Children who snore from time to time, have a blocked nose, or sometimes seem not to hear well are common situations in childhood. In most cases, they are not associated with any underlying problem, are temporary, and resolve on their own. However, these signs should not always be ignored, it may not be just a phase. What should be taken seriously? When signs are persistent, do not occur in isolation, or the child seems to be frequently unwell, attention is needed. In these cases, seeking medical care almost always allows for rapid intervention in a simple and effective way. Stay alert and take note of the following signs : Frequent snoring; Restless sleep or pauses in breathing during sleep; A constantly blocked or runny nose; Habitual mouth breathing; Recurrent ear or throat infections; Signs of reduced hearing; Changes in speech or learning. These signs rarely appear on their own and should be assessed as a whole. What are the most common causes? Enlarged tonsils and adenoids are common in children and can obstruct airflow during sleep, leading to snoring, restless sleep, or breathing pauses (sleep apnea). The child may sleep poorly, become more irritable, or have difficulty concentrating. This condition is often associated with persistent nasal congestion and chronic runny nose, which contribute to habitual mouth breathing. When this adaptation continues over time, it may not be without consequences. Persistent mouth breathing can influence the development of facial and oral structures, affecting tongue position, the palate, dental alignment, and facial muscles. In more prolonged and severe cases, it may contribute to altered orofacial growth. The presence of fluid in the middle ear (serous otitis media) may occur without pain or fever and subtly affect hearing. The child may ask for repetition, appear inattentive, increase the volume of the television, or show delayed language development. Recurrent ear infections and tonsillitis are often part of this same condition, a cycle of inflammation that simultaneously affects breathing, sleep, and hearing. All of these situations benefit from early assessment. How is the evaluation carried out? The evaluation and clinical examination of these signs and symptoms are performed by ear, nose, and throat (ENT) specialists and are simple and tailored to children. They enable clinicians to: Examine the tonsils and adenoids; Identify nasal congestion and airway obstruction; Detect fluid in the ear; Carry out age-appropriate hearing tests; Perform sleep studies, in selected cases. If a problem is diagnosed, what is the treatment? The initial approach is conservative and includes simple measures, such as: Nasal hygiene and irrigation Treatment directed at upper airway inflammation Monitoring of hearing Many children improve significantly with these measures. If symptoms persist, additional interventions may be needed , always planned according to each child’s specific needs. Remember: Not everything that is common in childhood should be considered normal; Breathing well, sleeping well, and hearing well are fundamental pillars of healthy growth and development ; Being attentive and recognising signs early allows for prompt intervention — often making a significant difference in comfort, growth, and quality of life. Author : André de Sousa Machado (otorhinolaryngology ) Meet the otorhinolaryngology clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
