Nasal Discharge in Infants and Children
The Beginning of the Immunological War

Prof JC Sanasam *

The nasal discharge (the mucous fluid that comes out from the nose) we call it 'Nap' in Manipuri. Many parents and the general population take the 'nap' for a natural or normal thing, not to be of much significance.

But one must know that it is not a natural or normal thing. A person, maybe an infant, a child or an adult, should not have nasal discharge if he or she is healthy. In fact it is the waste product of the destruction of the cells or tissue in the nose due to the invasion of bugs – organisms like bacteria or virus, sometimes fungus or due to allergic disorder in the nose.

Very rarely parasites like maggots inhabit in the nose and they can cause severe destruction of tissues with copious discharge. Bleeding from the nose caused by the leech is a different thing.

In one way what the parents and the general population consider is right - one need not be terrified with occasional episodes of nasal discharge as is seen in cases of common cold or rhinitis (infection of the nose usually caused by some common virus). However it should not escape from our awareness that if not controlled in time it can complicate further like switching on to additional bacterial infection and spreading into the sinuses and other areas which then will definitely cause ill health to the individual.

On the other way round, occasional episodes of cold (viral rhinitis) in infants and children can be regarded as a boon in disguise; because, they are as good as vaccine-shots to build up immune system in the body (resistance against the common bug invaders, the enemies to the body). There are collections of certain kind of tissues called 'lymphoid tissues' behind the vulnerable portals of entries of viruses or bacteria.

The commonest portals of entries of virus and bacteria are the nose and the mouth because it is through these areas that a person breathes in air and ingest food respectively, which again are essential for sustenance of life. The nose is the gateway for the respiratory tract and the mouth for the ingestion tract.

Adenoids are placed behind the nose and likewise tonsils behind the mouth cavity. Both are composed of lymphoid tissues rich with B Lymphocytes and A Lymphocytes which are the forerunner army personals to fight against the invaders. They tackle the invaders and reduce them harmless.

In simple words adenoids and tonsils are the jail-houses of bacteria and viruses, adenoids for the bugs that come in along with inspired air and tonsils for those that come in along with food. With such episodes the body builds up its immune mechanism. When an infant is born it has very little strength of resistance or immune system; the little they have is from the mother's womb and the colostrums, the first breast milk of a mother when a baby is born.

Thus in this way an infant or a child gradually builds up its resistance. The first encounters or battles the infant fights its battles of immunological war are when it has nasal discharge or loose motions (diarrhoeas). In other words the nose, throat and intestine are the first battle grounds where the first immunological wars are fought with.

The army of lymphocytes at the intestine level is located at certain areas called Peyer's Patches. By the time the child reaches the maximum of its growth, say by about 17 or 18 years of age, it is supposed to have gained the maximum level of immune system, appropriately and more so if it grew up with a normal physiological growth.

That is why in most normal individuals these adenoids and tonsils regress back; their size and activities get reduced physiologically when the individuals reach this age.

However if and when these jail-houses become too full or congested with the onslaught of frequent invasions and thick population of the invading bugs (the prisoners) the jail houses become inefficient to tackle the invaders and they become the harmful storehouses of dangerous enemies. That is when the adenoids or the tonsils be best removed and it is best to leave to the doctors to decide to do it or not to.

If unhealthy adenoids and tonsils are left untreated they can cause all sorts of problems of ill health in a child and even in adults.

Sinusitis (infection of the sinus),
polyp formation in the sinuses,
nose bleeds,
tonsillitis (infection of the tonsils),
abscess around the tonsil,
painful swelling with infection of the eyeball,
deep neck infection and abscess,
lymph node infections around the neck,
dental infections,
frequent upper and lower respiratory tract infections,
pneumonia,
broncho-pneumonia,
lung abscess,
chronic nasal allergy,
bronchial asthma,
stunted growth,
lack of intelligence,
ear infections and deafness,
rheumatic joints,
rheumatic valvular diseases of the heart,
skin infections,
and a host of other complications can arise.