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We can all admit that when children snore it can be quite cute. However, a child who snores loudly and frequently may have a medical problem that needs to be addressed. This article discusses how to tell whether your little one is snoring due to a sinus infection or tiny airways, or if they have a medical problem like tonsil and adenoid enlargement, that an ear, nose, and throat surgeon can manage.

Harmless Snoring

If your child snores only when they have a sinus infection, cold, or are otherwise congested, this situation can usually be managed with medication. The snoring will usually subside once they are healthy again. This situation can usually be managed by your family doctor or paediatrician.

Understanding Sleep Apnoea

Before you become alarmed at the term “apnoea”, you should know that apnoeas are simply pauses in breathing. Almost everyone on earth experiences them from time to time during sleep. Most people are not aware of them and are not affected by them.

However, when a child experiences frequent apnoeas, and when they struggle to begin breathing again, this is called sleep apnoea. This is a serious issue. Sleep apnoea interferes with quality rest and can cause fatigue and even exhaustion. A child with sleep apnoea may have behavioural issues at school or with their parents simply because they are not well rested.

Associated Ear, Nose, and Throat Problems

There are several types of childhood infections associated with snoring, sleep apnoea, and lack of rest in children.

Sinusitis

Sometimes snoring can be a symptom of a sinus infection. If your child has had what seems to be a cold that will not go away for more than 10 days, take them your local doctor for medical review. This could be a sign of sinusitis, a sinus infection, and can usually be treated with antibiotics.

Once the infection is treated, the snoring and any apnoeas, due to nose and sinus blockage, should go away. If not, you should make another appointment with your doctor to discuss how you can help your child sleep more soundly at night.

Adenoiditis

The adenoids are a mass of lymphatic tissue positioned between the back of the nasal cavity and the top of the throat. They protect children against infection by trapping viruses and bacteria. Unfortunately, they can become infected and inflamed, themselves. When this occurs the adenoids swell and become enlarged.

Enlarged adenoids can block your child’s airways and cause breathing problems during sleep. The adenoid gland takes up space between the nasal cavity and the throat. With an enlarged adenoid, your child may be forced to breathe through their mouth while sleeping. Pay attention to how your child is breathing and if you have concerns, schedule an appointment with their ENT surgeon.

Tonsil and Adenoid Infection

The most common reason children snore (around 90%) is enlargement of both the tonsils and adenoid. Snoring is worst in children ages between 2 and 8 years. Removal of the tonsils and adenoid is usually the recommended treatment for children who have tonsil and adenoid infection, when antibiotic therapy is not effective. Removal of the tonsils and adenoid cures snoring and sleep apnoea in 85 to 90% of children.

When Infection Is Not the Cause

Other factors which may increase the risk of snoring include altered airway muscle tone, obesity and genetic factors. If your child has sleep apnoea due to one of these factors, your pediatrician will probably recommend a combination of treatments. In addition to a better diet and more activity, they may prescribe the use of a continuous positive airway pressure (CPAP) machine to allow your child to sleep better at night.

Child sleeping with CPAP

Your doctor may also recommend the use of a CPAP machine if your child has a deviated septum, or otherwise blocked airways. It may take some adjusting to get your child to sleep with an air mask on, but it will be worth it in the end. Once they have developed fully, they may be a candidate for surgery or other treatment for sleep apnoea.

Most causes of sleep apnoea in children are manageable and can be treated by an ear nose and throat surgeon.

If you have questions about the management of childhood sleep apnoea and snoring make an appointment to see our ear nose and throat specialist.

Click here to find out more about treatment for snoring in children

References

The post Treating Childhood Sleep Apnoea and Snoring appeared first on ENT Clinic Sydney.

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What are supplements?

A dietary supplement is a product that provides additional nutrients to someone who are not obtaining nutrients naturally from their diet. Examples include vitamin, mineral and fibre supplements.

Who requires supplements?

  • Pregnant or Breastfeeding women are recommended to take a folic acid supplement of 0.5 mg daily. It must be taken at least 1 month before conceiving and during the first 3 months of pregnancy.
  • Women with excessive bleeding during menstruation may also require an iron supplement.
  • People with malabsorption disorders such as celiac disease or specific food allergies may also need a supplement.
  • People who follow certain diets such as the vegan diet where one avoids all animal products may have a Vitamin B12, iron, zinc or calcium deficiency and hence may need to take a supplement.
  • Older adults may need a multi-vitamin supplement if a poor diet is consumed or if they are unable to tolerate certain foods. Examples of nutrients they might be deficient include folate, vitamin B12 and vitamin D.
  • Individuals recovering from surgery may require a specific supplement that can aid in the recovery process.

Replacement  for a balanced diet?

Taking supplements is not an alternative option to balanced diet and it cannot fix poor eating habits. In fact, research suggests that since supplements work in isolation as opposed to a meal which is a combination of foods, it may not be as beneficial as obtaining nutrients from a variety of foods such as fruits, vegetables, wholegrain breads and cereals, lean meat and low fat dairy products.

Do you need a supplement?

One should not self prescribe supplements. Sometimes people feel that their vitamin deficiency might be the reason for feeling stress and this may not be true. Supplements are not meant to diagnose health conditions. It is best to get advice from health care providers  such as a doctor or a dietitian before taking a supplement. The doctor would indicate if the level of a particular nutrient is low as per your blood tests.

Some nutrients are not easily available through diet, such as Vitamin D. Also, it is not always possible to obtain sufficient amounts of nutrients through exposure to the sunlight. This is especially true for people who are housebound, living in aged care homes or people who wear completely covered clothing due to religious reasons.

Supplementation toxicity

More than required supplement intake can sometimes cause adverse effects. For example, increased fish oil intake may cause blood clotting and excess iron can lead to gastrointestinal distress.

Contact us for results focused nutritional advice

This article was written by our dietitian and nutritionist Juhi Bhambhaney. If you have questions regarding health and nutrition, make an appointment with one of our dietitians. We‘ll provide you with a simple and effective routine targeted to your concerns. Contact us today!

The post Dietary Supplements appeared first on ENT Wellbeing Sydney.

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About how stress affects IBS. To completely understand how stress affects the symptoms of irritable bowel syndrome (IBS), it is important to have an understanding of the brain-gut axis. The brain gut axis is a bidirectional continuous feedback loop between the gut and the brain. The gut has its own ‘second brain’ which controls the process of digestion and absorption and communicates back and forth from the main brain. The reason why we say the gut has its own brain is because the gut consists of a number of neurons which control the digestion, absorption, the mixing of food and muscle contractions.

The brain-gut axis is the reason why we have feelings like ‘butterflies in the stomach’ or a feeling of nausea before having to deliver an important presentation at work. This happens because the gut responds strongly to your thoughts and emotions. For example, even just   the thought of food can cause your stomach to release juices in preparation of the food.

IBS may not be caused by psychological factors but emotional stress worsens the symptoms of IBS The reason for this is  that movement and contraction of the GI tract can altered  by stress. The walls of the intestines are lined with layers of muscle that relax and contract in a rhythm that moves food from the stomach through the intestinal tract. During times of stress, individuals with IBS experience stronger contractions which last for a long time and cause gastrointestinal issues such as gas, bloating and diarrhoea.

The opposite could also happen with some people where the food is not digested properly causing constipation. Stress can also directly or indirectly affects the composition and growth of the micro biota in the gut which disturbs the two way communication between the gut and the brain and alters the functioning of the gut worsening the symptoms of IBS.

Recommendations to reduce stress:

  • Intervention from a mental health professional: a clinical psychologist may be able to use cognitive behavioural therapy to help manage the stress.
  • Exercise: Walking, running, hiking, riding a bike, yoga or tai chi are some ways of relieving stress.
  • Meditation and deep breathing exercises
  • Relaxation activities such as listening to music and spending time with friends and family.

Contact us for results focused nutritional advice

This article was written by our dietitian and nutritionist Juhi Bhambhaney. If you have questions regarding health and nutrition, make an appointment with one of our dietitians. We‘ll provide you with a simple and effective routine targeted to your concerns. Contact us today!

References

The post How stress affects IBS appeared first on ENT Wellbeing Sydney.

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There are a number or speech errors, also know as phonological processes, that normally developing children produce. These include substitutions of back sounds, which are harder to produce, e.g. K and G sounds, for front sounds, e.g. T and D sound, causing them to say a word like ‘cat’ as ‘tat’. Children may also voice a sound, which does not require voicing, e.g. the ‘k’ in ‘dock’ when voiced may sound like ‘dog’.

Another common error is deleting one sound within a cluster such as the ‘st’ cluster without the ‘s’ which would turn a word such as ‘star’ into ‘tar’. Alternatively, the child may delete a sound at the start or at the end of a word and instead produce a word like ‘cat’ as ‘ca’.

Processes such as these are normal around 3-4 years of age however if these errors are present after this age, sometimes the child’s representation of the sound has been distorted during this time and when they attempt to pair the sound with a letter, their poor awareness of this sound causes spelling errors.

Some common examples of these spelling errors may include;

  • Substitution of sounds for the error sound they used to produce or deleting the sound entirely. This may cause a child to spell the word ‘cat’ or ‘tat’ and the word ‘dock’ may be spelt as ‘dog’.
  • Deleting sounds within a word when sounding out to spell.

This may look like ‘star’ being spelled as ‘sar’ or ‘cat being spelt as ‘ca’ or ‘at’

Errors such as these require specific speech pathology intervention targeted at improving sound awareness. This type of intervention improves a child’s ability to detect the sounds within a word, and manipulate these sounds in their head without the use of letters. For this reason, we refer to these phonological awareness skills as pre-literacy skills.

Once your child has mastered the ability to detect and manipulate the sounds without the symbolic alphabet letters, these same skills are then applied with the letters to detect and manipulate written words. This in turn allows them to correctly spell words and detect spelling mistakes they have made in order to self-correct independently.

Contact us for results focused speech therapy

This article was written by our Speech Pathologist Ashleigh Fattah who is a Speech Pathology Australia member. If you have speech pathology related questions, make an appointment. We‘ll provide you with simple and effective therapy targeted to your concerns. Contact us today.

The post How speech delay can impact reading and spelling appeared first on ENT Wellbeing Sydney.

By

There are a number or speech errors, also know as phonological processes, that normally developing children produce. These include substitutions of back sounds, which are harder to produce, e.g. K and G sounds, for front sounds, e.g. T and D sound, causing them to say a word like ‘cat’ as ‘tat’. Children may also voice a sound, which does not require voicing, e.g. the ‘k’ in ‘dock’ when voiced may sound like ‘dog’.

Another common error is deleting one sound within a cluster such as the ‘st’ cluster without the ‘s’ which would turn a word such as ‘star’ into ‘tar’. Alternatively, the child may delete a sound at the start or at the end of a word and instead produce a word like ‘cat’ as ‘ca’.

Processes such as these are normal around 3-4 years of age however if these errors are present after this age, sometimes the child’s representation of the sound has been distorted during this time and when they attempt to pair the sound with a letter, their poor awareness of this sound causes spelling errors.

Some common examples of these spelling errors may include;

  • Substitution of sounds for the error sound they used to produce or deleting the sound entirely. This may cause a child to spell the word ‘cat’ or ‘tat’ and the word ‘dock’ may be spelt as ‘dog’.
  • Deleting sounds within a word when sounding out to spell.

This may look like ‘star’ being spelled as ‘sar’ or ‘cat being spelt as ‘ca’ or ‘at’

Errors such as these require specific speech pathology intervention targeted at improving sound awareness. This type of intervention improves a child’s ability to detect the sounds within a word, and manipulate these sounds in their head without the use of letters. For this reason, we refer to these phonological awareness skills as pre-literacy skills.

Once your child has mastered the ability to detect and manipulate the sounds without the symbolic alphabet letters, these same skills are then applied with the letters to detect and manipulate written words. This in turn allows them to correctly spell words and detect spelling mistakes they have made in order to self-correct independently.

Contact us for results focused speech therapy

This article was written by our Speech Pathologist Ashleigh Fattah who is a Speech Pathology Australia member. If you have speech pathology related questions, make an appointment. We‘ll provide you with simple and effective therapy targeted to your concerns. Contact us today.

The post How speech delay can impact reading and spelling appeared first on ENT Wellbeing Sydney.

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