How to manage noisy breathing in children

A mother recently complained to me that her four-year-old baby usually breathes heavily at night. She was worried because her son always opens his mouth and the loud noise was becoming embarrassing.

After I examined the boy, I noticed that his tonsils were inflamed, a condition called tonsillitis. The X-ray done also showed an enlargement of the adenoids. The two conditions are called adenotonsilitis and are responsible for the boy’s noisy breathing.

Adenoids are the two infection-fighting glands at the back of the nostrils and above the tonsils. Adenoid enlargement refers to the increase in the size of the adenoids.

Noisy breathing is associated with breathing through the mouth, bad breath, snoring, fast breathing and cough. Adenoid enlargement is a major cause of noisy breathing in children.

Other conditions that cause abnormal breathing include asthma, poor dentition and abnormality in the mouth. The adenoids, along with the tonsils, help prevent agents such as bacteria and viruses from entering the body. When infection or inflammation occurs, the adenoids become swollen preventing air from flowing in and out of the nostrils freely.

To breathe, they have to inhale and exhale via mouth. The adenoids also shrink, as a child grows older.

Causes

The exact cause of enlarged adenoids is not always clear. Chronic infection of the upper respiratory tract and allergies may cause the adenoids to enlarge.

Symptoms

When adenoids cause obstruction, the child now develops snoring (noisy breathing) because of the obstruction of the passage of the nose at the back, will have bad breath with bad odour and will not gain weight as expected since he uses a lot of energy to breath. Most of the children will have recurrent catarrh, low to high-grade fever, cough, noisy breathing from birth.

Diagnosis

Diagnosis of adenotonsilitis begins with a history and physical exam. The tonsil can be viewed via direct light source when the child opens his mouth. Adenoids cannot be seen by looking in the mouth directly. The doctor can see them by using a special mirror in the mouth or a flexible tube (called an endoscope) placed through the nose. In young children, the easiest way to find an enlarged adenoid is with an X-ray called postnasal X-ray.

Complications: It may result in Otitis media (infection of middle ear), Chronis sinusitis, obstruction of the airway, recurrent chest infection and sleep problems like sleep apnea. It may also affect the facial appearance of the child, which in medical terms is referred to as adenoid faces.

Prevention

Effective treatment of allergies may prevent some cases of adenoidal hypertrophy. Many times, the condition cannot be prevented. There is the need to prevent children from dusty environment and things like smoking, frying things, sweeping, sharing of items with mates in the school.”

Treatments: Use antibiotics, anti-inflammatory (analgesics), oral corticosteroids and anti-allergy drugs, among others. Surgical removal of the adenoids (adenoidectomy) is sometimes necessary for those who do not respond to medicine.

According to MayoClinic.com, babies can have as many as 10 upper respiratory infections–better known as the common cold–before age 2. It’s also common for newborn babies to have some nasal congestion in the first two months of life. All of that sniffling and stuffiness can make your baby uncomfortable and interfere with his sleep, making for a sad and grumpy little one.

Call the doctor

Newborns can become dehydrated quickly, and colds can easily develop into croup or pneumonia. If your newborn is having trouble breathing, has a runny nose, sounds “stuffy” or has a rattling or raspy sound coming from her chest, call your pediatrician. Chances are it’s just normal newborn congestion or simply a cold, but with newborns, it’s best to err on the side of safety.

Clear congestion

A stuffy nose can make it hard for your newborn to suck, so keeping his nasal passages clear is important. If your pediatrician approves, use a mild nasal saline spray, available at most drug and baby supply stores. Follow the directions on the bottle and gently spray it into one nostril at a time. A drop of breast milk in each nostril may help clear the congestion as well. Use a bulb syringe, also available at drug stores and sometimes given out at the hospital where you gave birth, to suck out the mucous. Squeeze the bulb of the syringe, insert just the tip into baby’s nostril and slowly let the bulb re-inflate, drawing the mucous out. Clean the syringe well with hot water after each use, and make sure it’s fully dry before using it again.

Use a humidifier in your newborn’s room to help keep the air moist and ease congestion. Keep it away from the crib or bassinet so the mist doesn’t spray directly on the baby, and make sure the cord is kept well out of baby’s reach. Change the water every day to ensure that mold doesn’t grow in the tub. Sitting with your newborn in the bathroom with the hot water running and the door closed may help loosen congestion as well. Let the steam fill the room and sit with your baby for a few minutes, but be sure he doesn’t get too warm. If his cheeks start to get red or he looks more uncomfortable, move to a cooler room.

Letting your baby sleep partially reclined in a car seat or swing can help his breathing if his chest is congested. Be sure he’s buckled in and that the seat is on the floor and can’t be knocked over.

In conclusion, parents should release their children for necessary surgery that may be beneficial to such children at adulthood. The failure to do this make the patients to snore heavily later in life. It may also affect their speech.