Sniffles in the baby

Introduction

While an adult suffers from a cold on average two to three times a year, small children are affected about twelve times a year due to the immature immune system. The common cold then usually occurs in the course of a simple cold, which is almost exclusively caused by viruses, just like in adults. In this respect, a frequent cold in children is generally not a cause for concern, rather the immune system is further strengthened by each contact with viruses, it learns, so to speak. But allergies can also be the trigger for persistent or recurring rhinitis symptoms. Beyond that, other, rarer causes come into question.

Causes

The most common cause of a cold in children – as in adults – is infection with a virus that is transmitted by droplet or smear infection and where the immature immune system also has an easier time of it. In principle, the same pathogens as for adults are possible, of which more than 200 different types are known. In addition to rhinoviruses as the most common triggers, respiratory syncytial, human metapneumoviruses, corona, parainfluenza and adenoviruses, and in summertime especially coxsackie, enteroviruses and echoviruses can be responsible.

Special features are partly the severity and frequency distribution; for example, children fall ill much more frequently with the human metapneumovirus and an infection with the respiratory syncytial virus usually results in a more severe course. The influenza virus, the causative agent of “real” influenza, must also be considered, which generally leads to a much more severe course and can endanger babies under one year of age in particular. Children’s diseases such as measles, chickenpox, scarlet fever (bacterial) or whooping cough (bacterial) can also cause rhinitis, but these are usually accompanied by other symptoms.

Otherwise, bacteria such as staphylococcus, streptococcus or pneumococcus can cause or aggravate a rhinitis in the course of a so-called bacterial superinfection if the nasal mucous membrane is already damaged and the immune system is weakened as a result of a viral infection. In general, infections are favoured by a nasal mucosa that is affected by dry room air or has a poorer blood supply due to hypothermia, but also by underlying diseases (e.g. cystic fibrosis) or narrowed nasal cavities (due to polyps or a crooked nasal septum). Special cases are e.g. the bacterial infectious disease diphtheria, which can lead to a bloody, fluid rhinitis (Rhinitis pseudomembranacea), or the congenital syphilis, which can lead to a bloody rhinitis.

Chronic rhinitis in children, on the other hand, is usually caused by allergies. On the one hand, a wide variety of grass and flower pollen can play a role, which then manifests itself as seasonally limited hay fever. On the other hand, an allergic rhinitis can persist throughout the year if allergens such as animal hair or dust mites are the trigger.

It is also possible that such a rhinitis occurs without a provable cause. In this context, one speaks of a vasomotoric rhinitis, which is apparently based on a misregulation of blood vessels; irritants such as cleaning agents or perfumes can cause or intensify this problem in small children. Other causes such as hypertrophic rhinitis, in which an increase in the volume of the lower and middle nasal conchae leads to symptoms, or atrophic rhinitis (ozaena), which favors the growth of germs due to the loss of tissue in the nasal mucosa, are conceivable, but are much rarer.

In addition, it should be remembered, especially in small children, that introduced foreign bodies (e.g. a marble) can also be responsible, which then cause unilateral, purulent rhinitis. An enlarged pharyngeal tonsil is another possible cause of non-healing colds in winter. In babies, open breast milk that has entered the nasal passages can also cause rhinitis-like symptoms or a “runny nose“.