Persistent Runny Nose in Infants: When to Seek Medical Advice

The baby has been experiencing a persistent cold with a runny nose?

Hello, doctor.
My baby is almost 11 months old.
Since he started attending daycare last September (when he was over 6 months old), he has frequently caught colds.
Recently, I've noticed that even when he doesn't show cold symptoms, he still has a runny nose, which then leads to another cold.
His nasal discharge is almost continuous (just varying in severity), which makes it seem like he has been sick for a long time.
He has been taking medication for his runny nose almost constantly.
What could be the issue? Should we go to a major hospital for an examination? Which department should we consult?

SHUAN, 40~49 year old female. Ask Date: 2022/01/17

Dr. Xiao Kaiwen reply Pediatrics

The most common cause of long-term nasal discharge in children is allergic rhinitis.
However, it may be too early to diagnose nasal allergies in a 6-month-old infant.
At this age, the maternal antibodies have already been metabolized, leaving the baby in a state of weakened immunity.
Additionally, attending a daycare center exposes the infant to many other young children, which can be a significant source of infections.
Upper respiratory infections, in particular, have a high transmission rate.
Therefore, recurrent upper respiratory infections are possible.
It may be advisable to consider removing the child from such a high-infection environment to potentially improve the situation.

Reply Date: 2022/01/17

More Info

Persistent runny nose in infants, especially when it lasts for an extended period, can be concerning for parents. In your case, your baby has been experiencing a continuous runny nose since starting daycare, which is not uncommon. Infants and young children are particularly susceptible to respiratory infections due to their developing immune systems and increased exposure to other children in daycare settings. However, when a runny nose persists without other symptoms of illness, it may indicate a few different underlying issues.

Firstly, it’s important to differentiate between a runny nose caused by an acute infection (like a cold) and one that is chronic. If your baby has been experiencing a runny nose consistently, it could be due to several reasons:
1. Allergic Rhinitis: This is a common cause of a persistent runny nose in children. Allergies to dust mites, pet dander, pollen, or mold can lead to ongoing nasal symptoms. If your baby has other symptoms like sneezing, itchy eyes, or a rash, allergies might be the culprit.

2. Non-Allergic Rhinitis: This condition can cause a runny nose without the allergic component. It can be triggered by irritants such as smoke, strong odors, or changes in weather.

3. Chronic Sinusitis: If your child has had multiple colds or respiratory infections, it could lead to inflammation of the sinuses, resulting in a persistent runny nose. This condition may require further evaluation.

4. Anatomical Issues: Sometimes, structural issues in the nasal passages, such as nasal polyps or a deviated septum, can lead to chronic nasal symptoms.

5. Viral Infections: Some viral infections can lead to prolonged symptoms even after the acute phase has resolved.
Given that your baby has been on medication for the runny nose, it’s essential to consult a healthcare professional for a thorough evaluation. Here are some recommendations on when to seek medical advice and what to expect:
- When to Seek Medical Advice: If your baby’s runny nose is accompanied by other symptoms such as fever, persistent cough, difficulty breathing, or if the nasal discharge changes in color (especially if it becomes green or yellow and is accompanied by facial pain), you should seek medical attention promptly. Additionally, if the runny nose persists for more than a few weeks without improvement, it’s advisable to consult a doctor.

- Which Specialist to See: You can start by visiting your pediatrician, who can assess your child’s symptoms and determine if a referral to an ear, nose, and throat (ENT) specialist or an allergist is necessary. The pediatrician may perform a physical examination, review your child’s medical history, and possibly recommend allergy testing or imaging studies if indicated.

- What to Expect During the Visit: During the appointment, the doctor will likely ask about your child’s symptoms, their duration, any associated symptoms, and any potential triggers you’ve noticed. They may perform a nasal examination and possibly recommend allergy testing or other diagnostic procedures based on their findings.

In the meantime, you can help alleviate some of your baby’s symptoms by ensuring they stay hydrated, using a humidifier in their room, and keeping their nasal passages clear with saline drops or sprays.
In conclusion, while a persistent runny nose can be common in infants, especially those in daycare, it’s essential to monitor the situation closely and consult a healthcare professional if symptoms persist or worsen. Early intervention can help identify any underlying issues and ensure your child receives appropriate care.

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