Snoring in Toddlers: Causes and When to Seek Help

The child has been snoring during sleep recently?

Hello Dr.
Hsiao: My daughter is currently one year and eight months old.
On May 9th, my parents took her to the health center for her fourth dose of the diphtheria, pertussis, and tetanus (DPT) combination vaccine, as well as the fourth dose of the oral polio vaccine.
After the vaccinations, she started to have a fever, and taking children's paracetamol did not help much; her temperature peaked at 39.9 degrees Celsius.
Eventually, we had to administer a rectal medication to bring it down.
The next day, May 10th, we visited a pediatrician who found no signs of a cold.
It was determined that the fever might be a reaction to the vaccinations, and we were prescribed antipyretics to take home.
We administered the medication as directed twice, but she developed a fever again.
That night, we noticed her snoring was much louder than usual, suggesting nasal congestion.
On the morning of May 11th, she woke up with another fever, and we continued to give her medication.
After the medication wore off, she developed a fever again.
On the evening of May 13th, we went back to the pediatrician, who still found no signs of a cold.
The doctor prescribed medication for nasal congestion and fever and recommended a urinalysis.
On the morning of May 14th, she no longer had a fever, but we continued to give her medication on schedule.
After the urinalysis that afternoon, the results were normal.
Before bed that night, we gave her the prescribed medication, and on May 15th, she woke up with a fever again, but her snoring during sleep was still much louder than usual (she does not snore when awake).
Dr.
Hsiao, should I stop giving my daughter medication now? How should I address her snoring, and is it related to this recent fever?

Aqiu, 0~9 year old female. Ask Date: 2008/05/15

Dr. Xiao Kaiwen reply Pediatrics

Fever from vaccines typically lasts less than two days, and since your child has had a fever for six days, it is advisable to go to the hospital for a thorough examination (blood tests, urine tests, chest X-ray, etc.) to determine the cause of the infection.
Whether the snoring is related to this fever may need to be investigated.
If there is an obstruction in the respiratory tract, it could lead to snoring during sleep, such as from nasal congestion due to a cold, mucus blockage, swollen respiratory glands (tonsils), or an enlarged tongue, among other factors.

Reply Date: 2008/05/15

More Info

Understanding snoring in toddlers can be a concern for many parents, especially when it is accompanied by other symptoms such as fever. In your case, your daughter, who is one year and eight months old, has experienced a series of events following her vaccinations, including fever and increased snoring. Let’s break down the situation and explore the potential causes of her snoring, its relation to her recent illness, and when you should seek further medical help.

Causes of Snoring in Toddlers
1. Nasal Congestion: One of the most common reasons for snoring in toddlers is nasal congestion. This can occur due to allergies, colds, or even as a reaction to vaccinations. In your daughter’s case, it seems that she may have developed nasal congestion, which could explain the loud snoring you observed, especially during sleep.

2. Enlarged Tonsils or Adenoids: Another potential cause of snoring in young children is enlarged tonsils or adenoids. These can obstruct the airway during sleep, leading to snoring. If your daughter has had recurrent upper respiratory infections or allergies, this could be a contributing factor.

3. Sleep Position: Sometimes, the position in which a child sleeps can lead to snoring. For example, sleeping on the back can cause the tongue to fall backward, partially obstructing the airway.

4. Obesity: Although less common in toddlers, excess weight can contribute to snoring due to increased fatty tissue around the neck, which can narrow the airway.

Relation to Recent Illness
The timing of your daughter's increased snoring with her recent fever and vaccination is noteworthy. It is possible that the fever and subsequent nasal congestion could be linked. The body’s immune response to vaccinations can sometimes lead to temporary inflammation and congestion, which may resolve as her body adjusts.

When to Seek Help
You should consider seeking medical advice if:
- The snoring persists for more than a few days after the fever has resolved.

- Your daughter exhibits other concerning symptoms, such as difficulty breathing, gasping for air during sleep, or excessive daytime sleepiness.

- You notice any changes in her behavior, such as irritability or lethargy.

- The snoring is loud enough to disrupt her sleep or the sleep of others in the household.

Managing the Situation
1. Medication: If your daughter is still experiencing fever, it is important to follow your pediatrician's advice regarding medication. If her fever has resolved and she is not showing signs of discomfort, you may consider tapering off the medication, but always consult with your healthcare provider first.

2. Nasal Saline Drops: Using saline nasal drops can help relieve nasal congestion. This can be particularly helpful before bedtime to ensure she can breathe more easily while sleeping.

3. Humidifier: A cool-mist humidifier in her room can help keep the air moist, which may ease nasal congestion and reduce snoring.

4. Monitor Sleep Position: Encourage her to sleep on her side rather than her back, if possible, as this may help reduce snoring.

5. Follow-Up: If the snoring continues or worsens, or if you have any concerns about her health, it is advisable to follow up with her pediatrician. They may recommend further evaluation, such as a referral to an ENT specialist if they suspect enlarged tonsils or adenoids.

Conclusion
In summary, while snoring in toddlers can be common and often benign, it is essential to monitor your daughter’s overall health and any accompanying symptoms. Given the recent fever and vaccination, it is likely that her snoring is related to nasal congestion. However, if the situation does not improve or if you have any concerns, do not hesitate to seek further medical advice. Your pediatrician can provide the best guidance tailored to your daughter's specific needs.

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