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Snuffles in infants--infection or autonomic dysfunction
T G Teoh1, G P Fox, T G Matthews
1Rotunda Hospital, Dublin.
Insights
Infant snuffles, or noisy nasal breathing, may be linked to impaired autonomic nervous system function rather than infection. This study found a higher incidence of postural hypotension in infants with snuffles, suggesting a potential role for vasomotor control issues.
Area of Science:
- Pediatrics
- Neonatology
- Autonomic Nervous System Function
Background:
- Infant snuffles (noisy nasal breathing with mucus) are common in the first three months of life.
- Traditionally attributed to upper respiratory tract infections, this is often unproven in infants without other infection signs.
Purpose of the Study:
- To investigate the potential role of impaired vasomotor control (autonomic function) in the development of infant snuffles.
- To assess if changes in body position affect blood pressure in infants with snuffles.
Main Methods:
- Compared resting blood pressure changes upon postural change (supine to upright) in 50 infants with snuffles and 50 healthy controls.
- Defined postural hypotension as a fall of greater than 10% in resting blood pressure.
- All infants were healthy, without signs of acute infection or medication.
Main Results:
- Postural hypotension was observed in 22 out of 50 infants with snuffles.
- Only 4 out of 50 healthy control infants exhibited postural hypotension.
- This difference was statistically significant (Chi square 16.84, p < 0.001).
Conclusions:
- The findings suggest a potential association between infant snuffles and impaired vasomotor control.
- Autonomic dysfunction may play a role in the pathogenesis of snuffles in some infants.
Abstract:
The presence of excess nasal mucus causing noisy nasal breathing with an obvious mucus discharge (snuffles) is a common problem in infants in the first three months of life. The presence of "snuffles" has traditionally been ascribed, unproven, to an upper respiratory tract infection despite there being no other signs of an acute infection in the majority of infants with "snuffles". To assess the possible role of impaired vasomotor control (autonomic function) in the pathogenesis of snuffles we measured the effect of a change from the supine to the upright position on resting blood pressure in 50 infants with "snuffles" and 50 healthy control infants. The mean age in both groups was 7 weeks post delivery, all infants were attending a well baby clinic for a routine examination, had no signs of an acute infection and none were on any medication (including nasal drops). A fall of greater than 10% of resting blood pressure was taken to indicate postural hypotension. Four of fifty infants in the control group compared to 22 of 50 in the snuffles group demonstrated postural hypotension (Chi square 16.84, p less than 0.001). The results suggest that in some infants "snuffles" may be associated with impaired vasomotor control.