What should I do if my child has rhinitis?
May 24, 2022
Source: Cainiu Health
Dr. Guo Xiheng
Introduction
Children with rhinitis can typically be treated with physiological saline nasal irrigation. If symptoms improve with this approach, no additional medication is required. However, if the response is inadequate—especially when symptoms such as nasal itching, sneezing, nose rubbing, and profuse clear rhinorrhea are prominent—this suggests allergic rhinitis. In such cases, intranasal mometasone furoate (e.g., Nasonex) may be added, along with oral antihistamines such as loratadine syrup (e.g., Claritin) and montelukast chewable tablets (e.g., Singulair).
The child shows no signs of a cold, but experiences some nasal discomfort. When the weather turns cold, exposure to cold outdoor air triggers nasal itching and persistent rhinorrhea; at times, nasal congestion becomes so severe that breathing becomes difficult. Symptoms are most pronounced before bedtime and upon waking in the morning. So, what should be done for a child with rhinitis?
Management of Pediatric Rhinitis
Physiological saline nasal irrigation is commonly used for children with rhinitis. If symptoms improve with this approach, no additional medications are typically required. However, if symptoms persist—particularly nasal itching, sneezing, nose-rubbing, and profuse clear rhinorrhea—this often indicates allergic rhinitis. In such cases, intranasal mometasone furoate (e.g., Nasonex®) may be added, along with oral antihistamines such as loratadine syrup (Claritin®) or montelukast chewable tablets (Singulair®). These medications are generally suitable for children aged two years and older.
Additionally, pediatric rhinitis is frequently associated with adenoid hypertrophy. Adenoids are lymphoid tissues located in the nasopharynx (the area behind the nasal cavity). When enlarged, they can obstruct the posterior nasal apertures, impairing nasal ventilation and drainage. Over time, this obstruction may trigger or exacerbate rhinitis.
Rhinitis episodes commonly occur during autumn and winter—the seasons when colds are more prevalent. Lower ambient temperatures, combined with significant indoor–outdoor temperature differences (e.g., warm indoor heating versus cold outdoor air), can provoke rhinorrhea. To mitigate this, avoid excessive indoor heating and minimize temperature fluctuations between indoors and outdoors. Regularly open windows to ensure adequate ventilation and maintain fresh indoor air. In addition to avoiding excessively high indoor temperatures, it is essential to maintain appropriate indoor humidity. Keeping the nasal mucosa moist and preventing dryness helps reduce the risk of rhinitis flare-ups. We hope this information proves helpful!
