Children's airway disorders can affect how babies and children breathe, eat, sleep, learn, and develop. Many disorders are diagnosable at or before birth; however, many of the signs are missed during the initial birth screening. Exams and evaluations, such as the APGAR examination, do not currently require review for these signs or symptoms.
The Apgar test is done by a doctor, midwife, or nurse. Apgar is a quick test performed on a baby at 1 and 5 minutes after birth. The 1-minute score determines how well the baby tolerated the birthing process. The 5-minute score tells the health care provider how well the baby is doing outside the mother's womb.
The provider examines the baby's:
Breathing effort
Heart rate
Muscle tone
Reflexes
Skin color
It is important to recognize the limitations of the Apgar examination and score calculation. According to the American College of Obstetrics and Gynecology, there are numerous factors that can influence and incorrectly impact the Apgar score, including maternal sedation or anesthesia, congenital malformations, gestational age, trauma, and interobserver variability.
Additionally, the process does not require that a medical provider open an infant's mouth to examine that airway, tongue placement, or oral cavity for a high-arched palate. Should this step be included, many preventable childhood airway disorders could be identified and treated immediately.
WHAT ARE AIRWAY DISORDERS?
It is estimated that there are more than 400-million children around the globe that are currently experiencing breathing issues. Many of these are treatable airway disorders that often go undiagnosed and untreated.
Child breathing disorders encompass a variety of conditions that affect the airways of a child. Various issues, blockages, or malformations of the nose, oral cavity, throat, trachea, and bronchi can result in pediatric airway disorders.
Children may experience problems with attention, behavior, and learning because of mouth breathing, sleep-disorder breathing, and snoring. Childhood airway disorders are associated with many unrecognized symptoms, including bed-wetting, nightmares, sleepwalking, and colic.
WHAT IS PEDIATRIC SLEEP-DISORDERED BREATHING?
Pediatric sleep-disordered breathing (SDB) is a sleep disorder in which your child's breathing is partially or completely blocked repeatedly during sleep. In children, SDB can range from frequent, loud snoring to Obstructive Sleep Apnea (OSA), a condition where part, or all, of the airway, is blocked repeatedly during sleep.
When a child’s breathing is disrupted during sleep, the body thinks the child is choking. The heart rate increases, blood pressure rises, the brain is aroused, and sleep is disrupted. Oxygen levels in the blood can also drop.
Approximately 10% of children snore regularly, and about 2%-4% of children experience OSA. Recent studies indicate that mild SDB or snoring may cause many of the same problems as OSA in children. However, there are differences between pediatric obstructive sleep apnea and adult sleep apnea. One main difference is that while adults usually have daytime sleepiness, children are more likely to have behavioral problems.
HOW CAN I TELL IF MY CHILD HAS AN AIRWAY DISORDER?
There are several signs and symptoms to look for that will help to identify if your child might have an airway disorder. One of the most common, yet often overlooked signs, is chronic mouth breathing. Children who are chronic mouth breathers often exhibit the following symptoms:
Abnormal irritability
Increased crying or bedwetting episodes at night
Waking with a dry mouth or sore throat
Trouble waking up
Problems concentrating at school; brain fog
Daytime sleepiness
Being diagnosed with ADHD
Chronic anxiety and allergies
Children who exhibit problems concentrating at school are often misdiagnosed with attention deficit disorder (ADD) or hyperactivity; however, in many cases, the child is actually suffering from an undiagnosed airway issue.
When evaluating your child for a possible airway disorder, ask yourself the following:
Does your child sleep through the night?
How many times does your child chew each bite or mouthful before swallowing?
Does your child almost always have a stuffy nose?
Does your child have a "worried" expression when swallowing?
Does your child sleep with an open mouth?
These are just a few of the questions that can help you identify if your child might be dealing with a sleep-breathing or other airway disorder. Visit the Children's Airway First Foundation Resource Library for videos, podcasts, medical papers, blogs, recommended reading, and more to discover more about treatable children's airway issues.
As with any medical condition, consult your child's pediatrician should you see any of these symptoms in your child or if you suspect your child is suffering from an airway disorder.