Because neonates may be obligate nasal breathers until they are at least 2 months old, nasal obstruction,particularly if bilateral and complete,can cause severe respiratory distress quickly. Nasal airway problems far less consequential than total nasal obstruction can be worrisome in the neonate and young infant. Their nasal passages may exhibit as much as 50% of the total airway resistance, and the degree of obstruction often worsens when the infant has an upper respiratory tract infection. Focal obstruction can occur in the nasal vestibule or in any of the three anatomic regions of the nose: nasal piriform aperture, mid-nasal cavity, or the posterior choanae.
Most cases of nasal obstruction in the neonate and young infant are due to generalized nasal airway obstruction associated with neonatal rhinitis,viral upper respiratory tract infections, and possibly milk/soy allergies. A relatively unrecognized,but important percentage of neonatal nasal obstruction is due to gastroesophageal reflux disease (GERD),with secondary...
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