When a child keeps their mouth open during the day or snores and breathes through the mouth at night without a cold, parents often wonder about the adenoids. This article covers causes, signs, and when to seek care.
Why It Happens
The adenoids are immune tissue high in the throat behind the nose. MedlinePlus explains that when they are enlarged, the nose can become blocked and a child breathes through the mouth, mostly at night but sometimes during the day. Long-term mouth breathing may lead to a dry mouth, bad breath, and cracked lips. Repeated infections or allergies are thought to play a role, and the adenoids cannot be seen by simply looking into the mouth.
How It Differs by Age
Many children with adenoids have few or no symptoms, and MedlinePlus notes that the adenoids tend to shrink as a child gets older. When symptoms are notable, children may toss at night, snore loudly, and seem to pause in their breathing (sleep apnea). If the opening of the tube linking the nose and ear is affected, ear infections can become more frequent. Because snoring and nasal blockage can also come from allergies or large tonsils, a clinician has to sort out which cause is involved.
Care at Home
Notice how your child sleeps about half an hour after falling asleep, and keep a short log of mouth breathing, snoring, and pauses, or record a brief video; this helps at the appointment. On stuffy days, saline rinses, reasonable bedroom humidity, and less dust and smoke can help. Offer water through the day so the mouth stays moist, and brush teeth and tongue to manage mouth-breathing breath. To diagnose, a provider may use a small mirror or a thin flexible scope through the nose, and an X-ray; a sleep study may be ordered if sleep apnea is suspected. If infection is involved, antibiotics or nasal steroid sprays may be prescribed.
Common Misunderstandings
First, that all snoring means enlarged adenoids; allergies or large tonsils can also be responsible. Second, that big adenoids always lead to surgery; with mild symptoms, watching is common. Third, that removing them cures every nose problem; allergic rhinitis needs its own care. Fourth, that mouth breathing is only a habit; a blockage may be behind it. The AAO-HNS adenoidectomy indicators are described as suggestions rather than rules, to be adapted to each child.
Signs That Need Emergency Care Right Away
Seek emergency care right away if your child stops breathing during sleep and turns blue, has severe trouble breathing with the skin between the ribs pulling in, or has a high fever with a throat so painful that swallowing saliva is impossible. Even if it is not an emergency, consider calling your pediatrician or an ear, nose, and throat specialist if nasal blockage, mouth breathing, or snoring lasts several weeks, ear infections are frequent, or your child is very sleepy and has trouble focusing during the day. Surgery (adenoidectomy) is generally considered when symptoms are severe or persistent. Consider talking with a pediatrician if you are unsure. This information reflects general guidance for the United States; if you live elsewhere, check with a local pediatrician. This information isn’t a diagnostic tool and doesn’t replace advice from a medical professional.