Janet Lee, MD, a pediatric ENT, sees a patient in clinic.
Constant runny nose? A cough that lasts all winter? Another ear infection? Parents of young kids know all too well that kids get sick…a lot. But where’s the line between normal and abnormal, and at what point does your child need care beyond a pediatrician? Duke ear, nose, and throat experts explain when it might be time for your child to see a specialist.
Is This Normal?
An otolaryngologist specializes in diagnosing and treating problems with the ear, nose, and throat (which is why they’re also called “ENT” doctors). ENT symptoms are common in kids, and that’s because getting sick is part of the normal process of development for children’s immune systems. These issues are usually minor, often caused by common viruses like colds that must run their course, or can be easily managed by a pediatrician, a primary care doctor, or at urgent care. However, if the problem persists, gets worse, or starts to affect your child’s quality of life, you may need to see a specialist. While not exhaustive, here’s a list of questions to help you decide whether seeing an ENT should be your next step.
Does it keep coming back?
- More than three ear infections in six months
- More than three sinus infections in a year
- More than six instances of tonsillitis in a year (tonsillitis is often caused by strep throat)
- Frequent nosebleeds that don’t respond well to standard treatment
Has it never really gone away?
- Fluid in the ears for three months or longer
- A persistent cough lasting longer than four weeks
- Ongoing nasal congestion, especially if it’s only on one side of the nose
Is it affecting your child’s quality of life?
- Allergies, especially if they contribute to other problems like asthma
- Frequent waking at night or trouble sleeping due to breathing issues like snoring, coughing, or sleep apnea (when your child stops breathing for short periods while asleep)
- Concerns about potential hearing loss or speech delays
Could it make breastfeeding or eating difficult?
- Tongue ties and lip ties
- Trouble swallowing
Specialized Care for Kids
In addition to treating kids with common ENT issues, pediatric otolaryngologists also have advanced training in caring for children with more complex problems. These include stridor (noisy breathing that means airflow is disrupted), neck lumps or bumps, voice changes, and ENT concerns related to other conditions or diseases.
“We know it can be difficult to know when your child needs more advanced care. Part of our job is to put your child's symptoms in context,” said Duke pediatric ENT Janet Lee, MD. “What we can do is present all the options, from medical management to surgery. We have a lot of tools at our disposal to provide solutions.”
ENT doctors work closely with other specialists like audiologists, speech language pathologists, pulmonologists, gastroenterologists, and others to ensure your child receives thorough, comprehensive care.
“Duke is an amazing place, because people here are extremely collaborative and willing to work together to take care of the patient,” said Duke pediatric ENT Eileen Raynor, MD. “It’s a privilege to play a small role in helping a child’s growth and development.”