Shaken Baby Syndrome

A large number of child deaths are reported in South Africa each year. A lot of deaths relate to neglect, abuse or murder. Despite this, there's a knowledge gap in relation to understanding the issue....

Amniotic fluid problems

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Choosing a pre-school

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Newborn reflexes

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Pelvic floor exercises

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Antenatal Classes

Antenatal classes are informative sessions provided to prepare expecting parents for the birth of their child and the early days of being a parent.Most antenatal classes are run by Midwives and occasi...


The Decade of Action for Road Safety 2011-2020 was launched on the 11 May 2011. It is a global declaration of war against road crashes and fatalities. According to Mr Sibusiso Ndebele, MP Minister of ...

  • Shaken Baby Syndrome

    Tuesday, 21 July 2015 16:28
  • Amniotic fluid problems

    Thursday, 14 May 2015 12:54
  • Choosing a pre-school

    Friday, 10 April 2015 17:50
  • Newborn reflexes

    Tuesday, 03 March 2015 15:49
  • Mastitis

    Tuesday, 03 March 2015 15:41
  • Pelvic floor exercises

    Wednesday, 11 February 2015 17:20
  • Colic

    Wednesday, 11 February 2015 17:11
  • Antenatal Classes

    Monday, 03 June 2013 09:34
  • Strap-in-the-Future

    Thursday, 30 June 2011 13:52


Children are incredibly resilient and have a remarkable ability to withstand chronic, low-grade URI without seeming to be particularly bothered by them. However, a closer look at their histories shows that they are never completely well and often not completely happy either. This is evident in poor appetite, disturbed sleeping patterns, absenteeism from school, stuffy nose, mouth breathing and dark circles under the eyes. The cause may include chronic low-grade infections of the ears, tonsils, adenoids, sinuses, or allergies. Children who do not seem that sick often do not receive medical attention. Advances in medicine provide children who are not completely well with a chance to be healthy, so that they can utilise their energy to graduate through and enjoy the various developmental stages, instead of having to use their resources to get well unassisted. This may involve a variety of treatments, such as allergy identification and treatment, medication, possible surgery, such as a tonsillectomy or adenoidectomy etc (Leary, 1990).





Tonsils and adenoids are collections of lymph tissue that help the body fight infection. The tonsils are a round mass of reddish tissue situated on either side of the throat. The adenoids are located higher and further back, behind the nasal passages. Tonsils are visible when looking in the mouth, while adenoids can only be seen with a special mirror. Tonsils and adenoids are usually larger in childhood and decrease in size as your child gets older (Leary, 1990; The Merck Manuals, 2009-2010).


Enlarged tonsils are problematic when they result in:

·                Recurrent ear infections and hearing impediments, due to blockages of the Eustachian tubes and an accumulation of fluid in the middle ear.

·                Recurrent sinusitis and nosebleeds.

·                Obstructive sleep apnoea, which occurs when the enlarged tonsils and adenoids result in snoring and some children stop breathing for brief periods during the night. As a consequence, oxygen levels in the blood may be low, your child may wake frequently during the night and feel sleepy in the daytime.

·                Weight loss and an inability to gain weight, caused by an inability to eat sufficiently due to pain or because breathing requires constant physical effort.

·                Some orthodontists believe that chronic mouth breathing caused by large tonsils or adenoids may result in dental problems and changes in the position of the palate (ENT Association of Corpus Christi, 1993; Leary, 1990; The Merck Manuals, 2009-2010).


When should tonsils or adenoids be surgically removed?

Tonsillectomy and adenoidectomy are common operations for children in South Africa. Unfortunately, these operations are sometimes performed unnecessarily. Children who benefit from these surgeries are those who experience:

·         Obstructive sleep apnoea.

·                Enlarged tonsils or adenoids resulting in breathing difficulties, persistent snoring and problems swallowing.

·                Persistent throat or ear infections, despite antibiotic therapy, defined by some as 3 or more genuine bacterial infections in a year, over a 3-year period.

·                Cancerous tumours, which are rarely a cause (The Merck Manuals, 2009-2010).


An adenoidectomy may be recommended on its own for the following reasons:

·                Large adenoids may block the openings to the Eustachian tubes, predisposing your child to frequent ear infections.

·                Recurring nasal congestion, sinusitis and breathing through the mouth, may occur when enlarged adenoids obstruct the flow of air from the nose to the throat.

·                Prolonged adenoidal obstruction results in the ‘adenoidal child’ or adenoidal fasciaes. These children appear to be generally unwell, their voices have a pinched nose quality and they tend to be open-mouth breathers who snore loudly at night (Leary, 1990; The Merck Manuals, 2009-2010).


How to prepare your child for surgery

Discuss your child’s feelings about the surgery openly, reassure and support her throughout the process. If she has a friend who has had the surgery, encourage her to talk to the friend about it. Explain that she will have a sore throat afterwards for a few days and that she will look exactly the same afterwards because the operation won’t remove important parts of her body (ENT Association of Corpus Christi, 1993).


Inform your doctor of any medication your child may be taking and if she or any family member has problems with anaesthesia.


Post-operative symptoms

Several post-operative symptoms may arise, including vomiting, fever, sore throat, earache, swallowing difficulties and, occasionally, bleeding (ENT Association of Corpus Christi, 1993).