Adenoids in Kids: Mouth Breathing, Snoring and When to Operate

Can home remedies shrink adenoids? No. Nothing you drink, steam or rub will make them smaller. What home care can do is clear the nose with saline and cut down allergy triggers, while you watch for the signs of blocked breathing in sleep that tell you it’s time to see an ENT specialist.

What adenoids are, and why children’s get big

Adenoids are a small pad of immune tissue at the very back of the nose, above the roof of the mouth. You can’t see them by opening a child’s mouth, unlike tonsils. They help young children meet germs, grow largest between about 3 and 7 years of age, and usually shrink through the teenage years. Most adults have little left.

Colds, allergies and smoke at home can make them swell further. Big enough, and they block the nose. The child then switches to breathing through the mouth, day and night, which is why so many parents first notice the problem as an open mouth in photos or a pillow wet with drool.

Adenoids home remedies for kids: what actually helps

Here’s the honest list. None of it shrinks tissue. All of it helps.

1. Home saline for the nose. Half a level teaspoon of salt in 250 ml of boiled, cooled water. Use a few drops in each nostril, or a saline spray from a pharmacy, before sleep and feeds. Make a fresh batch each day. For babies, our guide to saline drops and bulb suction shows the technique.
2. A smoke-free home. No cigarettes, sheesha or mosquito coils in the child’s room. Smoke keeps the nose swollen.
3. Dust and allergy control. Wash pillow covers and sheets weekly in hot water, keep soft toys off the bed, damp-dust rather than sweep, and keep pets out of the bedroom if the child sneezes around them.
4. Treat colds promptly with rest and fluids. Every cold swells the adenoids for a while.
5. Raise the head end of the bed slightly for children over 2, by putting something firm under the legs of the bed, not extra pillows. Babies always sleep flat on their back in a bare cot, with nothing propped or tilted.
6. Allergy medicines or nasal sprays may be prescribed by a doctor for some children. The doctor sets which and how much.

Sleep apnoea signs: when snoring isn’t just snoring

Many children snore with a cold. That’s fine. Normal, even. Snoring on most nights for weeks, with the signs below, suggests obstructive sleep apnoea, where the airway partly closes during sleep.

• Pauses of a few seconds in breathing, followed by a gasp or snort
• Chest sucking in on each breath while asleep
• Bedwetting starting again in a child who was dry
• Waking tired, morning headaches, dark circles
• Poor attention, irritability or hyperactivity at school
• Poor weight gain or growth

Try filming a minute or two of the child’s sleep on your phone on a noisy night. It helps the doctor more than any description. Adult snoring is a different story; see snoring and sleep apnoea for grown-ups.

Adenoids by age

• Under 6 months: noisy breathing is common and usually from a small, mucky nose. Breast milk or formula only; saline drops are fine. See a doctor for fast breathing or poor feeding.
• 6 to 12 months: saline, flat safe sleep, smoke-free room.
• 1 to 3 years: adenoids start growing. Watch for constant mouth breathing and ear infections.
• 3 to 6 years: peak size and the commonest age for surgery when needed.
• Over 6: adenoids often start shrinking. Symptoms may ease over a year or two.

Adenoids ENT visit: what the X-ray and scope show

The ENT specialist (ear, nose and throat doctor) will ask about sleep, ears and growth, look in the ears and throat, and often order one of two tests.

Lateral neck X-ray

A side view of the head and neck. It shows the shadow of the adenoids against the airway behind the nose. The report may give an adenoid-to-nasopharynx ratio or say how much of the airway is narrowed. It’s a snapshot. A child who happens to have a cold on the day of the X-ray can look a good deal worse than usual, so some doctors repeat it or rely more on the story of the child’s sleep, ears and growth over several months.

Nasal endoscopy

A thin, flexible camera passed gently into the nose. A numbing spray goes first. It shows the adenoids directly, is often done in the clinic in a few minutes, and many children cope with it better than parents expect when it is explained to them beforehand in simple words.

A hearing test and ear pressure test (tympanometry) may be added if there are ear problems. In some cases a sleep study is ordered.

Adenoids and tonsils: when surgery makes sense

Adenoids and tonsils are cousins. When both are big, surgeons often remove both. Our guide to tonsils and sore throats covers the tonsil side.

Removal (adenoidectomy) is usually offered for sleep apnoea, repeated ear infections or glue ear affecting hearing, or constant blocked nose that hasn’t improved with months of good care. It is a short operation done through the mouth, under general anaesthetic, with no cuts on the face, and most children go home the same day or the next morning with a sore throat, a blocked nose and a few days of soft food ahead. Recovery is quick.

Questions to ask the surgeon

• Why do you recommend it now, rather than waiting a year?
• Will the tonsils or ear tubes be done at the same time, and why?
• What should recovery look like, and how many days off school?
• Which bleeding or fever signs after surgery mean coming back straight away?
• What should the child eat and drink in the first week?

Myth: adenoids grow back after removal

A small amount of tissue can regrow in some children, but it rarely causes the same trouble again. The fear comes from children who still snore afterwards, usually because the tonsils, allergies or weight are also playing a part.

Adenoids questions parents search