Should I Continue Visiting an ENT for My Child's Persistent Phlegm?

Do you see an otolaryngologist?

For more than a month, I have been taking my 14-year-old child to see an ENT specialist.
There has been no cough, but there is persistent white phlegm that is difficult to expel.
After several visits and trying different medications without improvement, we switched to another ENT clinic.
In the past week, the situation has worsened; my child suddenly wakes up in the middle of the night with difficulty breathing, gasping for air.
I was startled awake and helped my child by patting their back.
They say they feel like phlegm is blocking their breathing, and this has been happening for several consecutive days.
Should I continue to see an ENT specialist?

Xue Ling, 40~49 year old female. Ask Date: 2017/08/22

Dr. Ye Qianyu reply Family Medicine

Hello! Based on your description, it is important to consider whether there is asthma or atypical pneumonia.
I recommend taking your child to a pediatric specialist.
If there is a nearby clinic that specializes in asthma or pediatric immunology and rheumatology, that would be even better.
Thank you for your inquiry, and I wish your child a speedy recovery!

Reply Date: 2017/08/22

More Info

It sounds like you are understandably concerned about your child's persistent phlegm and recent episodes of breathing difficulties. Given the symptoms you've described, it is crucial to take a comprehensive approach to your child's health.

Firstly, persistent phlegm, especially when accompanied by difficulty breathing, can indicate several underlying issues. While your child may not have a cough, the presence of white phlegm suggests that there could be an ongoing inflammatory process in the respiratory system. This could be due to allergies, post-nasal drip, or even an infection that may not have been fully addressed.
The fact that your child has experienced episodes of waking up at night with breathing difficulties is particularly concerning. This could indicate that the phlegm is obstructing the airways, leading to a condition known as "airway obstruction." In children, this can sometimes be exacerbated by conditions like asthma, which can cause wheezing and difficulty breathing, especially at night or during physical activity.

Given that you have already consulted with multiple ENT specialists without significant improvement, it may be time to consider a few different approaches:
1. Follow-Up with a Pediatric Pulmonologist: Since your child is experiencing respiratory symptoms, it might be beneficial to consult a pediatric pulmonologist. They specialize in lung and respiratory issues in children and may provide a different perspective or treatment options that an ENT might not typically address.

2. Consider Allergy Testing: If allergies are suspected, testing can help identify specific triggers that may be causing the phlegm production. Common allergens include dust mites, pollen, pet dander, and mold. Managing these allergies can significantly reduce respiratory symptoms.

3. Evaluate for Asthma: Given the breathing difficulties, it would be prudent to evaluate whether your child has asthma or another respiratory condition. A spirometry test can assess lung function and help determine if asthma is a contributing factor.

4. Home Management Strategies: In the meantime, consider some home management strategies. Keeping the air humidified can help loosen phlegm, and encouraging your child to drink plenty of fluids can also aid in thinning mucus. Additionally, elevating the head during sleep may help reduce nighttime symptoms.

5. Emergency Care: If your child continues to experience severe breathing difficulties, it is essential to seek emergency medical care. Signs of respiratory distress, such as rapid breathing, wheezing, or bluish lips or face, require immediate attention.

In summary, while continuing to see an ENT may be beneficial, it is also important to broaden the scope of care to include a pediatric pulmonologist and possibly an allergist. The combination of specialized care and home management strategies can help address your child's persistent phlegm and breathing difficulties more effectively. Always prioritize your child's health and well-being, and do not hesitate to seek further medical advice if symptoms persist or worsen.

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