Mouth breathing in children is a common concern for parents. While occasional mouth breathing is natural, chronic or persistent mouth breathing can have underlying causes that need attention, as it can have long-term effects on oral and facial development, overall health, and even on behaviour.

If your little one wakes frequently overnight, sleeps in unusual positions, wakes up tired and irritable, or needs a dummy or is a thumb sucker to help them sleep, something underlying could be at play.

This article aims to provide parents with a comprehensive understanding of mouth breathing, its potential effects on a child’s health, and actionable steps to address the issue.

Mouth breathing in children: Causes and actionable steps for parents

Breathing through the nose is the body’s preferred and natural way of taking in air. It plays a vital role in ensuring optimal oxygen intake, filtering air, and maintaining a healthy respiratory system. Healthy breathing is crucial for proper growth and development for children.

Identifying mouth breathing

Mouth breathing in children is characterised by the habit of breathing primarily through the mouth instead of the nose. It can be observed during both waking hours and sleep.

Identifying mouth breathing is important as it could be indicative of underlying health issues, so watch them during play, listen for noisy breathing or snoring during sleep, and observe the positions they sleep in. Positions that can indicate breathing challenges are sleeping on their tummy with their bottom in the air, or with their head arched back.

Potential causes of mouth breathing

• Nasal congestion and allergies: Chronic nasal congestion due to allergies or other factors can force children to breathe through their mouths for easier airflow.
• Anatomical factors: Some children might have anatomical issues such as a deviated septum, nasal polyps, or enlarged adenoids that obstruct nasal airflow, leading to mouth breathing.
• Chronic thumb sucking or dummy use: Habits like thumb sucking or prolonged dummy use can alter oral posture and contribute to mouth breathing.
• Respiratory infections: Repeated respiratory infections can temporarily lead to mouth breathing, especially if nasal passages are blocked due to congestion.

Effects of chronic mouth breathing

• Dental and facial development: Mouth breathing can affect dental alignment, leading to issues like an open bite, crowded teeth, and a narrow palate. It can also alter facial growth, potentially leading to long-term aesthetic concerns.
• Sleep disruption: Mouth breathing during sleep might cause restless sleep, sleep fragmentation, and increased risk of sleep-disordered breathing, such as sleep apnea.
• Speech and language development: Improper airflow due to mouth breathing can influence speech and language development in children.
• Dry mouth and bad breath: Breathing through the mouth can lead to dry mouth, which may result in bad breath and increased risk of cavities.

Actionable steps for parents

1. Consult a paediatrician

If you notice persistent mouth breathing in your child, consult a paediatrician for a thorough evaluation. The doctor can identify the underlying cause and recommend appropriate treatment.

2. Address allergies

If allergies are a suspected cause, work with a healthcare professional to manage allergies through medications or allergen avoidance strategies.

3. Seek advice from an ENT specialist

If anatomical factors are involved, such as a deviated septum, enlarged tonsils or adenoids, or a narrow nasal passage, consult an ear, nose, and throat (ENT) specialist for further evaluation and potential intervention. Your GP can give you a referral.

4. Encourage proper oral habits

If habits like thumb sucking or dummy use contribute to mouth breathing, seek support from a gentle sleep coach who can provide a plan to gradually wean them off it. It’s also important to note that some children use their thumb or dummy to help keep their airways open when sleeping, which is why it’s best to see an ENT specialist first.

5. Nasal breathing exercises

You may need to work with a speech therapist or myofunctional therapist to practise exercises that encourage nasal breathing.

6. Create a healthy sleep environment

Ensure your child’s sleeping environment is conducive to nasal breathing, with proper humidity, good ventilation, free from strong cleaning products or laundry detergent, is dust-free, and has minimal clutter.