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One of the most common reasons kids visit the pediatrician is for problems related to their ear, nose, or throat. A few run-of-the-mill ear infections, sore throats, or runny noses are simply a part of growing up. But if your child is having recurrent problems—or they affect their ability to hear, speak, swallow, and breathe—they should see a specialist.

“Kids are not just little adults. There are many conditions that are unique to them,” says Conor Blanco, DO, a pediatric ear, nose, and throat physician at Summit Health. “Specialists in my field are trained to recognize these differences and diagnoses that do not exist in the adult world.”

Dr. Blanco treats children of all ages from infancy to adolescence. Some of the most common problems he addresses are chronic ear infections, nose and sinus congestion, adenoid and tonsil inflammation, airway and breathing obstructions, nosebleeds, and tongue ties. Many of these conditions can be corrected with minor outpatient surgical procedures.

“Ear, nose, and throat issues can have a severe impact on a child’s quality of life. They can affect their ability to breathe, develop, communicate, and sleep,” he explains. “My goal is to correct the problem so these children can live their best life.”

The first five years of childhood is a critical time for learning and development. It is important to recognize any potential problems and intervene right away before valuable time is lost. Here are eight red flags that mean it is time to check in with a specialist.

Your child has chronic ear infections.

Recurrent inner ear infections are the most common reason children come to see Dr. Blanco. The condition is extremely prevalent in kids under five because the eustachian tube—the small passageway in the ear canal that connects the throat to the middle ear—is tiny and has not fully formed yet. As a result, fluid does not drain out of the ear very well.

Dr. Blanco recommends ear tube surgery for many patients with chronic ear infections. During the procedure, a hollow cylinder is placed into the eardrum that prevents fluid from building up in the middle ear. This reduces the number of inner ear infections, as well as the need for antibiotics.

“Ear tubes help in two ways,” explains Dr. Blanco. “First, they relieve the fluid that has built up over the years and may be causing hearing loss. Secondly, they reduce side effects from the overuse of oral antibiotics. Once the tubes are in place, any future ear infections can be treated with a topical antibiotic ear drop.”

Their speech is delayed.

Hearing loss can significantly impact a child’s speech and development. If your little one is missing developmental milestones, it is important to rule out any potential hearing-related problems. Any patient who comes to Dr. Blanco with a speech delay is also referred to a pediatric audiologist for a hearing evaluation.

There are several causes of hearing loss in children. Chronic ear infections are often the culprit because fluid lingers in the middle ear for too long. Ear tubes can help correct this problem.

Nerve-related hearing loss can also occur. Hearing aids may be used to amplify sound. Dr. Blanco also surgically places a device known as a cochlear implant behind the ear that stimulates the hearing nerve and can help restore sound.

“The first few years of language development are critical. That is why we aggressively screen all babies with a newborn hearing test and continue to evaluate children when they are young,” explains Dr. Blanco. “If there is a speech delay, we want to figure out if it is related to hearing because that is a very treatable potential cause.”

You can’t seem to keep strep throat away.

Strep throat and tonsillitis are infections that cause soreness and difficulty swallowing. Like ear infections, the mainstay of treatment is antibiotics. It is very common for children to get strep throat since it is highly contagious and easily spread around schools and daycare centers. If your child has more than three throat infections in a year, however, it is time to be looked at by an ENT.

The tonsils and adenoids are tissues in the back of the throat that prevent germs from entering the body. In some kids, however, these tissues end up trapping bacteria. When kids have recurrent throat infections, Dr. Blanco often recommends removing the tonsils and adenoids. The procedure helps reduce the frequency and severity of the infections.

Noisy breathing—during the day or night — has you concerned.

Does your child breathe heavily through their mouth or snore? Nasal congestion, sleep apnea, or an obstruction can make it difficult for kids to move air the way they should. Snoring or gasping for breath during what should be a peaceful slumber are common symptoms of sleep apnea. Removing the tonsils or adenoids can improve your child’s breathing because there is more room in the airway.

“Sleep apnea can cause issues with learning, growth, and brain development, as well as long-term health consequences like high blood pressure. If a child is having symptoms of sleep apnea, we typically recommend taking the tonsils and adenoids out because it usually corrects the problem,” explains Dr. Blanco.

Your kid is always stuffy.

Nasal congestion can be extremely debilitating for children. Anything that prevents the mucus from draining—a persistent cold, allergies, or a blockage—can cause an infection to develop in the nose or sinuses. When kids have more than one sinus infection in a year, they are generally referred to Dr. Blanco.

Like adults, many children also have a deviated septum, which causes the nasal passages to be uneven. Dr. Blanco advises trying medication first. His goal is to maximize the amount of air that can flow through the nasal passageways so the mucus can drain properly. He generally tries to avoid surgery in young patients because it can interfere with the growth of the facial skeleton. 

Those pesky nosebleeds won’t quit.

Nosebleeds, which can be caused by dry air, nose-picking, and allergies, are common in kids under 10 years old. Usually, nosebleeds are not a cause for concern; however, if your child’s nose is bleeding more than once a week, or if the blood is very heavy, they should be evaluated. A nose cautery is a simple procedure Dr. Blanco performs in the office to seal the blood vessels.

You were told your baby has a tongue-tie.

Normally, the tongue moves freely within the mouth. But sometimes babies are born with a tongue-tie — a condition that causes the tip of the tongue to be attached to the bottom of the mouth by an extra piece of tissue. Babies with tongue-ties may have difficulty latching during breastfeeding or making certain sounds. Dr. Blanco can usually correct tongue-ties in his office by simply snipping the band of tissue.

There have been too many prescriptions for antibiotics. 

Antibiotics are a group of medications used to treat bacterial infections like strep throat. While these drugs are extremely helpful, they can also have harmful side effects like stomach distress. When they are needed regularly, the bacteria in your child’s body can also become resistant to the antibiotic.

Dr. Blanco says that children who are prescribed antibiotics frequently for ear, throat, or sinus infections should be evaluated by a specialist. Many simple and safe surgical procedures that can be performed in his office can significantly reduce the need for antibiotics.