Think DS (2) might have enlarged adenoids...how on earth will the doc examine him?!

[LollopingLil]

DS, just turned two, is still dribbling copiously. He has a cold atm which is exacerbating things and he's soaking through a top every 1.5-2 hours, but even when he's not cold-y, he still dribbles a lot more than other DC his age.

He's also a very poor sleeper, taking more than an hour to get off to sleep and usually waking a few times. His speech has been slightly delayed, but now that it's starting to take off you can hear than he sounds nasal and congested, even without a cold.

I'd like to take him to have his adenoids looked at but I'd like to know how on earth he could be examined, as he hates people fiddling with his mouth (brushing teeth a nightmare) or coming at his face with instruments (he had a hearing test a few months ago because of his speech, all fine). He screams and thrashes and quickly becomes hysterical - virtually impossible to examine then, and I hate distressing him so much. Particularly hate being complicit by holding him down!

Dribbling, poor sleeping and speech probs make me wonder if he is tongue tied.

How was he as a baby? Did you breastfeed him or try to? list of symptoms here

more info here

Does he have allergies/intolerance, ear trouble, digestive issues? These are common amongst tongue tied children

Hi mawbroon - he's still breastfed now actually, although we had a hell of a start and he gained weight very slowly for the first six months (25th centile at birth, then dropped to the 2nd. Now at two, he's up on the 90something, where he absolutely should be). He definitely had problems with milk transfer.

However, I'm pretty sure there's no tongue tie - no cupid's bow shape to the tongue and nothing visible underneath. What he does have is a really thick thingiebob between upper lip and teeth, but I've been assured that makes no difference...

My other thought is that maybe he has some muscle weakness around his mouth, I've heard that can also cause excessive dribbling and slow speech.

Sorry, didn't answer your other questions. No ear trouble and no allergies but he does have some digestive troubles (we're in a bit of a constipated/loose/constipated rut).

He avoids words that start with 't'. Loves those that start with m/n (clever boy:o).

Dont think adenoids are easily examined! When dd was referred for adenoitonsillectomy, the doc had a lquick look at the back of her mouth and her tonsils, but said they'd just have to wait until the op to check adenoids. The decision to remove went on symptoms not visual assessment. As it turns out, dds adenoids were in fact v enlarged and scarred, but we didn't know that in advance. Good luck!

Sounds just like my DS and we've got him booked in for an adenoidectomy shortly. They have not attempted to look at the adenoids themselves at any point in the process (they will try to do so for a much younger child who doesn't understand what is going on, but not at this sort of age) - simply go to your GP and ask for a referral to an ENT specialist. Tell the specialist what you posted above. You will probably be put on the list for the adenoidectomy without them having to see the adenoids as they can only see them with DS under GA unless you wait till he's old enough to understand and cooperate with having instruments in his mouth which would be years and years.

In preparation for the ENT appointment we did practicing saying AAAH with sweetie rewards if he opened his mouth wide and let me use a wooden fork to press down his tongue. He didn't want to at first but became very cooperative when he understood the reward system!

Libelulle, how old was your DD when she had the op? What were her symptoms?

Feersum, can I ask which bits sound familiar?

Thanks for all the responses.

Ah, ok. He has a lip tie by the sounds of it (would explain hating getting his teeth brushed). It is very rare to have a lip tie without a tongue tie. He probably has a posterior tie. These are hard to spot unless you know what to look for. What you have mentioned of your breastfeeding experience and the digestive troubles would also be explained by a tongue tie.

The heart shaped tongue and visible frenulum is only one type of tongue tie. Posterior tongue tie is when the frenulum is further back on the tongue. The frenulum could be partially or completely buried in the membranes in the mouth meaning there is nothing much to see.

Sorry, posted too soon. DS1 had posterior tongue tie, and a lip tie which went undiagnosed until he was 6. His tongue looked completely normal and he could stick it out and lift it up really well. I had considered that he was tongue tied, but dismissed it because his tongue looked ok. Until I learned about tongue tie that is....

Trouble with posterior tongue tie is that most hcps are not knowledgeable about it and many ties are missed, sometimes multiple times

She was 3 1/2. She was referred to ENT by her chest consultant - repeated chest infections (needing long-term antibiotics to control) and asthma. Her enlarged adenoids and tonsils were apparently obstructing the airways and causing her lungs to gunk up . That, and she snored like an express train!

Hi Loll. My DS has copious dribbling long after his contemporaries had stopped (still wearing baby bibs at the age of 3, and they get soaked with dribble in less than an hour), worse when he has a cold. He's a poor sleeper and snores incredibly loudly, doesn't seem refreshed by his sleep. (He gets occasional sleep apnoea too - does your DS?) and his voice sounds very nasal and his breath is always quite audible and panty. Your first two paras in your OP could have been written about my DS.

I'm sure your GP will b able to help.

Interesting, thanks again all.

No, DS doesn't snore, although you can hear him breathing when he's asleep if that makes sense.

Mawbroon, very interesting, thank you - I will have a look at that thread. How does one go about getting a PTT diagnosed or examined in a toddler or older child? Privately, I assume? I'm desperate to get the sleep issues in particular cracked as DS2 is due at the end of Feb. have to say, I will actually cry if it turns about to be that because I thought I had explored every avenue when he was a newborn and we had such a hellish time. I actually had PND related in no small part to his feeding and sleeping difficulties and have spent a long time thinking I must be the worst mother in the whole bloody world :(.

I would suggest that you join the tongue tie babies support group on Facebook. It's a closed group, but just ask to join and wait for admin approval.

You probably wouldn't get very far with the NHS tbh, and if they did agree to do a revision (if it's tt causing the prob, of course) they would want to do it under GA which is not neccessary. It can be done with local, in fact it should be done with local so that the tongue function can be assessed during the process, which can't be done under a GA. Also, the lip tie should probably be revised too, and I don't think the NHS would do that, although I could well be wrong.

FeersumEndjinn, I would recommend looking into tongue tie for your ds too. It can cause the dribbling and sleep apnoea and some of the other things that you mention, also check for a high palate, which again can be caused by tongue tie.

My 4 yr old daughter has enlarged adenoids, tonsils and glue ear and will have an op to remove them in a couple of weeks. She was initially diagnosed with enlarged adenoids through discussion of her symptoms - poor sleeping, speech delay, in particular with the nasal sounding consonants (m,n etc), speech sounding very nasal, snoring, mouth breathing. She also used to dribble a lot even at 3 years old but this has stopped now and if she doesn't snore she breathes VERY heavily at night - she likes to sleep with her door open and we can hear her breathing while we're sat in the lounge downstairs!!

When we met with her ENT surgeon her got her to have an xray of her head to see how big her adenoids were and this showed that they are so enlarged there is hardly any space in her nasal passages for air to pass through! We live abroad though so this is private health care so the NHS may not order an xray i'm not sure. Hope you manage to find an answer.