Please don’t obstruct your baby’s mouth with tape! Plus some notes on normal sleep
Please don’t put tape on the mouth of your baby or child or otherwise block their airway!! This can be extremely dangerous!!! Don’t mess around with your child’s airway, it is the most important thing keeping them alive. I’m Dr. Wagner, I’m a pediatrician. I’m only about three weeks into being on Instagram, and a parent here asked me to talk about mouth breathing. A quick search here showed me that there is a whole corner of the internet that would convince you that if your child ever breathes through their mouth, they will have deformities and all kinds of poor outcomes. This is NOT TRUE. SLEEP DISORDERED BREATHING like sleep apnea is a huge deal, but not all mouth breathing is sleep disordered breathing. Every child has to breathe through their mouth sometimes – this is critical to life because the nasal passages are the narrowest part of the airway overall, especially in tiny babies, so when the nose is obstructed which happens in every single child sometimes from mucus and swelling, we need babies and kids to breathe through their mouths or else they wouldn’t get any oxygen. If your child is mouth breathing, you don’t know from looking at them if their nose is obstructed, so limiting their ability to breathe through their mouth by taping or holding their mouth shut as some of these accounts would tell you to do, could very easily cut off all oxygen since they already are can’t breathe through their nose so are using their mouth, so now they just can’t breathe at all. Your child’s airway is NOT something to mess around with – if anyone, even if they are presenting themselves as a medical professional online, is telling you to tape your child’s mouth shut or hold your newborn’s mouth shut for five seconds to stop their mouth breathing and will send you a pdf if you comment or pay them on Instagram, they are NOT the ones to trust with truly the most important function that child is doing – breathing. If your child breathes through their mouth sometimes (like every child does!) but not all the time, and doesn’t have concerning symptoms for sleep disordered breathing like snoring, is sleeping well, isn’t working hard to breathe in their sleep, isn’t coughing or choking in their sleep, you probably have less to worry about. If you have concerns about SLEEP DISORDERED BREATHING in your child, your first stop should be a true expert in a child’s AIRWAY and BREATHING, a pediatric ear nose and throat doctor (4 years medical school + 5 years residency + 2 years pediatric fellowship) or a pediatric pulmonologist or pediatric sleep medicine doctor, not someone who is willing to gamble with your child’s airway online. Thanks for listening.
Some of my notes on normal vs sleep disordered breathing (from the UpToDate article on this topic):
Sleep disordered breathing:
Normal sleep:
Sleep efficiency is high (>90% of time in bed is asleep time)
Child awakens refreshed, ready to learn and play
Not signs of daytime sleepiness (including hyperactivity and poor impulse control)
Sleep disordered breathing spectrum – primary snoring (mild) -> obstructive sleep apnea (severe)
REM sleep: muscle atonia, increased cerebral blood flow, EEG, variability of HR RR BP, increased upper airway resistance
NREM: reduced tone, decreased cerebral blood flow, regular HR, RR, BP, increased upper airway resistance
Normal kids – increased upper airway resistance, small decrease in ventilation (getting rid of carbon dioxide), very small decrease in oxygen
Site of highest resistance - NOSE
Normally muscles while you’re awake keep that upper airway patent, so it is rare to see obstructive symptoms while someone is awake unless their symptoms are extremely severe - when they relax during sleep, that’s where we see more symptoms. Increased upper airway resistance in pharynx during sleep from relaxation of these muscles
Sleep related breathing disorders – What to look for: increased work of breathing with snoring, obstructive sleep apnea, obstructive hypoventilation – YOU NEED A SLEEP STUDY – sleep disruption you can sometimes see, but low oxygen and high carbon dioxide you cannot
Sleep disordered breathing - poor growth, systemic or pulmonary hypertension, heart reshaping; OSA - neurocognitive and behavioral problems
Higher risk for sleep disordered breathing: adenotonsillar hypertrophy, obesity, asthma/allergic rhinitis - localized swelling, neurological dysfunction like CP or neuromuscular disease, hx of prematurity
Large tonsils and adenoids don’t necessarily mean OSA – plenty of kids have huge tonsils without sleep disordered breathing
Irritants and inflammation – easiest fix is removing inflammatory things like exposure to cigarette smoke, strong synthetic smells, allergens
Mouth breathing can be a symptom of obstructive sleep apneas but among a constellation of other symptoms like work of breathing, noisy breathing, pauses in breathing, coughing or choking in sleep, loud snoring
