In the winter and transitional seasons, newborns and infants often experience more frequent problems with nasal breathing. This is not only related to the increased incidence of infectious rhinitis but also to the abundant formation of crusts in the baby's nasal cavity due to the decreased humidity in most centrally heated rooms. During the heating season, the humidity in indoor spaces can drop below the recommended levels (according to standards, during the cold season, the optimal relative humidity in all types of rooms should not be lower than 30%).

Constant inhalation of dry air contributes to the dryness of the nasal mucosa, leading to nasal congestion, the intermittent formation of crusts in the nasal cavity, and symptoms such as itching and burning, which cause the baby to sneeze and wrinkle their nose. In addition to discomfort, the dryness of the nasal mucosa negatively affects mucociliary transport (MCT) and, as a result, the filtration function of the nose. This means that dust particles, bacteria, and viruses present in the air can easily enter the trachea, bronchi, and lungs during breathing. In turn, changes in the nasal mucosa, including increased histamine production during infectious rhinitis, contribute to a reduction in MCT.

The situation becomes more complicated in cases where infants frequently regurgitate after feeding while in a horizontal position. This can lead to irritation and swelling of the nasal and nasopharyngeal mucosa due to the entry of stomach contents, resulting in prolonged nasal congestion.

Impaired nasal function can lead to a range of disorders in infants. In breastfed infants, it can disrupt sucking and swallowing, causing restlessness, refusal of food, and slower weight gain. The absence of nasal breathing can lead to increased intracranial pressure and dysfunction of the central nervous system. Infants, in the first year of life, become restless and irritable. Some infants experience sleep disturbances. Severe and prolonged nasal congestion can lead to hypoxia, which can slow down development. Infants with impaired nasal breathing may start breathing through their mouths, which can lead to easy entry of cold air into the respiratory tract and an increased risk of respiratory infections.

Nasal breathing is particularly important for newborns and infants because breathing through the mouth is almost impossible, as the large tongue obstructs the oropharynx.

In general, the nose performs several important functions. It warms and humidifies atmospheric air as it passes through the nasal passages. Additionally, the nose acts as a filter, cleansing the air we breathe. Approximately 0.5-1 liter of mucus is secreted into the nasal cavity daily, and it moves through the posterior two-thirds of the nasal cavity at a speed of 8-10 mm/min and in the anterior third at a speed of 1-2 mm/min. Every 10 minutes, a new layer of mucus containing bactericidal substances, secretory IgA, passes through the nasal cavity.

During the first 3-5 months of life, which is considered a period of "physiological immunodeficiency in early childhood," infants are protected by passively acquired maternal antibodies against most respiratory viruses. However, respiratory syncytial infection is an exception. Swelling of the nasal mucosa, crust formation in the nasal cavity not only worsen mucociliary transport and the filtration function of the nose but also lead to drainage disturbances in the perinasal sinuses and middle ear, creating favorable conditions for the activation of conditionally pathogenic microflora and the development of bacterial complications. It should be noted that inflammatory processes in the nasal mucosa of children often spread to the nasopharynx and can cause adenoiditis due to anatomical features in children.

Hygiene of the nasal cavity in newborns and infants is crucial, as they cannot independently care for their nasal cavity and remove mucus. Many authors recommend instilling vasoconstrictor drops in infants 5 minutes before feeding. However, like all medications, vasoconstrictor preparations have their drawbacks and side effects. Prolonged use of topical decongestants can lead to the development of tachyphylaxis (gradual reduction in the effect), the "rebound" syndrome, and the so-called medicamentous rhinitis, so their duration of use should be limited. In addition, local vasoconstrictors and binding agents, oily drops, do not eliminate bacteria and viruses, whose activity increases during the transitional seasons and winter.

Using the nasal aspirator method for removing nasal secretions in newborns and infants with a rubber bulb syringe is inconvenient—parents may not immediately understand how to correctly squeeze or expand the walls of the bulb to remove mucus. The process of removing secretions cannot be monitored due to the opacity of the bulb's walls, and regular sterilization is required after each use. Moreover, incorrect use of such aspirators can lead to negative consequences, including pushing secretions deeper into the nasal passages.

References:

Samsigina G.A., Bogomilsky M.R. (2000). Respiratory tract infections in early childhood. Moscow: Miklosh. (In Russian)

Kryukov A.I., Arkhangelskaya I.I. (2004). Acute rhinitis in children. Consilium medicum, 6(3).

Karpova E.P. (2007). Acute rhinitis in children. RMZh, 14(22), 1637-1641. (In Russian)

Karpova E.P., Vagina E.E. (2009). Irrigation therapy in pediatric rhinology. Questions of modern pediatrics: a scientific-practical journal, 8(5), 115-118. (In Russian)