By Evan Tobin, MD
Ohio ENT & Allergy Physicians
Most kids get a stuffy nose from time to time, usually from a cold or allergies. Because children (and adults) are meant to breathe through their nose, congestion can affect sleep, appetite, and comfort.
If it continues, you may notice:
- Mouth breathing
- Snoring or restless sleep
- Bed wetting can occur
- Hyperactivity
- Over time, possible dental or bite changes
The nose warms, filters, and cleans the air. In children, the adenoids (tissue in the back of the nose) help fight infection—but if they get too big, they can block airflow.
Why Kids Get Stuffy Noses
1. Viral Infection — “A Cold” (Very Common)
Kids can get 6–10 colds per year. These are more common in colder months and in school or daycare settings.
Symptoms:
- Runny/stuffy nose
- Cough or sore throat
- Sometimes low fever
What helps:
- Saline spray or rinse
- Fluids and rest
- Tylenol® or Motrin® for comfort
Antibiotics are not helpful early.
➡️ Call your pediatrician if symptoms last >10–14 days or worsen.
2. Allergies
Triggered by pollen, dust, pets, or mold. Can be seasonal or year round.
Symptoms:
- Sneezing
- Itchy nose (frequent rubbing)
- Clear runny nose
- Congestion
What helps:
- Antihistamines (Zyrtec®, Claritin®)
- Daily nasal sprays (work best with consistent use)
- Saline rinses
➡️ Ongoing symptoms may need allergy testing or specialist care.
3. Sinus Infection
Sometimes follows a cold. Not as common as in adults.
Watch for:
- Symptoms >10–14 days
- Thick drainage
- Nighttime cough
- Facial pressure (older kids)
- Fever, pain/headache, or facial/eye swelling are warning signs that require a doctor call or consultation.
- May require an office CAT scan if becomes chronic.
Usual treatment as for a cold but the patient may need antibiotics.
Enlarged Adenoids
Very common cause of chronic nasal symptoms — like a cold that won’t go away. Often overlooked.
Signs:
- Mouth breathing
- Snoring / poor sleep
- Constant runny nose
- Frequent ear infections
- Nighttime cough
- Simple scope in office can make the diagnosis
Something Stuck (Foreign Body) in the Nose
More common in younger kids.
Clues:
- Drainage from one side only
- Bad smell
- Symptoms that don’t improve
Swollen Nasal Turbinate Tissue
Normal structures inside the nose can become chronically swollen after colds or allergies and block airflow. Allergy and cold treatment can help. Nasal steroid sprays may be recommended.
When to Call a Doctor
Seek immediate care if your child has:
- High fever
- Severe headache
- Swelling around the eyes
- Vision changes
- Trouble breathing
- Symptoms not improving after 10–14 days
Bottom Line
Most childhood nasal congestion is caused by colds, allergies, enlarged adenoids, or (less commonly) sinus infections. Most cases improve with simple care.
If symptoms persist or affect sleep and daily life, it’s worth getting checked — effective treatment can be life changing.
The doctors at Ohio ENT & Allergy are happy to evaluate your child. All insurance is accepted, and a referral may not be necessary.
— Dr. Tobin