When your child is experiencing a medical issue, it can be confusing to know when to consult a pediatric ENT (ear, nose, and throat) doctor. Will the problem resolve on its own, or do they need medical intervention? There are issues that might require a diagnosis and treatment by a professional, and we’re here to help you be able to tell the difference.

Chronic ear infections, chronic nosebleeds, chronic sinus infections, and severe nosebleeds can be indicators of a problem that requires medical attention. Let’s go through each of these issues to point out when your child is probably okay and when to take them to a pediatric ENT.

Chronic Ear Infections

Chronic ear infections (otitis media) occur when an ear infection won’t go away or continually comes back. If left untreated, hearing loss and permanent ear damage can be the result. There are some common signs that children are dealing with an ear infection, including:

  • Mild pressure or ear pain
  • Mild fever
  • Ear fluid drainage
  • Excessive clinginess
  • Excessive crankiness
  • Being hard of hearing
  • Restless sleeping habits
  • Loss of appetite
  • Stomach issues (vomiting, diarrhea)
  • Constantly touching or toying with the ear
  • Balance problems

Most ear infection symptoms should stop after a few days with basic treatment. If this continues to happen and children have 4 or more ear infections per year, it’s reason enough to bring them to a pediatric ENT. Also consider bringing your child to a pediatric ENT if they’re experiencing the following symptoms with their ear infections:

  • Speech delay
  • 3 months of ear fluid
  • Eardrum rupture
  • Needing multiple antibiotics to treat one infection
  • Inability to take oral medications
  • Severe nausea, vomiting, or diarrhea
  • Medication allergies

The underlying issue of chronic ear infections is the accumulation of fluid or mucus behind the ear drum, which the Eustachian tube is responsible for draining. Children’s Eustachian tubes are smaller because they’re still growing, so they can have trouble draining excess fluid, resulting in chronic ear infections. They also have underdeveloped immune systems that can make fighting off these infections more difficult.

When necessary, pediatric ENTs can perform a surgical procedure to place a small ventilation tube in the eardrum. After 6-9 months of observed functionality, they fall out on their own. If this procedure doesn’t stop the chronic ear infections, a pediatric ENT may remove a child’s adenoids (part of the lymphatic system) to stop infections from spreading to the Eustachian tubes.

Chronic Nosebleeds

Chronic nosebleeds (epistaxis) can signify a serious problem. Usually, nosebleeds are nothing to be concerned about. By tilting their head forward and applying pressure for ten minutes, most nosebleeds will subside.

If the nosebleed is still occurring after 15-20 minutes of applying consistent pressure, it’s time to call the pediatric ENT. Also consider bringing them in if the blood loss is significant and fast, nosebleeds are frequent and numerous, and blood is going down their throat despite leaning forward.

Other reasons a nosebleed should lead to a trip to your pediatric ENT include:

  • Nosebleeds that occur after taking a new medication
  • Nosebleeds accompanied by chronic congestion and easy bleeding/bruising
  • If it’s a result of physical trauma
  • If your child has severe headache or fever
  • The nose appears altered or misshapen
  • Your child is pale and sweaty

In the emergency room, gauze could be inserted into the nasal cavity or the bleeding blood vessel can be cauterized. If this is still a continual issue, your child may be evaluated for a bleeding disorder.

Chronic Sinus Infections

Sinus infections (sinusitis) can start off appearing just like a regular cold, mirroring the same symptoms. If these are accompanied by constant coughing, fever, ear pain, dental pain, or increasing congestion, your child probably has a sinus infection.

Common causes of sinus infections include:

  • Dryness
  • Colds, allergies, or the flu
  • Contact with peers or older siblings
  • Pets
  • Second-hand smoke
  • Environmental allergens
  • Immune deficiency or abnormality
  • Septal deviation
  • Enlarged adenoids

A typical sinus infection will go away on its own. More severe cases may be prescribed decongestants, antihistamines, or antibiotics. If the infections keep occurring and don’t respond to these treatments, surgical intervention may be necessary. Minimally invasive surgery can be performed to open blocked sinus pathways, and adenoids can be removed if they’re a contributing issue.


Most children who snore occasionally don’t have a problematic issue. If snoring is constant and severe, it might be a breathing issue called obstructive sleep apnea (OSA). If your child is having trouble sleeping, snoring often, and breathing from their mouth constantly during the night, the condition should be checked out by a pediatric ENT.

Common causes of severe snoring and OSA include:

  • Large or swollen tonsils
  • Large or swollen adenoids
  • Obesity
  • Congestion
  • Allergies
  • Asthma
  • Air pollutants
  • Deviated septum
  • Shorter duration of breastfeeding

If your child is snoring in addition to any of the following symptoms, you should take them to your pediatric ENT:

  • Hyperactivity
  • Fatigue
  • Behavioral or learning issues
  • Slow growth
  • Obesity
  • High blood pressure
  • Bedwetting
  • Blue-tinted skin
  • Morning headaches
  • Inadequate weight gain

To resolve these issues, your pediatric ENT may recommend surgical procedures to remove the tonsils, adenoids, or both. Depending on the underlying cause and additional medical issues, other treatments may also be recommended. Removing these tissues that commonly block airways usually results in the complete resolution of the issue. In cases where this isn’t enough, a child may be prescribed a continuous positive airway pressure (CPAP) machine to help your child breathe during the night.

Get Expert Help From an ENT in Birmingham

Our board-certified experts here in Birmingham, AL, are proud to help children solve these medical issues. At Pediatric ENT Associates at Children’s of Alabama, our team of pediatric otolaryngologists helps children with these chronic issues through surgical procedures. Our pediatric ENT specialists are careful to perform these surgeries without altering any other aspect of your child’s anatomical structure. You can trust us as your pediatric ENT to care for your child and restore them to a healthy condition.

For any issue your child is facing in terms of ear, nose, throat, or head and neck problems, we’re here to help. Whether they need a diagnosis or surgery, our experts can help resolve medical issues and bring your child back to health. Contact us today to schedule your appointment with our team here at Pediatric ENT Associates.