Colds and nasal hygiene in toddlers
Colds, coughs and ear infections in children
10% of parents are afraid to wash their baby's nose, yet this nasal hygiene prevents the recurrence of colds in winter and improves the comfort of the little one when he has a cold. How to practice nasal washing of the baby? What to do when he has a cold?
The morphology of the nose of babies
The sinuses are cavities dug in the bones of the face and lined with a mucous membrane just like the nasal cavities. They communicate with them by small holes called ostium.
We have 4 sinuses:
- the maxillary sinus,
- the frontal sinus,
- the sphenoid sinus,
- the ethmoid sinus.
The sinuses in babies are not formed
The development of the nasal cavities and sinuses begins in the mother's womb and continues until adulthood. At birth, all the nasal structures are in place (nasal septum, nasal turbinates) but the sinuses are not finished. They form gradually during early childhood:
- The ethmoid sinus is present from the first months of life and will continue to grow until around the age of 12.
- The maxillary sinus is a shallow cavity at birth. It continues to develop gradually and ends around 6-8 years of age.
- The frontal sinus develops from the first year of life until adolescence. It is only from the age of 6 that it is sufficiently individualized and formed.
- The sphenoid sinus begins its development around the age of one and continues until adolescence.
Up to the age of 6, we therefore mainly observe nasopharyngitis (inflammation of the nasal mucosa and pharynx). It is only after the age of 6 that we can really observe and talk about rhinosinusitis.
Nasal hygiene in infants
A newborn and up to the age of one, has an exclusive nasal breathing, if his nose becomes blocked because of a cold it can quickly make it difficult for him to breathe and eat.
In winter, it is difficult to escape germs. Regularly washing your child's nose helps limit the risks of viral infections responsible for colds. Nasal washing during nasopharyngitis also helps reduce the manifestation and duration of symptoms.
How do you treat a cold?
A cold is a viral infection that occurs mainly in winter. It is a benign pathology, which disappears quickly in the majority of cases if it is well managed.
Colds in adults
There are many medications that help to cope with the symptoms of a cold in an adult:
- Pain medications,
- Fever medications if present,
- Nose decongestant medications if they are not contraindicated.
Antibiotics are only indicated in certain sinusitis according to certain criteria that are determined by a doctor.
Colds in infants
There are few medications that are authorized and have a real benefit. Up to 5 years of age, nasopharyngitis is inevitable in children (on average 7 to 8 colds per year). The infant will gradually build up his immune defenses upon contact with these microbes, which are mostly viruses. This is called an "adaptation disease".
Fever
Fever is a symptom and rarely leads to complications; it is the body's way of defending itself against infection. However, it needs to be monitored; above 38.5°C, the child's comfort must be improved by removing clothes, giving them something to drink and administering fever-reducing medication, most often paracetamol.
Cough
In colds, coughing is due to nasal discharge in the back of the throat, it can become annoying when the child is lying down. Coughing is also a means of the body's defense against infections.
Cough syrups are not always indicated and a large majority of them are not before the age of one. Fluidifying syrups, called mucolytics, are no longer authorized for children under 2 years old. (Overly fluid and abundant secretions can hinder breathing at this age).
If the cough prevents the child from sleeping, tilting the bed and clearing the nose by blowing and washing it appropriately are the current recommendations.
A herbal syrup like thyme, or homeopathy can also be a solution.
Runny nose
If the runny nose goes from clear to thick, it is a common stage of nasopharyngitis, it does not mean that there is a bacterial superinfection and that antibiotics should be prescribed. This thickening of the secretions corresponds rather to the elimination of the corpses of the immune cells (polymorphonuclear cells) that have done their job of protection.
Nasal washing eliminates them, improves breathing comfort and reduces the duration of cold symptoms. This is the common point between the management of colds in adults and babies.
Nose washing in babies
Create a soothing atmosphere
Nose washing in infants and young children can quickly become traumatic, to avoid this, think about creating a relaxing atmosphere:
- Wash your nose in an environment that he enjoys with his favorite music
- Capture his attention with toys to keep him busy
How to perform nasal washing?
The golden rule: wash your hands well before and after nasal washing to avoid spreading germs and spreading the infection.
The baby should be lying on his back. His head turned to one side and held to avoid any sudden movements.
Gently insert the tip into the upper nostril and apply a spray of seawater (firm pressure for 2 to 3 seconds) or instill part of a dose of physiological serum or seawater for babies (pressure on the body of the plastic dose) by directing the jet horizontally. Part of the liquid comes out through the lowest nostril, carrying the secretions.
Proceed in exactly the same way by turning the head to the other side.
Baby nasal aspirator
In case of a cold, it is best to blow your nose well before performing nasal irrigation to increase its effectiveness.
In newborns, infants and young children, nose blowing is not mastered, the use of a baby nasal aspirator is then recommended. It can also be useful to reduce nasal congestion between 2 nasal irrigations by aspirating the secretions that prevent the baby from breathing.
Doses, sprays? What to choose?
For daily washing, outside of a cold period, it is preferable to use isotonic saline solutions (0.9%):
- Or physiological serum doses: no need to be afraid of pushing the tip too deep into the little one's nostril, there are doses with a larger tip to avoid this and can be used from birth. Any opened dose must be thrown away after use.
- Either seawater sprays with tips adapted to the baby's nostril.
In case of cold, hypertonic saline solutions are used because they decongest the nose and facilitate breathing. Be careful to choose hypertonic sprays suitable for babies because the tip is adapted. These solutions also exist in pods.
Whatever the spray, its tip must be rinsed with clean water after each use.
Complications of a cold, when to consult?
Nasopharyngitis in an infant under 3 months requires a medical consultation, especially in the case of fever.
In other cases, certain signs point to a doctor:
- A high fever (over 38.5°C) that has persisted for more than 48 hours
- An intense sore throat that prevents swallowing (the child no longer wants to eat)
- Ear pain
- Nose pain
- Purulent conjunctivitis, edema of the eyelids
- Breathing difficulties
- Digestive disorders (diarrhea, vomiting, loss of appetite)
What are the complications of a cold in children?
The evolution is naturally favorable in the majority of children, but sometimes a bacterial superinfection can occur.
The most commonly observed complications are:
- Acute otitis media, which is the main complication of nasopharyngitis. It requires management by a doctor who will prescribe an appropriate antibiotic.
- Bacterial purulent conjunctivitis: nasopharyngitis is often accompanied by conjunctivitis. Washing your hands before handling the child and regularly washing your eyes with physiological serum or an appropriate eye solution can prevent it.
- Pulmonary complications such as bronchitis.
Your baby has a cold? Some advice
To avoid contagion: do not use the same nasal aspirator tip or nasal spray for several children.
Do not overheat the room: 18°C is the ideal temperature, also humidify the air (this helps prevent dry noses and mouths), you can put a wet cloth on a radiator or use humidifiers.
Air the rooms daily to prevent germs from stasis and spreading within the family.
Avoid dusty and smoky environments, as this irritates and dries out the mucous membranes.
In case of fever, keep the child well hydrated and uncovered.
Hand washing is essential to protect against colds and prevent their spread in case of contamination. A child can be taught to wash their hands from the age of 2.
