A blocked nose is common in childhood. Many children experience nasal congestion during colds, allergy seasons or short viral illnesses. In most cases, this settles with simple care and time. However, when nasal obstruction becomes persistent, affects sleep, causes mouth breathing or interferes with daily activities, it may be time to arrange an ENT assessment.
Nasal obstruction in children can have many causes. Some are related to inflammation, such as allergies or sinus disease. Others are structural, such as a deviated septum, enlarged turbinates or narrowing of the nasal airway. In some children, enlarged adenoids are the main reason for ongoing nasal blockage, snoring or disturbed sleep.
At Melbourne ENT in St Kilda East, Victoria, Dr Simon Braham, ENT and Head & Neck Surgeon, assesses children and adults with nasal breathing concerns. The goal is to identify the underlying cause of obstruction and recommend treatment that is appropriate, safe and evidence-based.
Functional Rhinoplasty is one option for structural nasal airway problems, but it is not the first treatment for most children. In paediatric patients, careful diagnosis is essential before considering any surgical approach.
Nasal obstruction means that air does not move freely through one or both sides of the nose. A child may describe this as a blocked nose, stuffiness or difficulty breathing through the nose. Parents may notice mouth breathing, noisy breathing, snoring, restless sleep or frequent waking.
Temporary congestion is usually linked to a cold or short-term irritation. Chronic nasal obstruction is different. It may continue for weeks or months, return frequently or fail to improve with standard treatment.
Healthy nasal breathing is important because the nose helps:
When nasal obstruction is ongoing, an ENT specialist can examine the nose, throat and upper airway to identify the cause.
Children are more prone to nasal blockage because their airways are smaller and more sensitive to swelling. Even mild inflammation can make breathing feel difficult. Children also commonly develop enlarged adenoids, which sit at the back of the nose and can block airflow.
Not every blocked nose is caused by infection. Common contributing factors include:
Melbourne ENT focuses on careful assessment so families can understand whether the problem is inflammatory, structural, infection-related or a combination of factors.
Adenoids are small pads of immune tissue located behind the nose. They are normal in children and often shrink with age. When adenoids become enlarged, they can block airflow through the back of the nose.
Children with enlarged adenoids may experience:
If enlarged adenoids are causing significant symptoms, Dr Simon Braham, ENT and Head & Neck Surgeon at Melbourne ENT, may discuss observation, medical treatment or adenoid surgery.
Allergic rhinitis is a common cause of nasal obstruction in children. It may be seasonal, such as hay fever, or occur throughout the year due to dust mites, mould, pets or other triggers.
Symptoms may include:
Treatment often begins with reducing triggers, saline rinses and appropriate allergy medications. If symptoms persist, ENT review can help identify whether there are other contributing issues, such as enlarged turbinates or adenoids.
The nasal septum is the wall that divides the nose into two sides. If it is bent or deviated, it may narrow one or both nasal passages. In children, this may be present from birth or occur after injury.
A deviated septum may cause:
Septal surgery in children is approached carefully because the nose is still growing. An ENT assessment helps determine whether monitoring, medical treatment or surgery may be appropriate.
Turbinates are natural structures inside the nose that warm, filter and humidify air. When they become enlarged, they can narrow the nasal airway and make breathing difficult.
Turbinate enlargement is often linked to allergy, chronic inflammation or irritant exposure. Children may feel blocked on both sides of the nose, especially at night.
Treatment may include allergy care, nasal sprays and saline rinses. If symptoms remain significant, turbinoplasty may be considered.
Children can develop chronic sinus inflammation, especially if they have allergies, enlarged adenoids or recurrent infections. Symptoms may include persistent nasal discharge, blocked nose, facial pressure, cough, postnasal drip or reduced sense of smell.
It can be difficult for parents to know whether a child has repeated colds or a more persistent sinus condition. ENT assessment can help clarify the diagnosis and guide treatment.
Some children are born with structural differences that affect nasal breathing. These are less common, but they can be important. Examples may include narrowing at the back of the nose, nasal valve narrowing or other developmental airway issues.
These conditions require specialist assessment. Early diagnosis can help families understand the cause of breathing difficulty and plan the right treatment pathway.
If a child’s blocked nose continues for several weeks, keeps returning or does not improve with appropriate treatment, ENT assessment is worthwhile. Ongoing obstruction may indicate adenoids, allergy, turbinate enlargement, sinus disease or structural narrowing.
Mouth breathing is common during a cold. However, when it becomes the usual way a child breathes, it may suggest a chronic nasal airway problem. Parents may notice dry lips, bad breath, restless sleep or difficulty eating with the mouth closed.
Snoring in children should not be ignored when it is regular, loud or associated with pauses in breathing, gasping, restless sleep or daytime tiredness. Nasal obstruction can contribute to sleep-disordered breathing, especially when enlarged adenoids or tonsils are also present.
Dr Simon Braham at Melbourne ENT assesses children with breathing issues, snoring concerns and sleep disturbances, with a focus on identifying the cause and explaining treatment options clearly.
The nose, sinuses and ears are closely connected. When nasal obstruction is related to adenoids or chronic inflammation, children may also experience recurrent ear infections, blocked ears or fluid behind the eardrum.
ENT assessment can help determine whether nasal obstruction is contributing to these repeated problems.
Poor sleep can affect a child’s mood, behaviour, learning and concentration. Some children become tired and withdrawn. Others become restless or irritable.
When nasal obstruction affects sleep quality, treatment may improve more than breathing. It may also support better daytime energy and overall wellbeing.
An ENT consultation usually begins with a detailed history. Dr Simon Braham, ENT and Head & Neck Surgeon, may ask about:
Parents may be asked whether symptoms are worse at night, during certain seasons or around specific triggers. This helps narrow down the likely cause.
The examination may include the nose, ears, throat, tonsils, mouth and neck. The aim is to assess the entire upper airway, not just the nostrils.
In children, this is done as gently as possible. Melbourne ENT places strong emphasis on communication, comfort and patient-centred care.
In some cases, nasal endoscopy for children may be recommended. This involves using a fine camera to look inside the nose and towards the adenoids. It can help identify swelling, discharge, structural narrowing, polyps, adenoid enlargement or other causes of obstruction.
Nasal endoscopy can provide valuable information without needing immediate imaging.
Further tests are only arranged when clinically appropriate. Imaging may be considered if sinus disease or structural abnormality is suspected. A sleep study may be recommended if there are concerns about sleep apnoea or significant sleep-disordered breathing.
The purpose of assessment is to avoid guesswork. Melbourne ENT aims to provide a clear diagnosis before recommending treatment.
Many children improve with non-surgical treatment. This may include:
Medical treatment is often the first step for allergic rhinitis, turbinate swelling and mild sinus inflammation. It may also help reduce symptoms while the child is being monitored.
If enlarged adenoids are contributing to persistent nasal obstruction, mouth breathing or sleep-related symptoms, adenoidectomy may be discussed after assessment. Whether surgery is appropriate depends on the child’s symptoms and clinical findings.
Learn more about Adenoidectomy.
If enlarged turbinates continue to contribute to obstruction despite appropriate medical treatment, turbinoplasty may be considered in selected patients.
Learn more about Turbinoplasty.
Where a significant deviated septum contributes to persistent obstruction, septoplasty may sometimes be considered. In children and adolescents, timing and nasal growth are important considerations.
Learn more about Septoplasty.
Medicare rebates may apply to some medically indicated ENT procedures where relevant MBS criteria are met. Eligibility varies according to the procedure and individual clinical circumstances. See our ENT Medicare Item Numbers page for current information.
Most children with nasal obstruction do not require functional rhinoplasty. Where an older child or adolescent has significant structural narrowing, nasal valve collapse, post-traumatic deformity or another complex airway problem, functional nasal surgery may sometimes be considered after specialist assessment.
See our Airway Rhinoplasty page for detailed information about functional rhinoplasty, suitability, procedure options, risks and recovery.
Persistent nasal obstruction can affect more than breathing. It can disturb sleep, contribute to snoring, worsen daytime fatigue and increase the risk of recurrent infections. In some children, poor sleep may affect concentration, behaviour and school performance.
Early ENT assessment helps identify the cause before symptoms become more disruptive. It may also allow treatment to begin with less invasive options.
Every child’s airway is different. Two children may both have blocked noses, but one may have allergies while the other has enlarged adenoids or a structural issue.
This is why individualised assessment is essential. Melbourne ENT provides tailored care based on symptoms, examination findings and the child’s stage of development.
Melbourne ENT is the practice of Dr Stephen Kleid and Dr Simon Braham, Nose and ENT Surgeons based in St Kilda East, Victoria. The clinic is known for evidence-based surgical techniques, clear communication and a focus on patient safety.
Dr Simon Braham MBBS (Hons) FRACS is an experienced Ear, Nose and Throat Surgeon who treats children and adults with breathing issues, snoring concerns and sleep disturbances. He performs paediatric ENT procedures as well as nasal and sinus surgery.
Families choose Melbourne ENT because care is thorough, practical and personalised. From the first consultation through to treatment planning and follow-up, the emphasis is on understanding the cause of symptoms and explaining options clearly.
Not every child needs surgery. When surgery is appropriate, the reasons, benefits, risks and recovery expectations are discussed in detail.
Melbourne ENT is located in St Kilda East, Victoria, and provides care for patients from Melbourne and surrounding areas. Dr Simon Braham also has appointments at Masada Private Hospital and the Royal Victorian Eye and Ear Hospital, supporting his work across both private and public ENT settings.
For families seeking help with childhood nasal obstruction, Melbourne ENT offers experienced assessment and a calm, patient-first approach.
Yes. A child can have significant nasal obstruction without having a runny nose. This often occurs when the blockage is caused by enlarged adenoids, a deviated nasal septum, enlarged turbinates or narrowing of the nasal airway rather than infection. An ENT assessment can help determine the underlying cause and whether treatment is needed.
Nasal tissues naturally become more congested when lying down, which can make existing airway narrowing more noticeable during sleep. Allergies, enlarged adenoids and turbinate swelling may all contribute to night-time nasal obstruction. If your child snores, sleeps with an open mouth or frequently wakes during the night, it is worth discussing these symptoms with an ENT specialist.
Long-term mouth breathing may influence how the face, jaws and teeth develop while a child is growing, particularly if it continues for many years. It can also contribute to dry mouth, poor sleep quality and daytime tiredness. Identifying and treating the cause of chronic nasal obstruction early may help support healthy breathing and overall development.
A deviated septum does not usually straighten as a child grows. However, not every septal deviation causes symptoms or requires treatment. If the deviation is causing significant nasal obstruction, recurrent sinus problems or poor sleep, Dr Simon Braham at Melbourne ENT can assess whether monitoring, medical treatment or surgery is the most appropriate option.
It can. Children who cannot breathe comfortably through their nose may find vigorous exercise more difficult, particularly if they rely on mouth breathing. Poor-quality sleep caused by nasal obstruction may also reduce energy levels, concentration and overall performance during school and recreational activities.
An ENT assessment combines a detailed medical history with a physical examination and, when appropriate, nasal endoscopy. This allows the specialist to identify whether symptoms are due to inflammation, allergy, enlarged adenoids, turbinate swelling, a deviated septum or another structural issue. Understanding the exact cause is essential for choosing the most effective treatment.
Functional Rhinoplasty is not a routine treatment for children with blocked noses. It may be considered for carefully selected older children or adolescents when there is significant structural narrowing, nasal valve collapse or deformity affecting breathing, particularly if other treatments are unlikely to provide adequate improvement. At Melbourne ENT, Dr Simon Braham carefully evaluates each patient to determine whether Functional Rhinoplasty is appropriate based on symptoms, nasal anatomy and stage of facial growth.
Persistent nasal obstruction in children may warrant assessment, particularly when it affects sleep, causes habitual mouth breathing, contributes to snoring or continues despite appropriate treatment.
The first step is an accurate diagnosis. Treatment may involve medical care, allergy management, adenoid surgery, turbinoplasty, septoplasty or, in carefully selected older children and adolescents, Functional Rhinoplasty.
To arrange an assessment with Dr Simon Braham, ENT and Head & Neck Surgeon at Melbourne ENT in St Kilda East, Victoria, visit the website.