Question: My adopted son was recently diagnosed. He has been with me for 2 years, but spent 12 years in the foster care system. Since the first day, I noticed that I had to blow his nose several times a day. If I did not, he would pick his nose, blow his nose in his hands and clothing, etc. One year ago, before his genetic testing, he had his tonsils and adenoids out. At that time, the ENT examined the nose and “cleaned it up.” I am wondering if the chronic nasal discharge is related to CdLS? He is microcephalic. He has seen an allergist and has zero allergies. I’m at a loss. Unfortunately, these behaviors are often unpleasant in school and social situations.

Answer: Whether it’s an allergy or vasomotor mediated, usually using a nasal steroid can minimize nasal drainage from inflammation. I would start with this. If this is not effective, it’s probably reasonable to get a more extensive evaluation from a local ENT. I don’t know if it’s explicitly related to CdLS, but a small nose can make it harder to clear, and there may be issues like turbinate hypertrophy that need to be addressed.

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