Dear Doctor,My two-year-old daughter started snoring. It’s been a month and the snoring keeps getting louder. Sometimes she sounds like she is having difficulty breathing. But she doesn’t have the flu. Does she have nasal problems that need to be checked out? I’ve tried giving her nasal spray before she sleeps but that doesn’t help. Betty

Dear Betty

Snoring occurs due to obstruction of the upper airways while sleeping. 3 per cent of children between the ages of one to nine snore while sleeping. They usually overcome it.

Most common cause for snoring in a small child is enlarged tonsils. Children are very sensitive to infections and can acquire infections easily from someone in their proximity like in day care centres. Any person handling a child can also pass on cold or cough easily to her. It can be through contaminated hands or toys. Infection may be viral, where it settles to normal within a week without any treatment. Bacterial infections would be accompanied by headache, fever and will not subside till suitable antibiotics are used. Stuffed congested nose can also lead to snoring. This commonly occurs due to allergy or a deviated nasal septum. Allergy can be due to something applied on the child, like baby care products with chemicals or something in the vicinity of a baby like hair, fur of pets, or spores of plants.

A deviated nasal septum causes repeated cold, snuffed nose and snoring in the night. A thick soft palate is yet another cause for snoring in a toddler. It can also occur and get aggravated due to anxiety. Due to snoring, a child does not get restful sleep and is usually somnolent during the day for long. She will seem dull as well to the onlooker.

Prevention consists of keeping potentially allergy causing substances away from a child. For two to three days, one can try stopping the use of toilette products with chemicals for a small child and replace it with natural substances. Anyone having a cold or cough should not be allowed to handle a toddler. A person handling a child should keep his hands clean. Toys, teethers, and etcetera, materials used by the child and put in her mouth often should also be kept clean. Steps should be taken to improve the immunity of the child by giving him a nutritious diet.

Treatment consists of raising the pillow at night so that the child can breathe freely. Anti-allergy drops or syrup help in removing the allergy. Decongestant drops help clear the blocked nose. Steam inhalation is also helpful. In case of throat infection, it is advisable to give suitable antibiotics on advice of a paediatrician.

If a low palate is suspected, it can be corrected by a minor surgery on discretion of a surgeon.

Dr. Rachna Pande is a specialist in internal medicine. rachna212002@yahoo.