I’ve identified that my child’s tonsils and/or adenoids may be impacting their eating. Now what?

To review, in my first installation of this blog I initiated a series of posts regarding “Simple reasons your child might not want to try that new food”. The impact of swollen and often painful tonsils and adenoids was discussed and how this can negatively impact a child’s willingness to eat, or even try, certain foods. Now the question is: “Why?” If your child does appear to have swollen tonsils and/or displays signs or complains of symptoms that you suspect involve the adenoids, the next question must be, “why?” As in “Why are their tonsils chronically swollen/inflamed? Why are their throats so often sore or irritated, and why do they snore at night and chew with their mouths open? Why is my child a mouth breather at such a young age?” It’s important we ask “why” because unless we understand the root cause, a round of antibiotics or perhaps homeopathic remedies are likely going to have limited impact.

So, what causes these very common conditions in children? The most obvious are viral and bacterial infections from everything from the common cold to something more serious, like strep. But infections come and go. We get over them. Some seasons they seem to bug our kids repeatedly, but in general, these things have a beginning-middle-end cycle after which a child’s function returns to “normal”. So, for “chronic” we have to look beyond the obvious “infection” and see what ELSE may be causing ongoing irritation and inflammation. For many kids, this is as simple as environmental allergies which result in post nasal drip and throats that become sore from the constant throat clearing and coughing on that little bit of gunk running down the back of the throat constantly.

But there is another, often overlooked reason, too. Acid reflux. Yep, lots of kids even babies, have chronic problems with acid reflux! So why don’t they complain about it? Because for some kids, that’s the way their tummies and throats always feel, so they really don’t know the difference. It seems odd to us as adults, because most of us really notice when we get “heartburn”, but for many of these kids, it’s been going on for so long that the pain receptors in their throats and esophagus aren’t very sensitive any longer, so they really don’t “notice” the reflux except when it really acts up to the point of being very painful. For other children, the refluxing itself only occurs at night when they are lying flat and the refluxed material from the stomach reaches all the way up into the throat. If this happens consistently enough, their tonsils and adenoids become consistently inflamed, irritated, and swollen. Many parents I talk to tell me that their children had reflux when they were infants but eventually “outgrew” it. They equate the decrease in fussiness, and perhaps vomiting, with the “outgrowing” of the problem of their child “refluxing”, and this is absolutely true for many children, but not for all children. Sometimes babies essentially transition from being fussy, unhappy babies diagnosed with the reflux associated with infancy, to babies who continue to reflux but now do it “silently” – that is, they don’t fuss and cry when it occurs but it still does happen! Or, they only display the signs that we associate with reflux, such as fussiness, arching their backs, or even vomiting, only when someone OVERfeeds them. These are the babies that often will eat a limited amount, take a break, and then return to the bottle or breast, repeatedly throughout the day. They stop to rest or play to give their tummies time to empty out a little bit, and then they come back and want some more. Often this leads to frustration and exhaustion in caregivers who just want some time “off” from the constant feeding cycle, and who may then spend a lot of time and energy really working to get the baby to stay with a feed and complete the bottle/empty a breast, with the result being as often as not that the baby vomits some, or all, of it back up.

But wait? MY child is a toddler/preschooler? They haven’t taken a bottle for quite some time! How does this apply to my older child? Well, as I said earlier, many of these children have chronically enlarged tonsils and adenoids, as well as throats that are at least mildly inflamed as a result of reflux that has been going on for a very long time without anyone really recognizing it for what it is. As a result, often these kids will start subconsciously linking certain foods to certain outcomes, i.e.: milk makes my tummy better, applesauce is cool on my throat, meat is lumpy and hurts when I swallow, but chicken nuggets fall apart when I chew them and don’t hurt, mushy fruits like bananas slide down my sore throat but hard fruits with tough skins like apples can hurt on the way to my tummy! These associations can become so strong, that a child will gag at the sight of the foods that are uncomfortable for them to eat. If that seems odd, think about a time that you had food poisoning or perhaps morning sickness. After being sick repeatedly with a particular food (or class of foods – I love seafood, but could not stomach ANY when I was pregnant!) just the sight or smell of it may set you off into a fit of gagging. That’s how our kids’ brains have become wired around these foods. The result? Selective eaters (I’m not a fan of the word “picky”).

Next up: “Okay, adenoids, tonsils, reflux… anything else?”