Allergic rhinitis in children is a very common condition and may start as early as the first months of life. Symptoms often worsen with seasonal changes and exposure to cold air.

Children commonly present with:

Nasal congestion Persistent runny nose Cough Frequent sneezing Nasal itching

---

Symptom Progression and Possible Complications

Symptoms of allergic rhinitis often worsen in the presence of:

Enlarged adenoids behind the nose Chronic tonsillitis or enlarged tonsils This may lead to complications such as: Snoring during sleep Sleep apnea (interrupted breathing during sleep) Hearing loss

---

Impact of Allergic Rhinitis on a Child’s Sleep

One of the main problems of allergic rhinitis in children is its significant impact on sleep quality. Affected children may experience:

Frequent movement during sleep Difficulty breathing Repeated awakening and sometimes sitting up to breathe

In cases associated with enlarged adenoids or tonsils, allergic rhinitis may also cause:

Hearing loss due to middle ear fluid Delayed speech development Incorrect pronunciation of words Nasal speech (hypernasality)

---

Proper Evaluation and Treatment

A comprehensive evaluation of the child is essential, including:

Nasal examination Ear assessment Chest evaluation, especially if the child also suffers from allergic asthma Treatment should target the entire respiratory system, both upper and lower airways, in collaboration with a pediatric specialist.

Treatment plans are tailored based on:

Severity of symptoms Child’s age

Treatment options may include:

Saline nasal sprays Corticosteroid nasal sprays Antihistamines Other supportive medications as needed

---

When Is Specialist Intervention Needed?

Evaluation of adenoids, tonsils, and ears is particularly important in severe cases that do not respond to standard medical treatment. Using multiple medications is often ineffective if enlarged adenoids or tonsils are preventing proper response to therapy.

---

When Should You Consult an ENT Specialist?

If your child suffers from:

Persistent nasal obstruction Snoring Hearing loss Continuous nasal discharge and does not improve with regular medications, consultation with an ENT specialist is essential for proper re-evaluation.

📌 Adenoid removal can be performed at any age, even in infancy. 📌 Tonsillectomy may be considered in children under 3 years old in selected cases, especially those with breathing difficulties or sleep apnea.