Baby salivating a lot: Drooling and Your Baby – HealthyChildren.org

Опубликовано: July 23, 2023 в 7:55 am

Автор: alexxlab

Категории: Baby

ENTchild: drooling

Drooling happens when your child is unable to control what happens to the saliva in the mouth. The problem usually isn’t too much saliva, the usual problem is that your child isn’t able to control the saliva that is there.

Drooling is common and normal in children under the age 2, because at that stage they have’t yet developed sufficiently to learn to control their mouth, tongue and swallowing well enough to control the saliva. Drooling can also affect children with neurological problems such as cerebral palsy, or those with developmental delay.

What should I do if I am concerned about drooling?

In the first instance, talk to your GP or your paediatrician. The important things to determine are:

-Is there an acute problem that has suddenly caused drooling in a child that is unwell (for example, tonsillitis could cause it)

-Is there a cause for drooling (for example delayed development, neuromuscular weakness or coordination problems, inability to close mouth due to blocked nose). Your GP might need to ask a paediatrician to review the child to look for any problems

What treatment is available in children that are otherwise-healthy?

In children that don’t have any other health problems to account for long-standing drooling, a period of observation is usually helpful. Drooling usually just settles over time.

Working with a speech and language therapist will be useful. They will assess your child’s mouth and tongue movement and swallowing, and provide exercises to teach your child how to gain control over the saliva.

Medication can be used to dry the flow of saliva. However, this can lead to dry mouth, which isn’t pleasant for the child. In addition, the antibacterial effectiveness of saliva is then also removed, which may predispose to tooth decay.

Surgery would be considered only in exceptional circumstances. Usually, a major contributing factor for drooling is the presence of large adenoids and tonsils, which interfere with the child’s ability to breathe with their mouth closed. If your child constantly has their mouth open because otherwise they can’t breathe, then saliva escapes through the mouth. Removal of tonsils and adenoids therefore would be one of the options for drooling management. However, because drooling often just gets better as the child gets older, surgery shouldn’t be undertaken lightly. An additional problem is the fact that NHS at present would probably not fund tonsil and adenoid surgery for drooling.

What treatment is available in children with neurological problems?

Children with neurological problems may be affected by drooling, which can have a significant impact on their quality of life. Again, working with a speech and language therapist is important. Medication is likely to play a role. It is also worth looking at your child’s posture, and seeing whether posture or seating modification could alter how saliva flows.

Removal of tonsils and adenoids may be suitable for some, but there are also other options available to reduce saliva flow, such as botox and surgery.

Botox

Botox injections into saliva glands can reduce the flow of saliva. However, the effect is temporary, and has to be repeated. Many children require a general anaesthetic for the injection, so this would mean repeat general anaesthetics. Botox injections are also not as simple to do as it may seem, and in fact there is the potential for significant problems in swallowing as a result of the injection.

Submandibular duct relocation

If your child has a safe swallow, then submandibular duct relocation would be an option. This operation moves the submandibular gland duct drainage from the front of the mouth to the back of the throat. So instead of saliva appearing at the front, it appears at the back, and the child therefore finds it easier to swallow the saliva rather than drool.

The procedure is not suitable for children who aspirate and have an unsafe swallow, because diversion of salivary flow to the back of the throat will increase the risk of aspiration.

Also, some surgeons find that operating on the very delicate salivary ducts is a challenge, and believe that in fact all that surgery achieves is to block off the salivary glands. In other words, surgery doesn’t work because saliva is diverted, it works because it has closed and blocked the flow of saliva. So those surgeons may suggest that rather than relocating the submandibular ducts, we may as well just stitch them closed. The downside of that is that because we create a block in the flow of saliva the glands swell up after surgery and are painful usually for a week or more.

The benefit of duct relocation is that saliva flow is preserved, so your child keeps the beneficial effects that saliva provides. If you remove the saliva glands, you remove the beneficial effect of saliva.

Submandibular gland excision

Removal of submandibular glands is another option. This is done from the outside, so a scar on each side of the neck will be required. Removal of the submandibular glands reduces the flow of saliva, and aspiration isn’t a risk, neither is significant pain. However, this surgery requires external scars, and there is a small chance of injury to the nerves of tongue and mouth.

What about other salivary glands?

You will note that so far we have largely talked about the submandibular glands, but the body has other salivary glands also. The submandibular glands produce the vast bulk of saliva that is present on a constant basis. The parotid glands tend to produce more saliva just in response to feeding. So for drooling, we need to address the salivary flow that is there all the time, and that means focusing on the submandibular glands. We may however also often look at reducing the flow from the parotid glands, which would typically involve blocking off the parotid duct to stop salivary flow. We do not advise surgical removal of the parotid glands because surgery would be unlikely to lead to major reduction in drooling and could lead to weakness of the nerve that moves the face. As you might expect, surgery to block of the parotid salivary ducts is likely to lead to painful swelling for a week or more.

Keeping some saliva production is a good thing, because saliva serves important functions. So the goal of surgery isn’t to completely remove saliva flow, it is to reduce the flow to a manageable level.

You will see that the management of drooling is quite complex. In children that are otherwise-healthy, just waiting for them to get older is usually a good option. For children with neurological problems, working with a multidisciplinary team experienced in drooling management is key.

Section contributor:

Rachael Lawrence MBBS BSc MRCS

ENT Registrar

Bacterial Sore Throat: Strep Confirmed (Child)

Sore throat (pharyngitis) is a common condition in children. It can be caused by an infection with the bacterium streptococcus. This is commonly known as strep throat.

Strep throat starts suddenly. Symptoms include a red, swollen throat and swollen lymph nodes, which make it painful to swallow. Red spots may appear on the roof of the mouth or white spots on the tonsils. Some children will be flushed and have a fever. Young children may not show that they feel pain. But they may refuse to eat or drink, or drool a lot.

Testing has confirmed strep throat. Antibiotic treatment has been prescribed. This treatment may be given by injection or pills. Children with strep throat are contagious until they have been taking an antibiotic for 24 hours.

Home care

Medicines

Follow these guidelines when giving your child medicine at home:

The healthcare provider has prescribed an antibiotic to treat the infection and possibly medicine to treat a fever. Follow the provider’s instructions for giving these medicines to your child. Make sure your child takes the medicine every day until it’s gone. You should not have any left over.

If your child has pain or fever, you can give him or her medicine as advised by the healthcare provider.

Don’t give your child any other medicine without first asking the healthcare provider, especially the first time.

If your child received an antibiotic shot, your child should not need any other antibiotics.

Follow these tips when giving fever medicine to a usually healthy child:

Don’t give ibuprofen to children younger than 6 months old. Also don’t give ibuprofen to an older child who is vomiting constantly and is dehydrated.

Read the label before giving fever medicine. This is to make sure that you are giving the right dose. The dose should be right for your child’s age and weight.

If your child is taking other medicine, check the list of ingredients. Look for acetaminophen or ibuprofen. If the medicine contains either of these, tell your child’s healthcare provider before giving your child the medicine. This is to prevent a possible overdose.

If your child is younger than 2 years, talk with your child’s healthcare provider before giving any medicines to find out the right medicine to use and how much to give.

Don’t give aspirin to a child younger than 19 years old who is ill with a fever. Aspirin can cause serious side effects such as liver damage and Reye syndrome. Although rare, Reye syndrome is a very serious illness usually found in children younger than age 15. The syndrome is closely linked to the use of aspirin or aspirin-containing medicines during viral infections.

General care

Wash your hands with clean, running water and soap before and after caring for your child. This is to help prevent the spread of infection. Others should do the same.

Limit your child’s contact with others until he or she is no longer contagious. This is 24 hours after starting antibiotics or as advised by your child’s provider. Keep him or her home from school or day care.

Give your child plenty of time to rest.

Encourage your child to drink liquids.

Don’t force your child to eat. If your child feels like eating, don’t give him or her salty or spicy foods. These can irritate the throat.

Older children may prefer ice chips, cold drinks, frozen desserts, or ice pops.

Older children may also like warm chicken soup or beverages with lemon and honey. Don’t give honey to a child younger than 1 year old.

Older children may gargle with warm salt water to ease throat pain. Have your child spit out the gargle afterward and not swallow it.

Tell people who may have had contact with your child about his or her illness. This may include school officials and daycare center workers.

Follow-up care

Follow up with your child’s healthcare provider, or as advised.

When to seek medical advice

Call your child’s healthcare provider right away if any of these occur:

Fever (see Fever and children, below)

Symptoms don’t get better after taking prescribed medicine or seem to be getting worse

New or worsening ear pain, sinus pain, or headache

Painful lumps in the back of neck

Lymph nodes are getting larger

Your child can’t swallow liquids, has lots of drooling, or can’t open his or her mouth wide because of throat pain

Signs of dehydration. These include very dark urine or no urine, sunken eyes, and dizziness.

Noisy breathing

Muffled voice

New rash

Call 911

Call 911 if your child has any of these:

Fever and your child has been in a very hot place such as an overheated car

Trouble breathing

Confusion

Feeling drowsy or having trouble waking up

Unresponsive

Fainting or loss of consciousness

Fast (rapid) heart rate

Seizure

Stiff neck

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

Mouth (oral). Don’t use a thermometer in your child’s mouth until he or she is at least 4 years old.

Use the rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell him or her which type you used.

Below are guidelines to know if your young child has a fever. Your child’s healthcare provider may give you different numbers for your child. Follow your provider’s specific instructions.

Fever readings for a baby under 3 months old:

Fever readings for a child age 3 months to 36 months (3 years):

Rectal, forehead, or ear: 102°F (38. 9°C) or higher

Armpit: 101°F (38.3°C) or higher

Call the healthcare provider in these cases:

Repeated temperature of 104°F (40°C) or higher in a child of any age

Fever of 100.4° F (38° C) or higher in baby younger than 3 months

Fever that lasts more than 24 hours in a child under age 2

Fever that lasts for 3 days in a child age 2 or older

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Diseases of the salivary glands and their ducts causes, signs, treatment |

The duties of a dental surgeon, in addition to removing teeth, include monitoring the condition of the salivary glands and removing cystic formations. Patients often come to the clinic with complaints about the viscosity of saliva or its absence, the appearance of pus in the oral cavity, pain when chewing, and the feeling of a foreign body. All this may indicate the presence of a cyst in the salivary gland. This disease is accompanied by specific symptoms and requires surgical treatment.

Causes of neoplasms of the salivary glands

Neoplasms in the salivary gland can occur regardless of age and status. Equally often this problem is faced by young children and the elderly. The main risk factors are changes in the consistency of saliva against the background of systemic diseases of the body. Also, unhealthy diet, non-observance of hygiene rules can provoke a cystic process.

Other common causes of cyst formation:

traumatic injury with rupture of the duct of the saliva gland, occurs with the ingress of a foreign body or infection, may be both;
scarring after surgery in the jaw area can provoke a narrowing of the canal, the outflow of saliva is delayed, which causes the disease;
obstruction of the duct of the salivary gland against the background of thickening of saliva;
infections coming directly from the oral cavity.

There are several types of diseases of the ducts of the salivary glands.

Cysts of the major salivary glands are parotid, sublingual, submandibular;
Cysts of the parenchyma of the gland.
Retention and post-traumatic.
Cysts of minor salivary glands – they are located everywhere under the oral mucosa.

When should I see a dental surgeon?

Once a cyst begins to form, certain symptoms cannot be elicited. But even then, the outflow of saliva begins to be disturbed. Dryness of the mucous membrane, the severity of swallowing may indicate the beginning of the pathological process. Over time, the cyst grows and already creates significant discomfort.

There is pain at the mere mention of food, that is, at any time when saliva is secreted, the patient feels a sharp pain.
Palpation reveals a small round formation in the area of the major salivary glands.
Pain is aggravated by talking, eating and mechanical damage to the site in the area of the cyst.

How to detect a cyst in the salivary gland?

Once a patient presents with specific symptoms, the diagnosis must be confirmed before treatment can begin. For this purpose, palpation, examination by a dentist of the oral cavity, laboratory examination of the oral fluid and saliva from the gland are carried out. As additional measures, ultrasound diagnostics and CT are used.

How are salivary gland duct cysts removed?

Some specialists are still trying to defeat salivary duct tumors with conservative methods. But this approach is increasingly futile and only exacerbates the course of the disease. It is better to immediately carry out surgical removal, followed by restorative therapy.

During the operation, the cyst and part of the healthy tissue is removed in order to prevent the risk of recurrence of the disease. The operation is performed under local anesthesia directly in the surgical room of the dental clinic. Removal of the cyst by the surgical method guarantees a complete recovery.

For a speedy recovery, it is necessary to refrain from salty, spicy, sour, solid foods for some time after the operation. Firstly, it will be very painful, and secondly, it can provoke a complication in the form of inflammation with swelling.

If there is a suspicion of a neoplasm in the jaw area, you should immediately contact the clinic. The risk of involuntary rupture of the capsule is increased, which threatens the spread of infection and intoxication of the body. At best, rupture of the cyst will lead to infection of the oral mucosa. Digestive complications may also occur when infected saliva is swallowed. A considerable risk of damage to the respiratory organs, which is associated with their close location.

As a preventive measure, you need to follow hygiene rules, monitor the state of saliva, drink plenty of fluids and undergo regular consultations with the dentist.

If a neoplasm occurs in a child, it should also be taken to a pediatric surgeon for further removal. But in fact, the development of a cyst in a child is a very complex process, and special difficulties arise at the time of treatment. A child’s fear of surgery can lead to problematic removal of the cyst. But, given that today dental clinics are sufficiently adapted for a children’s audience, treatment promises to be fast and with a 100% guarantee.

Enteroviral infection in children

Enteroviral infections include a group of diseases. Their specificity is such that lifelong immunity is formed after an infection. However, immunity will only be to the type of virus, the type of which the child has been ill with. Therefore, a child can get sick with an enterovirus infection several times in his life. For the same reason, there is no vaccine for this disease.

Most often, children aged 3 to 10 get sick. In breastfed children, there is immunity in the body received from the mother through breast milk, however, this immunity is not stable and quickly disappears after the cessation of breastfeeding.

The virus is transmitted from a sick child or from a child who is a carrier of the virus. Viruses are well preserved in water and soil, when frozen they can survive for several years, resistant to disinfectants, but susceptible to high temperatures (when heated to 45ºС, they die in 45-60 seconds).

Virus transmission routes:

– airborne (when sneezing and coughing with droplets of saliva from a sick child to a healthy one)

– fecal -oral when not comply with personal hygiene rules

– through water, when consuming raw ( not boiled) water

– it is possible to infect children through toys if children take them in their mouth

Symptoms of enterovirus infection

Enterovirus infections have both similar manifestations and different ones, depending on the type. Once in the child’s body, the viruses migrate to the lymph nodes, where they settle and begin to multiply. The incubation period for all enterovirus infections is the same – from 1 to 10 days (usually 2-5 days).

The disease begins acutely – with an increase in body temperature to 38-39º C. The temperature most often lasts 3-5 days, after which it drops to normal numbers. Very often, the temperature has a wave-like course: the temperature stays for 2-3 days, after which it decreases and stays at normal levels for 2-3 days, then rises again for 1-2 days and finally returns to normal. When the temperature rises, the child feels weakness, drowsiness, headache, nausea, and vomiting may occur. With a decrease in body temperature, all these symptoms disappear, but with a repeated increase, they may return. The cervical and submandibular lymph nodes also increase, as viruses multiply in them.

Depending on which organs are most affected, there are several forms of enterovirus infection. Enteroviruses can affect: the central and peripheral nervous systems, oropharyngeal mucosa, eye mucosa, skin, muscles, heart, intestinal mucosa, liver; in boys, testicular damage is possible.

The most severe consequence of enterovirus is the development of serous enteroviral meningitis. It can develop in a child of any age and is recognized by the following signs:

– diffuse headache, the intensity of which increases every hour;

– vomiting without nausea, after which the child does not feel relief;

– increased pain and repeated episode of vomiting may be provoked by a bright light or loud sound;

– the child may be inhibited or, conversely, extremely agitated;

– in severe cases, convulsions of all muscle groups develop;

The final diagnosis of meningitis can only be made by a doctor after a lumbar puncture and examination of the laboratory parameters of the obtained cerebrospinal fluid.

Treatment of enterovirus infection

There is no specific treatment for enterovirus infection. Treatment is carried out at home, hospitalization is indicated in the presence of damage to the nervous system, heart, high temperature, which cannot be reduced for a long time when using antipyretics.