Runny Nose in Children: Causes, How to Manage It & Prevention Tips  

Introduction

A runny nose seems like a minor problem, but for many parents, it can become a major concern, especially when a baby or toddler is affected.  

A runny nose, also known as rhinorrhea, occurs when the nasal passages produce excess discharge or mucus. Often, runny nose is a symptom of viral infections like the common cold or flu, or allergies. In some cases, it may occur due to other medical conditions¹.

Runny nose or a cold may lead to disturbed sleep, difficulty feeding, or symptoms such as fussiness and coughing, which often causes parents to wonder whether it is just a cold or something more serious².

In this blog, we will explore why runny noses are so common in babies and toddlers, causes of runny nose in different age groups, and how to treat runny nose in babies. We will also discuss some safe home remedies for cough and runny nose in babies. 

Why Are Runny Noses So Common in Babies and Toddlers?

A runny nose is one of the first symptoms of a common cold. It is very common for babies and toddlers to have frequent colds. In fact, it is normal for a child to have 8 to 10 colds a year before the age of two².

Let us understand why it is common in babies and toddlers: 

• Developing immune system: The common cold, which causes a runny nose, is caused by certain viruses that may infect the throat, sinuses, and nose. Babies and toddlers are more prone to catch these viruses since their immune system is still developing and learning to fight new infections².
• Narrow nasal passages: Newborns are obligatory nasal breathers, meaning they mainly breathe through their noses. This leads to stridor, a congested breathing due to narrow nasal passages³.
• Frequent exposure to viruses: Children can catch viruses from parents, siblings, other family members, caregivers, or playmates. Those who have older siblings or attend daycare are exposed to more viruses and therefore tend to have more colds². 
• Hand-to-mouth contact: Babies and toddlers constantly touch their mouth, nose and eyes, without washing their hands. This allows germs to spread easily^2,4.

When a child first gets a cold, the body starts developing immunity to the virus. Over time, as children are exposed to more viruses, the immunity becomes stronger and they begin to get fewer colds.  

Frequent colds are usually not a sign of a weak immune system. They simply indicate that a child has been exposed to many different viruses^2,4.

Runny Nose Causes by Age Group

It is very important to understand what causes a runny and congested nose in order to get the right treatment. Below are some common causes of a runny nose in children of different age groups. 

1. Runny Nose in Babies (0-12 Months)

Common causes of a runny nose in babies are: 

• Viral infections: Common viral infections such as influenza, rhinoviruses, and respiratory syncytial viruses can lead to the common cold, wherein increased mucus production occurs to help keep germs out of the lungs of the baby. This, in turn, could trickle down the throat or end up in the nose, giving a runny nose^5,6. 
• Allergies: Babies who are allergic to pollen, dust, smoke or animal hair usually feel stifled and develop runny noses when they come in contact with something they are allergic to⁷. 
• Crying: When babies cry, their tears come out from the tear glands, which drain into the nose. This mixes up with mucus and leads to a runny nose. 
• Cold weather: When it is cold, the nose warms the air before it reaches the lungs. This increases blood flow inside the nose and leads to more mucus production, causing a runny nose.² 
• Irritants: Exposure to cigarette smoke, strong perfumes, cleaning products, dust, or dry indoor air can irritate the nasal passages and increase mucus production⁷.
• Congenital causes: In rare cases, babies born with conditions like congenital syphilis may develop a persistent runny nose within the first week after birth⁸.
   

2. Runny Nose in Toddlers (1-3 Years)

A runny nose in toddlers could be caused by: 

• Viral infections: A common cause of a runny nose in toddlers is again viral infections, as they are frequently exposed to cold viruses through daycare, preschool, and playgroups. These can cause nasal congestion, sneezing, and a runny nose^2,9.
• Environmental irritants: Tobacco smoke, air pollution, fragrances, and chemical fumes can irritate the nose⁹.
• Allergens: Allergies to pollen, dust mites, mould, or pet dander can cause a persistent runny nose, sneezing, and itchy eyes. It could be seasonal or year-round⁹.
• Ear Infections: Middle ear infection is common in toddlers, frequently associated with a cold. Fluid builds up behind the eardrum, which can cause pain, headache, fever, etc. Associated symptoms like runny nose or sore throat may also be seen^5,10.
• Foreign object insertion: Toddlers may accidentally insert small objects into their nostrils. This often causes a persistent runny nose from typically only one side (site of foreign body insertion), which may be foul-smelling or blood-stained. Such cases require prompt medical evaluation and should not be managed at home¹¹.

3. Runny Nose in Older Children

Older children might have a runny nose because of any of the following: 

• Viral Infections: Viral infections affecting the upper respiratory tract are common in children and can cause runny noses².
• Sinus infections: Sinusitis is an infection that causes swelling of the sinuses. It can cause a runny nose and a blocked nose. A child may take 10 days to get better from acute sinusitis, while chronic sinusitis can take 12 weeks or longer¹².
• Allergies: Some allergies in children can occur when the body reacts to normally harmless substances like pollen, dust, certain foods, insect bites, or animals. Allergic rhinitis could also be triggered by cold weather, chemicals, pollution, dust, or smoke. Symptoms may be mild or, in some cases, severe. These can all lead to a congested and runny nose^13,14.
• Nasal polyps or structural nasal problems: These are soft growths inside the nose. Although harmless, they can block a child’s nose and also lead to a runny nose¹⁵.
• Nasal Trauma: Sometimes, a clear nasal discharge may occur after nasal injury such as a nasal fracture. This condition, known as Cerebrospinal fluid (CSF) rhinorrhea, is the leakage of CSF from the child’s nose due to trauma or defect. This requires prompt evaluation by a pediatrician¹⁶.

Symptoms Associated with a Runny Nose

Runny nose rarely occurs as a stand-alone symptom. Usually, when it is associated with infections or allergy, some other common symptoms may also occur along. These include^2,17:

• Sore throat 
• Sneezing 
• Coughing 
• Body ache 
• Lethargy 
• Nausea 
• Watery eyes 
• Itchy nose 
• Headaches 
• Excessive crying and fussiness, disturbed sleep and feeding in babies. 

It is important for parents to note the colour and smell of the child’s nasal discharge as this may sometimes provide useful clues about the underlying cause. It could indicate: 

• Viral Infections: This starts with a nasal discharge that is usually clear at first. As the illness progresses, the mucus may become white, yellow, or green¹⁸.
• Allergic rhinitis: In some children with allergic rhinitis, fungi present in the air can enter the sinuses and trigger allergic fungal sinusitis (AFS). This leads to sticky mucus, which can be light brown to dark green¹⁹.
• Foreign Body Obstruction: Sometimes, a small object stuck inside the nose can remain unnoticed and gradually become coated with minerals, forming a hard mass called a rhinolith. This can cause a persistent, foul-smelling nasal discharge²⁰.
• CSF Rhinorrhea: This typically presents as a clear, watery discharge from one nostril that increases on bending and coughing, with a history of trauma to the face or nose. There may be an associated salty taste²¹.

Any suspicion of discharge that may be due to a traumatic event or foreign body needs to be evaluated and managed properly by a pediatrician. 

Treatment Options for Runny Nose

The treatment of runny nose depends upon the cause. A viral infection or cold usually resolves by itself, and antibiotics are not prescribed. However, how to stop a runny nose is certainly a concern for the parents. To make the child feel better, the following treatments can be suggested by a doctor: 

• Saline nose drops or spray: Saline drops help loosen thick mucus in the baby’s nose. This helps to clear congestion and eases breathing. For younger babies, saline drops followed by gentle suction with a bulb syringe can clear the nostrils before a feed or sleep¹⁷.
• Medicated nose drops: These contain antihistamines or corticosteroids, which help to relieve nasal congestion. However, they provide only temporary relief. Also, these products are not recommended for children under 6 years of age unless specifically prescribed by a professional².
• Oral Medications:  
  • Decongestants: These are over-the-counter medicines (OTC’s) that help to clear the mucus and dry up the nasal passage. These provide relief from a runny nose.   
  • Antihistaminics: In some cases of allergic rhinitis, antihistamines may also be given to ease the allergies. 
  • Antibiotics: If a persistent runny nose occurs due to conditions like sinusitis or ear infections, antibiotics may be needed for management^17,21.
• Pain relief: In case of fever and body aches, acetaminophen, as per the paediatrician’s recommendation, can be given².
• Surgical management: In case of any congenital defects or traumatic injuries, surgical management may be required²¹.

Note: None of these medications should be given without a doctor’s prescription. 

Also Read: Nasal Drops for Babies and Kids: Types, Uses, and Safety Guide 

Home Remedies for Runny Nose

Runny nose can be very uncomfortable, and a child can easily become irritable. Here are some home remedies that may provide relief from a runny nose: 

1. Humidification

Dry air can worsen a runny nose. Using a cool-mist humidifier helps keep nasal passages moist and reduces irritation²².

2. Hydration

Staying hydrated helps thin the mucus, making it easier to clear the nose and reducing congestion. It is best to offer water, clear soups, or other age-appropriate fluids to children with a runny nose²³.

3. Head Elevation

Elevating the child’s head while sleeping can help mucus drain better and reduce nasal congestion²³. 

4. Steam Inhalation

Steam helps loosen mucus and soothes irritated nasal passages. The child and the parent can breathe steam in a closed bathroom after running a hot shower. For toddlers, this can provide quick relief from a blocked or runny nose²³.

5. Adequate Rest

Rest supports the immune system in fighting viral infections. Keep the child comfortably warm, avoid cold drafts, and ensure a calm environment to help with faster recovery²³.
 

Mistakes That Can Make a Runny Nose Worse

Some things can actually make a runny nose worse, and it’s important that parents be mindful of these. A few mistakes to avoid are: 

• Using OTC nasal sprays without doctor consultation and continuing for more than 2-3 days, as this may worsen the congestion².
• Not following the dosage instructions for any medicine or consulting a paediatrician in case of worsening of symptoms².
• Blowing nose too hard, which could force the germs back into the sinuses and also lead to pain and bleeding from the nose²⁴.
• Not resting enough, as this can often worsen the condition and make the child irritable. 
• Inadequate fluid intake, as dehydration can occur, especially if a viral infection is suspected. 
   

How to Prevent Frequent Runny Noses?

A runny nose is often caused by viral infections, so it cannot always be prevented. However, these simple habits can help reduce the spread of germs and lower a child’s chances of getting sick^2,7:

• Stay up to date with routine vaccinations 
• Wash hands frequently with soap and water, especially before eating and after coughing and sneezing 
• Teach children to cover their mouth while sneezing or coughing 
• Avoid sharing personal items like toys, cups, bottles, utensils, towels, and tissues 
• Babies under 3 months old should be kept away from people who have a cold 
• Keep the child at home when unwell 
• Avoiding exposure to allergens like dust, mold, mites, and pet dander can help reduce incidences of runny nose 

When to Consult a Doctor?

Babies younger than 3 months can have difficulty breathing and feeding when their nose is blocked. One should consult a doctor immediately if the baby has²:

• Troubled breathing 
• High fever (38.5°C or higher) 
• Not feeding 
• Vomiting 

Babies and children of any age should be seen by a doctor if runny nose or cold seems to be getting worse or causing serious symptoms. Seek medical advice if any of the following warning signs occur²:

• Difficulty in breathing 
• A high fever, or a fever that lasts for more than 2-3 days 
• Severe ear pain 
• Persistent irritability, or excessive crying 
• Blue or pale lips, face, or fingertips 
• Extreme sleepiness, difficulty waking up, confusion, or unusual drowsiness 
• A runny nose or cold symptoms lasting longer than 10-14 days 

Also, in case of any trauma to the head, face, or nose or foreign body obstruction in the nostril, an immediate evaluation by a pediatrician is always recommended. 

Also Read: How to Stop Constant Cough in Children: Expert Tips and Tricks

Conclusion

A runny nose is very common in babies and young children and is usually caused by a simple viral infection or sometimes allergies. In most cases, it is not serious and improves on its own with basic home care, such as keeping the child well hydrated, using saline drops, and ensuring adequate rest and comfort. However, it is important to avoid self-medication, understand the signs that indicate the need for medical attention, and follow the doctor’s instructions sincerely to prevent the risk of any complications in the child. 

Frequently Asked Questions (FAQs)

References

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