He Has Trouble Focusing at School
If your child is having problems like hyperactivity, inattention, or poor performance in class - or if he’s moody, frustrated, tired, and generally cranky, you may be thinking ADHD. However, it could be his tonsils. In fact, it’s very common for kids with tonsil problems to be misdiagnosed when their symptoms don’t seem to be physical. Enlarged tonsils and adenoids can block your child’s airway when he’s sleeping, causing sleep apnea, a condition in which he briefly stops breathing and wakes up repeatedly during the night. Surprisingly, 60 to 80 percent of all tonsillectomies are now done because kids’ tonsils are obstructing their airway and creating sleep problems. How to tell whether this could be the case? “Your child may be a restless sleeper. You might notice that he’ll snore loudly and then suddenly gasp and move around a little bit,” says Scott Manning, M.D., division chief of otolaryngology at the Seattle Children’s Hospital. That’s because the muscles around the tonsils and adenoids are relaxing, and they collapse around the tonsil tissues. If your child’s tonsils are large, the airway becomes blocked, causing him to startle and wake up very briefly. Once his tonsils are removed, your kid will sleep better and be able to focus more during the day. One study at the University of Kansas School of Medicine, in Kansas City, for example, found that many children who seemed to have ADHD actually had large tonsils and sleep apnea. After they had surgery, their apparent ADHD symptoms significantly improved.
She Snores a Lot
Sometimes a child’s naturally large tonsils and adenoids can partially obstruct her airway while she’s sleeping - causing snoring but not actual sleep apnea. “The tendency to have obstructed breathing can be hereditary,” says Dr. Manning. If you or your husband snored a lot as a kid, your child may be following suit. When she’s sleeping, the muscles of her throat relax, and the amount of space for airfl ow around her large tonsils is reduced. So you’ll hear your child snoring, but you won’t hear the startled gasp or see her moving around several times a night, as a child with apnea would. She’ll also seem well rested when she wakes up. The good news is that your child’s tonsils and adenoids will naturally shrink as she gets older (usually around the tween years), so her snoring may fade away over time. If it doesn’t, but she has no other signs of tonsil or adenoid issues, it could be that she was simply born with excess tissue in her throat and is naturally prone to snoring.
He Always Seems to Have Strep Throat
When tonsils are infected and enlarged, it hurts to swallow. Tonsillitis is frequently caused by a virus, and your child usually won’t need more than lots of fluids and rest. But tonsillitis can also be caused by the strep-throat bacteria (you’ll probably see white spots on your child’s tonsils). Doctors today will only consider removing your child’s tonsils if he’s had four or five positive strep tests in one year or six or seven over the course of a couple years. And keep in mind that even once his tonsils are out, your child won’t be immune to strep. “When kids get recurrent strep throat, it’s usually because the strep bacteria have become permanently colonized in the tonsils themselves and then occasionally erupt,” explains Dr. Wiatrak. “But after their tonsils are gone, kids can still catch strep from other infected kids.”
She Has Recurring Ear Infections
Even if your child’s tonsils are perfectly healthy, she can still have issues with her adenoids, which sit right next to the opening of the ear, at the back of the nose. “If the adenoids are chronically infected - and some kids are just unlucky that way - they’re basically a gathering place for bacteria, and will cause kids to continue to get ear infections,” says John McClay, M.D., a pediatric ear, nose, and throat specialist at the Children’s Medical Center of Dallas. In fact, if your child is getting ear infections so frequently that you’re considering having ear tubes placed, your doctor may suggest an adenoidectomy in addition to the tubes. “If your child has already had one set of tubes and your doctor thinks she needs a second set, that’s also a sign that her adenoids may be the culprit,” Dr. McClay explains. A peek in your child’s nose with a flexible fiber-optic scope can tell the doctor whether the adenoids are enlarged and infected.
He Always Breathes Through His Mouth
When his tonsils and adenoids are enlarged, your child may feel as though his nose is plugged, so he’ll start breathing more through his mouth. Then it’s a chain reaction: As he breathes through his mouth for extended periods - you’ll see and hear this even during the day - the saliva in his mouth can quickly dry out. “The dryness creates a welcoming environment for bacteria that increases his risk of getting cavities,” says John Rutkauskas, D.D.S., chief executive officer of the American Academy of Pediatric Dentistry in Chicago. The bottom line? Keep an eye out for potential problems, talk to your kid’s doctor, and listen to your instincts. Those pesky “seasonal allergies” might actually be something more. If you catch the early warning signs of tonsil or adenoid trouble, your child will breathe a lot easier, and so will you.