According to the American Academy of Otolaryngology, ear, nose and throat disorders are one of the main reasons children see a physician. And ear infections are the most common reason parents bring their children to the doctor. February is Kids ENT Health Month, so this blog reviews a few of the more common ENT disorders that affect children.  

Just about every child will experience an ear infection at some point. My child was no exception; he had his share. Acute otitis media is a painful ear infection that occurs when the middle ear becomes inflamed and infected. The middle ear lies between the eardrum and the inner ear, where the cochlea and vestibular system are located.  

With acute otitis media, your child’s eustachian tube becomes swollen or blocked, and fluid gets trapped in the middle ear. That fluid can become infected and cause symptoms. Symptoms of otitis media include unusual irritability, difficulty sleeping or staying asleep, tugging at one or both ears, fever, fluid draining from the ear, loss of balance, difficulty hearing and ear pain. 

Treatment begins with home care, which includes applying warm, moist compresses over the ear and using over-the-counter eardrops and pain relievers. If over-the-counter products don’t do the trick, your child’s doctor may prescribe stronger eardrops and pain relievers. If your child’s symptoms persist after that, the doctor may recommend antibiotics to treat the infection. 

Enlarged tonsils and adenoids are also common in children. Tonsils and adenoids are collections of lymphoid tissue that help the body fight infection, but they can become enlarged if they become infected or irritated.  

Enlarged tonsils and adenoids are actually normal in some children. But in other children, the enlargement is due to a bacterial or viral infection, allergies, exposure to irritants or possibly even to gastroesophageal reflux disease (GERD).  

Usually, there are no obvious symptoms when the tonsils and adenoids are enlarged. But the condition may lead to difficulty breathing or swallowing and can cause your child to sound like he or she has a stuffy nose when talking. Enlarged tonsils and adenoids can also cause nosebleeds, bad breath and cough. 

In some cases, enlarged tonsils and adenoids can cause recurring ear or sinus infections, or sleep apnea, a sleep disorder in which the upper airway becomes blocked, causing the child’s breathing to stop and start during the night. 

Treatment for enlarged tonsils and adenoids begins by addressing the underlying cause, such as the allergies or infection. If this fails to achieve results, your child’s doctor may suggest removing the tonsils and adenoids. Surgery may be recommended if your child has sleep apnea or extreme difficulty when talking and breathing, or experiences multiple throat infections. 

Another common ENT issue in children is sinusitis. The sinuses are air-filled cavities behind the face lined with mucus membranes. Sinusitis is an infection of the sinuses near the nose.  

Sinus infections often develop after a cold or upper respiratory infection. These cause inflammation of the nasal passages that can block the opening of the sinuses into the nose. Allergies can also cause sinusitis due to the swelling of the nasal tissue and increased mucus production. 

Treatment for sinusitis may include a course of antibiotics, acetaminophen for pain, a decongestant and/or mucus thinner, and a nasal spray to reduce inflammation. Your child’s doctor may recommend that you run a cool humidifier in your child’s room to keep the air moist. 

In extreme cases, surgery on the sinuses may be needed. 

Allergic rhinitis, also known as hay fever, is another ENT problem that is common in children. Allergic rhinitis, which is a reaction that happens in the eyes, nose and throat, can be seasonal or year-round. The most common causes of allergic rhinitis in children include pollen from trees, grass or weeds; dust mites; mold; cockroach waste; and animal dander. These substances are called allergens because they trigger an allergic reaction. 

Symptoms of allergic rhinitis include sneezing, nasal congestion, nasal discharge, fatigue and skin rashes. Treatment generally involves giving your child antihistamines, decongestants and nasal sprays. If your child also has asthma, the doctor will treat those symptoms as well. 

Consider allergy shots if your child has severe allergic rhinitis. The shots are a type of immunotherapy. 

Patti DiPanfilo

Sudden Infant Death Syndrome is the sudden, unexpected and unexplained death of a seemingly healthy baby less than 1 year old. SIDS is sometimes called crib death because it usually occurs when babies are asleep in their cribs. SIDS is a silent killer.

About 2,300 babies die of SIDS each year in the US. It is the most common cause of death in babies between the ages of 2 weeks to 1 year. It most often occurs in babies between 2 months and 4 months old. It occurs more often in African American and Native American babies than in Caucasian babies and is slightly more common in boys than in girls.

SIDS doesn’t have any recognizable symptoms. It happens to babies that appear healthy. A diagnosis of SIDS is one of exclusion. The diagnosis is generally made if no clear cause of death can be determined after a thorough investigation that includes an autopsy.

There are certain factors that increase a baby’s risk of dying from SIDS. The most important is laying down a baby to sleep on the stomach or side rather than the back. Other factors that increase risk include:

• A family history of SIDS.
• Being overheated with blankets or a high room temperature.
• Co-sleeping (sharing a bed with a parent or caretaker).
• Having a mattress that’s too soft.
• Having soft objects in the crib, such as stuffed toys, bumper pads, quilts and pillows
• Being born prematurely or having a low birth weight.
• A mother younger than 20 years old.
• A mother who received inadequate or no prenatal care.
• A mother who smoked, drank alcohol or took drugs during pregnancy.
• Exposure to secondhand smoke.

The cause of SIDS is unknown but researchers are studying certain theories. Many believe that SIDS is related to a baby’s inability to arouse from sleep when not getting sufficient oxygen from breathing. As a result, carbon dioxide builds up in the bloodstream. A high level of carbon dioxide can lead to death. Some researchers believe this occurs because the center in the baby’s brain that controls arousal is not fully developed.

The proposed “Triple-Risk Model” suggests that three factors combine to cause SIDS. This theory holds that SIDS occurs when an underlying brain abnormality and a triggering event, such as a poor sleep position (sleeping on the stomach), occur during a vulnerable stage in a baby’s development, essentially the first six months of life.

It may be frightening to know that there’re no symptoms to be alert for and no clear cause of SIDS, so there’s no way to prevent it from happening. But there are some tips for reducing a baby’s risk for SIDS. These include:

• Lay your baby on his or her back when putting him or her down for a nap and at night.
• Avoid overheating your baby. Don’t tightly swaddle your baby in a blanket and keep the room temperature at a level that’s comfortable for a lightly clothed adult.
• Don’t co-sleep with your baby or let your baby sleep with other children or adults.
• Choose a firm, safety-approved crib mattress and use a fitted sheet.
• Keep toys, bumper pads, fluffy blankets, quilts and pillows out of the crib when the baby is sleeping.
• Don’t smoke, drink or take drugs while pregnant and if breastfeeding.
• Get proper prenatal care during pregnancy.
• Don’t let anyone smoke around your baby.
• Set up your baby’s sleep area close to you but separate from your bedroom or those of other children.

In addition, make sure everyone who cares for your baby – including grandparents and other relatives, babysitters and friends – knows these recommendations. And consider sharing these tips with other parents and caregivers of infants.

Patti DiPanfilo