candidate for surgery. In conclusion the role of the pediatrician of free choice is fundamental in guiding parents in the best diagnostic-therapeutic path for the child, based on personal and family history.
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February 6, 2024 (modified February 6, 2024 | 08:18)
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