Feeding Children

Some Topics

Ear, Nose and Sinuses

The nose cleans, warms and humidifies inspired air. The nose is partitioned into two cavities by a medial septum. The side wall of the nose is further partitioned by three projections know as turbinates that extend the length of the nasal cavity. The nasolacrimal duct drains tears from the eyes into the nose. The turbinates filter the incoming air removing particles as small as pollen grains. The nasal mucosa actively expands and contracts regulating air flow through the nose. Usually, only one side of the nose is open to airflow, the other is partially obstructed; the airway alternates.

Sinuses are air-containing cavities that surround the nasal cavity and are connected to it. The nose and paranasal sinuses are covered with a mucosal lining that hosts immune cells and secretes mucus. The surface cells have moving hairs that push mucous out of the sinuses into the nose in a programmed sequence. Allergens and pollutants trapped in the nose cause local tissue swelling and may obstruct the sinus drainage holes. Bacterial infection tends to develop in blocked sinuses. Airborne chemicals are absorbed through the nasal mucosa into the circulation. Tobacco smoke is the number one source of carcinogens that cause cancers in the mouth, throat, larynx and bronchi.

Rhinitis means inflammation in the nose. Rhinitis may be intermittent or persistent. The cause of intermittent rhinitis is sometimes obvious; symptoms only occur at a specific time and place. Allergic rhinitis is one of the most obvious environmental diseases. The cause of persistent rhinitis is often concealed and some patients with this problem are treated with drugs and never discover the cause. Allergic responses in the nose are more easily studied than in the lung. There is reason to believe that there are similarities.

Allergic rhinitis and asthma go together in attack patterns when the allergens are airborne. Hay fever is the prototype of type I allergy and the mechanism was thought to be a straightforward histamine-mediated response to inhaled antigen. The early immediate response is characterized by sneezing and nasal discharge, often profuse. Antigen triggers mast cells to degranulate and preformed mediators such as histamine. Cytokines are released, and at the same time the lipid mediators, leukotrienes, are generated from arachidonic acid. Antihistamines are effective in the early stages of this inflammatory process. Learn more about rhinitis

Nasal congestion is the main symptom of the common cold. Nasal congestion can be more distressing than cough or sore throat, since it compromises breathing. Congestion in infants interferes with feeding, since infants must breathe through their noses while breast-feeding. Adults can clear their nose by blowing, but infants are unable to clear the nasal airway on their own.

The middle ear is connected to the throat by the Eustachian tube and often participates in infections and allergic inflammation that starts in the nose and throat. Recurrent middle ear pain and fluid collections (serous otitis media) that impair hearing are common in the first five years of life. Serous otitis recurrences are referred to as recurrent otitis media (ROM) which costs $2 billion per year to treat in the US and is responsible for an estimated 10 million medical office visits per year. ROM is often blamed on infection and children are prescribed repeated courses of antibiotics often with no benefit. Congestion or inflammation of the nose (rhinitis), sinuses (sinusitis), ear (otitis) and throat (pharyngitis) may be due to infections, airborne irritants and allergens; however, food allergy may be the undiagnosed cause of these common problems.

Otitis Media may be eliminated by proper diet revision. Milk, wheat, and egg white allergy are the most common causes of respiratory symptoms, but other foods can do this. Food allergy is suggested by symptoms that recur for months or years such as nasal stuffiness, snoring, increased mucus flow in nose and throat, and recurrent sore throats. Nsouli et al reported that of 104 children with chronic serous otitis media 78% had positive skin tests for food and an elimination diet led to a significant amelioration of symptoms in 86% . The most common allergenic foods were cow's milk (38%), wheat (33%), egg white (25%), peanut (20%) and soya (17%).

The book, Air and Breathing helps you understand the causes of breathing disorders. The solutions involve improving air quality and solving food problems with diet revision. Indoor air quality issues at home and at work are discussed. Air pollution and airborne causes of lung disease are also discussed with advice about improving both indoor and outdoor air quality.