Does your baby also have a lot of drooling? Is this normal? (Sialorrhea) Let's be aware!

As a mother, it's so cute when your little one drools, right? This is very normal, especially between the ages of 4 and 19 months. But if your child is still drooling excessively even after the age of 4, it might be something we should be concerned about. In medical terms, this condition is called Sialorrhea. Let's talk about this in a simple and easy way today.

Simply put, what is Sialorrhea?

Sialorrhea is excessive salivation or drooling. Normally, a child's mouth produces about 1.5 liters of saliva per day. However, a child with this condition may produce up to 5 liters of saliva per day. Sometimes, even though the amount of saliva produced is normal, the child is unable to swallow it properly. Even then, saliva still flows out of the mouth.

There are two main types of this:

• Anterior Sialorrhea: This is the most common type of drooling. Saliva flows out of the mouth and down the face and onto clothing. This can cause redness and peeling of the skin around the chin and mouth, and can lead to skin infections. It can also make the child feel a little shy and afraid to socialize with other children.

• Posterior Sialorrhea (drooling down the back of the throat): This is when saliva flows down the throat, into the airway , instead of flowing out. This is a bit dangerous. If the saliva continues to flow into the lungs, it can damage the lungs and cause frequent chest congestion and coughing.

Often, children with this condition exhibit symptoms of both types together.

What are the causes of drooling?

There are several main reasons why a child may be drooling excessively. Most often, it is a symptom of another underlying medical condition.

Let's look further at those reasons in the table below.

What could be the symptoms of this condition?

Symptoms depend on whether the saliva flows out (anterior) or into the throat (posterior).

• If saliva flows forward (Anterior Sialorrhea):
• Always having wet clothes and pillowcases.
• The skin around the mouth and chin is red, dry, and flaky.
• Sometimes there is a slight lack of water in the body (mild dehydration).
• Some difficulty speaking and eating.

• If saliva flows down the side of the throat (Posterior Sialorrhea): This can cause some serious symptoms.
• Frequent shortness of breath, coughing, nausea, and vomiting .
• Chest congestion.
• Difficulty breathing.
• Aspiration: This means sucking things like saliva into the lungs. This is very dangerous because it can cause serious infections like pneumonia .

How do you know if this is a medical condition?

Anterior sialorrhea can be easily diagnosed by a doctor after examining your child and asking you for details.

But if you suspect that your child is having a drooling problem, you may need to have special tests done to confirm it. Special equipment is used to check your child's throat, swallowing, and speech. For example, a special X-ray called videofluoroscopy can show exactly how the child swallows liquids and how they move down the throat. Don't worry, your doctor will only order this test if it's absolutely necessary.

What are you doing as treatment?

The best thing is that there are many treatments for this. Depending on the child's condition and the cause, the doctor will choose the most appropriate treatment.

• Oral medications: Medications that reduce saliva production or make the airway easier can be given. However, some of these medications can cause side effects such as dry mouth and constipation. Therefore, the doctor will give these after careful consideration.

• Botox injections: Botulinum Toxin (Botox) is injected into the salivary glands to control saliva production for about 4 months. This is a treatment that is now safe for children.

• Surgical procedures: In very severe cases, there are surgeries to remove several salivary glands or alter their function. These can provide a permanent solution.

• Oral motor training: This is a very important treatment. Especially for children who drool due to a structural problem in the body, speech therapists provide training to help them swallow properly and control the muscles of the mouth.

When should you take care of your child?

As we mentioned earlier, it's normal for a young child to drool. However, if excessive drooling continues after the age of four , it's best to talk to a doctor, as it could be a sign of an underlying condition.

Another thing to consider is if your child suddenly starts drooling excessively after a long time without any problems. It could be due to a throat infection or the child swallowing something (like a toy or coin). If you suspect this, take your child to the nearest hospital's Emergency Department (ETU) immediately .

If a child accidentally swallows poison or other inappropriate substance, seek medical advice immediately.You can also call the National Poison Information Center at the Colombo National Hospital.

However, if your child's drooling is interfering with their normal life and happiness, be sure to see a doctor and get proper advice and treatment.