Ask the Pediatric ENT

Ask the Pediatric ENT – How are Bedwetting and Sleep Apnea Related?

Question: My child is over five years old and has problems wetting the bed. The pediatrician says his kidneys and bladder are fine, but he might have problems breathing at night. How is that related to bedwetting?

Answer: Bedwetting and sleep apnea can be connected. Treating the sleep apnea often times resolves the bedwetting issue.

If your child has difficulty breathing while he sleeps and this difficulty results in sleep apnea, his brain is so busy trying to get oxygen that it diverts attention from other functions like bladder control. In addition, as oxygen levels drop carbon dioxide levels increase. The blood becomes more acidic and this affects the heart rate. When the heart sends out false signals of fluid overload the bladder will empty.

Bedwetting after the age of five is commonly a sign of sleep apnea due to breathing disorder. A pediatric ear, nose and throat (ENT) doctor can evaluate your son’s breathing to make sure it is not the cause of apnea.

Your son’s septum could have been deviated during the birth process or injured in an accident afterwards. If your son’s sinuses or turbinates are obstructing his airways when he sleeps, a pediatric ENT doctor can correct this.

The tonsils and adenoids could be enlarged and blocking his airway.

A thorough examination can determine the cause of the breathing disorder, correct the sleep apnea, and allow your son to sleep through the night dry and comfortable.

Ask the Pediatric ENT – Are Nosebleeds Normal?

Question: My child seems to get several nosebleeds each year. It is always frightening. Is this normal?

Answer: It is not uncommon for children to get nosebleeds. They can be the result of dry membranes, infections, allergies, and even injury by foreign objects placed in the nose. Unfortunately, children like to put things in their nose.

If your child has a nosebleed, it is important for you to remain calm. Children model the behavior of the adults around them. Remember, that it always looks like more blood than it is, so stay calm. An anxious child will have a racing heart causing the nose to bleed even more.

Calmly pinch the soft spot on the bridge of your child’s nose. Make sure your child remains standing or sitting in an upright position with their head in a slightly forward position. This position will allow the blood to drain forward through the nostrils instead of backwards down the throat. The nosebleed should stop within 10 to 15 minutes.

You can prevent nosebleeds by making sure that the air is properly humidified. Older children can benefit from saline nasal sprays, but they may not be tolerated by toddlers.

If your child has difficulty breathing during the nose during the day, snores at night, or has frequent nasal infections you should schedule an appointment with the pediatric ENT doctor. While most nosebleeds are not serious, recurring nosebleeds can be a symptom of a more serious condition.

Ask the Pediatric ENT – About Tonsillectomy

Question: My child’s pediatrician has referred me to a pediatric ENT doctor to remove my child’s tonsils. What can I expect while she recovers?

Answer: A pediatric ENT doctor is also a pediatric surgeon. Your pediatrician referred you to the right person to take care of your daughter!

Tonsillectomy is the removal of the tonsils. The tonsils may be enlarged due to infection or obstruct your child’s breathing while they sleep. The procedure will be done on an out-patient basis under general anesthesia. It only takes about 30 to 45 minutes, and your child should be able to go home that day.

She might experience a very low fever the first night. In addition there will be some discomfort. The pediatric ENT will prescribe medication in liquid form to make sure she is as comfortable as possible.

The recovery period is about seven to 10 days. It is important that she drink plenty of fluids during this period. She may be reluctant to eat due to pain while swallowing. If this is the case, just offer soft foods until they can tolerate swallowing again. A little snoring or mouth breathing is normal until recovery is complete.

If you have any questions during the recovery period, don’t hesitate to call the ENT’s office.