Causes of Runny Noses in Children

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If you feel like your kid always has a runny nose, take heart in knowing you're not alone. A runny nose (rhinorrhea) is a very common symptom of childhood illnesses, but many parents often aren't sure of the root cause of the problem. A runny nose could mean a wide variety of things, from something as simple as a cold or allergies to something more serious like a sinus infection.

Allergies

Allergic rhinitis, or hay fever, is a common cause for a runny nose in children. Allergy symptoms usually include an itchy nose; runny nose with clear discharge; stuffy nose or congestion; sneezing; and red eyes, with tearing and itching.

As allergies worsen or linger, children may also develop a sore throat, headaches, and coughing, and their allergies may interfere with their sleep, leading to daytime irritability. It is these allergy symptoms that are often confused with having a cold or sinus infection, as many parents don't believe that allergies should get "so bad."

In addition to these allergy symptoms, children with allergies often have dark circles under their eyes (allergic shiners) and may have a crease near the bottom of their nose (allergic crease) from rubbing their nose so much; this is often called an "allergic salute."

If a child also has asthma, uncontrolled allergies may also trigger asthma symptoms, leading to coughing, wheezing, and trouble breathing. Children with uncomplicated allergies will not usually have a fever or a runny nose that expels yellow or green discharge, though.

Infections

Infections are a very common cause of runny nose, especially in younger children. Most of these children have viral upper respiratory tract infections—the common cold. Symptoms include a runny nose that starts clear but may turn to a thick yellow or green discharge, congestion, cough, sore throat, headache or fever (usually low grade, but may go up to 102 degrees F).

When cold symptoms linger for more than 10 days, or when the symptoms are severe, including three to four days of fever over 102 degrees F, then the child might have a sinus infection requiring antibiotics. Keep in mind that a runny nose with green drainage doesn't always mean a sinus infection.

A runny nose can also be a symptom of the flu. In general, flu symptoms will be more severe than cold symptoms. They include high fever, body aches, and fatigue.

Other Causes of a Runny Nose

Although most children with a runny nose have either allergies or an infection, there are some other, less common causes for a runny nose. Your child's doctor can diagnose these conditions.

  • Deviated septum: Occurs when the cartilage between the nostrils isn't properly aligned and divides the nostrils unevenly
  • Nasal polyps: Growths that result from inflamed mucous membranes in the sinuses and nasal passages
  • Vasomotor rhinitis: Can be triggered by exposure to smoke, odors, foods, or changes in temperature and humidity
  • Rhinitis medicamentosa: Often occurs with the long-term use of topical decongestants

Stopping a Runny Nose

To stop your child's runny nose, choose a treatment that targets the underlying cause, whether it is allergies or an infection. Treatments that target specific nasal symptoms can also offer some relief.

Treatments can include oral or topical decongestants, which can help unclog a stuffy nose and relieve congestion. Topical decongestants should usually not be used in children under age 12 years and only for a few days at a time for teens.

An FDA public health advisory about children's cold and cough syrups states that "questions have been raised about the safety of these products and whether the benefits justify any potential risks from the use of these products in children, especially in children under 2 years of age."

Warnings on cold and cough syrups now say that they shouldn't be given to children under the age of 4. Consult your child's doctor before giving any over-the-counter medication, even if your child has taken it before. 

Nasal washes can relieve congestion and may prevent sinus infections, and antihistamines can stop a runny nose and sneezing caused by allergies. Antihistamines will make a child drowsy and should be used in consultation with your pediatrician, if at all.

Leukotriene antagonists (like Singulair) can decrease a runny nose, congestion, and sneezing caused by allergies, and steroid nasal sprays, which require a prescription, can decrease a runny nose, congestion, and sneezing caused by allergies.

Antihistamine nasal sprays (like Astelin) can decrease a runny nose, congestion, and sneezing caused by allergies and irritants. If your child has a sinus infection, their pediatrician will prescribe antibiotics.

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