For many parents, deciding when to seek specialist care for their child can be challenging. Children often experience common health issues, runny noses, ear aches, sore throats, that resolve on their own. But sometimes, these seemingly minor problems may point to something more persistent or complex. That’s where a visit to an otolaryngologist, a doctor trained in managing conditions of the ear, nose, and throat, can make all the difference.
While your child’s paediatrician is often the first point of contact, there are specific scenarios where a referral to an ENT doctor for children is not only appropriate, but necessary. Early intervention can prevent complications, support developmental milestones like speech and hearing, and improve quality of life.
Here are five common reasons your child may need to see a children’s ENT specialist, with a sixth that many parents may not expect.
1. Recurrent Ear Infections or Hearing Issues
Ear infections are incredibly common in young children due to the anatomy of their Eustachian tubes, which are shorter, more horizontal, and more easily blocked. Most cases resolve with time or simple treatment. But if your child experiences frequent ear infections (three or more in six months, or four in a year), or has persistent fluid behind the eardrum, it may signal a more chronic condition known as otitis media with effusion.
Signs to watch for include:
- Difficulty hearing
- Delayed speech development
- Frequent tugging at the ears
- Unresponsiveness to sound
- Balance issues
In such cases, an ENT doctor can assess the middle ear using specialised equipment and recommend treatment options. These may include tympanostomy tubes (grommets) to drain fluid and improve hearing, or hearing tests to assess potential long-term effects.
Early hearing loss, even temporary, can significantly affect a child’s language development. That’s why ENT intervention is so crucial when ear problems persist.
2. Persistent Nasal Congestion or Mouth Breathing
It’s not unusual for children to have runny noses or blocked noses, especially during flu season. However, chronic nasal congestion, snoring, or mouth breathing beyond the age of four may indicate underlying issues that require attention.
Possible causes include:
- Enlarged adenoids
- Chronic allergic rhinitis
- Deviated nasal septum
- Nasal polyps (rare in children but possible)
- Sinus infections that won’t resolve
Mouth breathing in particular can lead to facial growth abnormalities, dental issues, and even sleep disturbances. An ENT doctor will examine the nasal passages, assess adenoid size via nasoendoscopy or X-ray, and recommend targeted treatment such as medication, allergy testing, or in some cases, adenoidectomy (surgical removal of adenoids).
3. Snoring or Suspected Sleep Apnea
Loud snoring in children is not always benign. While occasional snoring can be normal, especially during colds, habitual snoring may be a sign of obstructive sleep apnea (OSA), a condition where breathing stops and starts repeatedly during sleep.
OSA in children is most commonly caused by:
- Enlarged tonsils and adenoids
- Obesity
- Nasal obstruction
- Craniofacial abnormalities
Symptoms of paediatric OSA include:
- Restless sleep or frequent waking
- Bedwetting
- Daytime fatigue or hyperactivity
- Poor concentration in school
- Behavioral changes
Left untreated, OSA can affect cognitive development, academic performance, and even the cardiovascular system. ENT specialists often perform a sleep study (polysomnography) and may recommend tonsillectomy and adenoidectomy, procedures that have high success rates in resolving paediatric sleep apnea.
If your child snores loudly and appears to struggle during sleep, it’s time to see an ENT doctor for a proper evaluation.
4. Delayed or Disordered Speech
Speech delays are a common concern in early childhood, and while some children are simply “late talkers,” it’s important to rule out medical causes, particularly those related to hearing and oral structures.
ENT-related causes of delayed speech include:
- Chronic fluid in the middle ear (affecting sound perception)
- Undiagnosed hearing loss
- Tongue-tie (ankyloglossia), which limits tongue movement
- Enlarged tonsils affecting oral resonance
An ENT doctor for children may work closely with audiologists and speech therapists to ensure comprehensive evaluation and management. Addressing anatomical or hearing issues early can prevent long-term challenges in communication and learning.
5. Frequent Sore Throats or Tonsillitis
If your child has recurrent sore throats, tonsil infections, or strep throat several times a year, they may be a candidate for tonsillectomy. According to medical guidelines, children who have:
- Seven episodes in one year, or
- Five episodes per year for two years, or
- Three episodes per year for three years
may benefit from tonsil removal.
Chronic tonsillitis can lead to missed school days, sleep disturbances, and difficulty eating. In some cases, the tonsils become so enlarged that they cause airway obstruction, contributing to snoring and sleep apnea.
A consultation with an ENT specialist will involve a detailed history, physical exam, and a discussion about the risks and benefits of surgical intervention.
6. Neck Lumps or Persistent Swelling
Parents may not immediately associate a neck lump with the need to see an ENT doctor, but any persistent swelling, especially if it’s one-sided, painless, or not responding to antibiotics, should be evaluated.
Common ENT-related causes of neck masses in children include:
- Reactive lymph nodes from infections
- Thyroglossal duct cysts
- Branchial cleft cysts
- Congenital masses
- In rare cases, nasopharyngeal or salivary gland tumours
A proper assessment may involve ultrasound, nasal endoscopy, or imaging studies to determine the nature of the mass. While most causes are benign, timely diagnosis and management are essential to avoid complications.
When Should You Seek ENT Care?
While many childhood ENT issues are temporary, chronic or recurring symptoms should not be ignored. An experienced ENT doctor will perform a comprehensive assessment and offer a tailored management plan, whether that includes medical treatment, watchful waiting, or surgical intervention.
Key signs your child should see an ENT specialist:
- Hearing or speech delays
- Recurrent ear or throat infections
- Noisy breathing, snoring, or sleep disturbances
- Chronic mouth breathing or nasal congestion
- Neck lumps that persist beyond two weeks
- Difficulty swallowing or frequent choking
Paediatric ENT care focuses not only on treating illness but also on supporting developmental milestones and long-term wellbeing.
Final Thoughts
Many ENT-related conditions in children can be subtle at first but may have a profound impact on hearing, speech, sleep, and daily function if left unaddressed. From recurrent ear infections to sleep apnea, each of the signs discussed above is a reason to consider consultation.
Timely assessment and management of ENT-related issues in children can prevent long-term complications and support healthy development. If your child is experiencing any of the concerns discussed, whether related to hearing, breathing, sleep, or speech, seeking input from an experienced ENT specialist such as Dr Annabelle ensures that underlying causes are identified early and managed appropriately. Staying informed and proactive is key to supporting your child’s overall health and well-being.