One of the most frequent concerns in pediatrics (and the least understood) involves the color and significance of nasal mucous. Many parents believe that when the mucous turns green, the child has a bacterial or sinus infection and needs antibiotics. This is “handed-down” information from grandmother to mother; and it is just not true.
Viral respiratory infections (colds) can cause a variety of mucous color changes in the first few days of an illness…green, yellow, orange, brown…just about every disgusting color you can imagine. If you are a parent that is a “mucous color watcher”, then read on….
- After sitting stagnant in a congested nose all night, mucous tends to be the worst and grossest in the morning (or after a big sneeze). This is not unlike a stagnant pond that turns green. There may be some bacteria at play, but this is usually the resident bacteria that flourish in the nose. A green nose in the morning is no cause to take warning.
- If you are a mucous color watcher, then pay more attention to it in the afternoon or as the cold progresses. If the nasal mucous is consistently green, day and night, for a week to ten days, it is more likely to be medically significant.
- If a persistent, foul, green mucous is only coming out of one side of a toddler’s nose – a toddler who does not seem to be sick – this is not likely an infection. One of the more common causes is a foreign body in the nose, usually decomposing food. Raisins, beans, and pieces of any food are occasional found in little noses. No one really knows why toddlers do this, but they do.
- Simple colds tend to last a week if we treat them and seven days if we leave them alone. In children, nasal congestion and cough can last a lot longer, especially children who are constantly exposed to other children. Back-to-back colds can make symptoms last a month or more. When persistent colds are accompanied by fever, rapid respirations, wheezing, or worsening symptoms over time, there is a good chance that a secondary bacterial infection has taken hold. These children need to be seen by a medical provider.
If a child has persistent green mucous, all day long for ten days or more, from both sides of the nose, and these symptoms are accompanied by headache, sore throat, or fever, then it is time to re-evaluate. Although rare, there are incidents where antibiotics may be needed.