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3 months
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Sorry by mistake, yes she is 3.5 years old and it is her first school year. We also noticed that she keeps mouth open during sleep. Is this related?
Apr 29, 2015
2nd opinion

Dr. Zakia Dimassi Pediatrics
Mouth breathing during sleep is an indicator of blockage at the level of the nasopharynx (the nose and throat), which, in this age group, results from enlarged tonsils and/or enlarged adenoids (what is known in Arabic as لحمية). The adenoid, along with the tonsils at the back of the mouth and tonsillar tissue at the base of the tongue are important in preventing bacteria, viruses, and toxins from entering the body. The adenoid tissue is located at the backmost part of the nasal cavity and up behind the soft palate; it can get infected both acutely and chronically.
If infections recur, this tissue enlarges (hypertrophy) and so causes obstruction of the upper
airways. So a child with a hypertrophic adenoid often have difficulty breathing through their nose, and compensates by mouth breathing. This may interfere with eating because these children have to stop chewing to catch their breath after swallowing.

Another complication is a continuous runny nose. This is because the enlarged adenoid tissue prevents the mucus (normally produced in the nasal cavity and goes backwards to be swallowed) from exiting the back part of the nasal cavity. When an adenoid is infected, it compresses the eustachian tube (a thin tube that functions in can also impair draining fluids from the ear), so fluids will build up behind the eardrum (otitis media) or there will be dysfunction of the eustachian tube.
An enlarged adenoid also causes upper airway obstruction in children, resulting in loud snoring. In addition, a child with an enlarged symptoms may continuously suffer from sinus symptoms.

To make the diagnosis of adenoid hypertrophy, a lateral view X-ray of the head and neck is needed.

The mainstay of treatment is a trial of oral anti-histamine plus intra-nasal steroids for a few months; should these medications fail to produce noticeable improvement, surgical intervention may have to be considered.

Regarding a supplement to boos immunity, some ear-nose-throat and immunology specialists recommend the use of bacterial extracts, a long-term treatment that may reduce the frequency of upper airway infections in children with enlarged adenoids and allergic tendencies, and there is a good number of scientific studies to support the use of such products.
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