Runny nose in children 1-3 years

Runny nose in children 1-3 years: Physiology and evidence‑based approach

Runny nose (rhinitis) is inflammation of the nasal mucosa accompanied by mucus discharge and nasal congestion. For infants who cannot yet blow their noses effectively, this becomes a real challenge, disrupting sleep, appetite, and overall well‑being. Parents need to understand that in most cases a runny nose is a manifestation of a viral infection that does not require specific treatment, only symptomatic care.

Why does a runny nose occur?

The nasal mucosa is the first barrier against infections. When viruses reach it, the body initiates a defensive response:

1. Inflammation and swelling: Blood vessels in the mucosa dilate, causing edema and a feeling of congestion.
2. Mucus production: Specialized cells begin actively producing mucus (snot), which aims to "wash away" viruses and keep the mucosa moist.

Most common causes of runny nose in infants:

• URTI: Viral infections account for more than 90% of runny‑nose cases. Initially the discharge is clear and watery; after a few days it may become thicker, white or yellowish – a normal process, not a sign of bacterial infection.
• Allergic rhinitis: If the runny nose is accompanied by sneezing, nasal itching and tearing and occurs in response to a specific trigger (pollen, dust, animals), it may be an allergy.
• Enlarged adenoids: Chronic nasal congestion and runny nose can be related to adenoid hypertrophy.

Complications of a runny nose

Although viral runny nose is harmless by itself, in infants it can lead to complications because of anatomical features. Mucus draining down the back of the throat triggers cough (post‑nasal drip). Because the eustachian tube is short and wide, infection from the nose can easily reach the middle ear, causing acute otitis media.