Common Is Not Always Normal
As parents, we spend a lot of time worrying about our children’s health. We schedule well visits, keep up with vaccinations, make sure they’re eating healthy foods, and celebrate every developmental milestone.
But there’s one area of health that often gets overlooked because many of its warning signs seem so ordinary. Ask yourself these questions:
- Does your child snore?
- Seem to always keep their mouth open?
- Wake up tired despite sleeping all night?
- Struggle with picky eating?
- Have chronic congestion or frequent ear infections?
- Do they lisp or have other sound errors?
Many parents have been told these things are ‘just part of childhood.’ While these behaviors are certainly common, it does not mean they are normal. These behaviors may also be clues that your child is working harder than they should to breathe.
One of my favorite sayings is simple and learned from my friend Dr. Baxter: Common is not always normal.
Breathing Is More Than Just Getting Air In
When we hear the word airway, we often think only about the nose. In reality, your child’s airway includes the nose, mouth, throat, voice box (larynx), windpipe (trachea), and lungs. These structures work together every minute of every day to provide oxygen to the brain and body. When one part of this system isn’t working efficiently, the effects may show up in surprising ways, including challenges with sleep, speech, feeding, attention, behavior, and facial growth.
Sleep Is When Children Grow
Children spend nearly one-third of their lives asleep. During those hours, the brain organizes new learning, hormones support growth, muscles recover, and the body repairs itself. If breathing becomes disrupted during sleep, children may never reach the deep, restorative sleep their growing bodies need. They may seem tired, irritable, have difficulty paying attention, or struggle in school.
Mouth Breathing Is Never Normal
Although mouth breathing is common, it usually develops for a reason. Allergies, enlarged tonsils or adenoids, chronic congestion, low muscle tone, or restricted tongue movement (tongue-tie) can all contribute. Over time, habitual mouth breathing may influence jaw development, oral resting posture, dental alignment, and sleep quality.
A Cycle of Dysfunction
This may be easier to digest with an example. A child with allergies may begin breathing through their mouth because their nose is blocked. Over time, mouth breathing can influence tongue posture and subsequently, facial growth. Another child with restricted tongue mobility (tongue tie) may have a tongue posture that blocks the airway during sleep. This can cause struggles with chewing, swallowing and speech.
Combined Symptoms?
If your child snores regularly, sleeps with an open mouth, wakes frequently, has chronic congestion, enlarged tonsils, difficulty paying attention, unusually picky eating, or persistent speech concerns, these signs may be worth discussing with your healthcare providers. One symptom alone rarely tells the whole story, but several together can provide valuable clues.
A Team Approach
Airway concerns are best evaluated by an interdisciplinary team. Depending on your child’s age and needs, that team may include any of the following specialists: IBCLC, pediatrician, ENT physician, allergist, dentist, orthodontist, sleep physician, and/or speech-language pathologist, who specializes in orofacial myology. Each professional contributes a different skill set to figuring out what the root causes may be and how to help your child overcome their challenges.
Final Thoughts
The first step is simply observing. Trust your instincts, notice patterns, and ask questions. Being your child’s airway advocate doesn’t mean assuming something is wrong. It means being curious enough to ask whether your child’s breathing, sleeping, eating, and communication are developing as well as they can. Every child deserves the opportunity to breathe well, sleep well, learn well, and thrive.
Adapted from Becoming Your Child’s Airway Advocate and Caring for Your Airway and Voice: A Vocologist’s Perspective.