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Strawberry birthmarks (also known as hemangiomas) are bright red skin spots named for its color, which forms a rubbery, bright red nodule of extra blood vessels that grow in or under the skin. Although called a birthmark, a hemangioma does not always only appear at birth (usually within a month). It can also manifest when a child is already several weeks old and commonly appears on the scalp, face, chest or back. Hemangiomas typically go through a period of rapid growth followed by more gradual fading and flattening.

At Pediatric ENT Associates at Children’s of Birmingham, AL, we know that any mark on your baby may immediately cause worry even if they’re harmless. Here we explore what infantile hemangiomas are by addressing important questions any concerned parent in Birmingham, Alabama would ask and possible treatments for their removal.

6 Common Questions about Hemangiomas
  1. What Are The Different Types Of Infantile Hemangiomas?

There are three main types of infantile hemangiomas:

  • Superficial hemangiomas are cutaneous (“in-the-skin”) red bumps that appear on the surface of the skin.
  • Deep hemangiomas are subcutaneous (“under the skin”) hemangiomas that tend to grow under the skin surface, causing bulges which often appear with a purple or blue tint.
  • Combined hemangiomas are a mixture of both superficial and deep hemangiomas.
  1. Who Gets Them?

According to The American Academy of Pediatrics (AAP), approximately 4-5% of infants get hemangiomas. They are more common in caucasians, girls, twins and preterm babies.

  1. What Causes Hemangiomas?

The causes of these vascular birthmarks, which vary in size, appearance and placement, still remain to be unknown. However, there are rare cases that show genetics play a role in its manifestation.

  1. How Are Hemangiomas Diagnosed?

A physical exam is needed in order to make a proper diagnosis. Testing is also needed in order to ensure that the hemangiomas do not go deeper into other tissues and are not close to any major organ. Tests to determine how far the hemangioma goes under the skin and whether it affects any internal organs include a biopsy, a CT scan or an MRI scan.

  1. What Are The Available Treatments for Infantile Hemangioma?

Fortunately, there are effective treatments today that can prevent any serious problems, especially if early intervention is done.

  • Propranolol

One systematic treatment involves the use of Propranolol –a beta-blocker medication used to treat high blood pressure. This oral medication has been shown to stop the growth of a hemangioma, as well as completely remove the hemangioma. 

  • Surgery

If the hemangioma may potentially cause serious problems, surgery may be recommended. If surgery is required, it is recommended to do it sooner to avoid it from growing or becoming painful.

  • Laser Treatment

Laser treatments can reduce the appearance of hemangiomas without affecting the surrounding tissue. Laser treatments are usually used in tandem with either a propranolol treatment or surgical resection.

  1. When Should A Hemangioma Be Treated?

Because infantile hemangiomas tend to change most quickly right after they appear and can leave behind permanent changes on the skin, it is important to identify and monitor them immediately. According to the American Academy of Pediatrics, the ideal “window of opportunity” for proper evaluation and treatment for hemangiomas is between 4-6 weeks old. Especially if the hemangiomas are potentially problematic, early intervention is best.

There are three main reasons why hemangiomas should be treated:

  • Serious Skin Problems

The skin on a hemangioma can break down and may develop into an ulcer (open sore), which could result in infection, bleeding or scarring.

  • Permanent Changes on the Skin

Even after a hemangioma has disappeared, changes in the color and texture of the skin can still be apparent. This can be a cause for major concern if the marks are found on the child’s face. Large bumps found on the nose or lips can cause distortion in growth and can alter the child’s facial features.

  • Medical Issues

For serious cases, the development of hemangiomas may affect the body’s vital functions. For instance, marks near the eyes, nose or mouth can interfere with the child’s sight, hearing and breathing. A child’s ability to eat may be affected as well.

Hemangiomas are not always seen. They can also develop in organs such as the lungs, liver, brain and kidneys. And because hemangiomas grow and change, they are categorized as tumors, but are universally benign or non-cancerous. They also do not spread to other areas of the body and are not contagious.

While some hemangiomas will shrink on their own, certain types of hemangiomas may require treatment and will need a consultation to determine the best course of action. At Pediatric ENT Associates, our own Dr. Brian Kulbersh is the director of the Vascular Anomalies Treatment Group – an interdisciplinary program at Children’s of Alabama aimed at managing children with congenital vascular lesions. This group works closely with parents and their children to create a treatment plan for issues like hemangiomas.

Schedule a Consultation for Strawberry Birthmarks

If you notice any unusual birthmarks developing on your baby’s skin, contact Pediatric ENT Associates at Children’s of Birmingham, Alabama. for an evaluation and treatment plan, as well as the best possible care for your child. Some hemangiomas are harmless and may go away on their own. But remember, prompt evaluation along with proper treatment and monitoring can help ensure that hemangiomas will have the least impact possible on your child. You can make an appointment by calling us at (205) 315-5633 today.

The post What Are Strawberry Birthmarks And When Can They Be Treated? appeared first on Pediatric ENT Associates.

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Pediatric otolaryngology programs can give hope to your child by maximizing the impact of a cochlear implant in children on his or her life while providing the most advanced care available. Children all over the world rely on their pediatric cochlear implant, also known as “bionic ear,” to not only improve their ability to sense sound but also to have the opportunity to lead a full life. The surgery to implant the device, however, is just one step of the process. Post-operative care will continue for a year or more after surgery and will impact your child’s progress.

Cochlear implants may be a routine treatment, but any surgery –no matter how common –can still be stressful for the patient and his or her parents. Here are some post-surgery and follow-up care tips, as well as recommendations, to help ensure that your child’s road to recovery becomes a smoother journey.

Post-Surgery Care after Cochlear Implant

General guidelines on caring for your child at home:

  • Your child can feel pressure over his or her implanted ear.
  • Dizziness and nausea can be experienced and are completely normal. These issues will gradually improve a few weeks after the procedure. Encourage your child to avoid extreme or strenuous physical activity as it resolves.
  • After removing the bandage, wash the incision with warm, soapy water (do this daily). Keep the area clean and dry. The bandage can be removed two to three days after surgery or when advised by the doctor. Diligently follow instructions on caring for the stitches, showering, diet and general care.
  • Your child will most likely spend the first few days after surgery in bed. Once the doctor gives the green light for activity, he or she can do quiet indoor play for the first three to five days.
  • Your child may return to school after a week, but cannot attend physical education classes or participate in sports for about three to four weeks (or until the doctor approves it).
Follow-Up Care after Cochlear Implant

The external device will be attached three weeks after surgery. The audiologist will attach the device to the outside of your child’s ear. This will give your child the opportunity to get used to wearing the device before it is switched on the following week. Your child’s audiologist will make the necessary adjustments on the sound processor, determine what sounds your child hears and provide all the information you need on the correct care and use of the device.

Follow-up care is essential to your child’s treatment and progress. Be sure to attend all appointments (Your child will have regular appointments after the first time the device is programmed). It is beneficial that a family member be included in the training program because learning how to operate the sound processor will ensure that your child can receive proper care regardless of location.    

How to Determine if Your Child is a Candidate for a Cochlear Implant?

To give your child the most comprehensive care possible or if you’d like to determine if your child is a candidate for a cochlear implant, seek advice from pediatric otolaryngology experts. According to a study published by the National Center for Biotechnology Information, a vocabulary test resulted in a success rate of 26.87% for the cochlear implanted children and 20.32% for those with conventional hearing aids. This exhibits the considerable advantage of cochlear implants over hearing aids.

Schedule an Appointment Today

The concept of cochlear implants may sound daunting, but medical technology today combined with solid support throughout your child’s life could mean a lifetime of success. Reach out to the Pediatric ENT Associates in Birmingham and find out how you can change your child’s life for the better. Call (205) 831-0101 or fill out the online contact form.

Next Read, When Is It Time for an Adenoidectomy?

The post What To Expect After Your Child Gets a Cochlear Implant appeared first on Pediatric ENT Associates.

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It’s no fun having a child who doesn’t feel well, no matter what the cause or symptoms are. And while having adenoids or tonsils removed has been de rigueur for American kids for generations, how do you know when it’s time for your child to undergo this procedure?

Pediatric ENT Associates (PENTA) at Children’s of Alabama in Birmingham is the state’s authority on pediatric adenoidectomy, and we know that any type of surgery, regardless of how simple or short, can be worrisome.

Yet, we know that if your daughter or son is enduring a sore throat, having issues breathing or sleeping, suffering from repeated ear infections and more, you’ll do what is necessary to alleviate their discomfort.

With that in mind, we want to share some symptoms that may indicate your child would be a candidate for an adenoidectomy.

Symptoms of Enlarged Adenoids

Part of the immune system, adenoids are located at top of the throat behind the nose and the roof of the mouth. These glands sometimes swell due to protecting the body from bacteria or viruses, which can cause soreness or pain and interfere with breathing and disrupt sleep.

If the issue is not addressed, a blockage of the Eustachian tube can occur, causing fluid to build up and eventually leading to repeated ear infections and temporary loss of hearing.

In addition, here are other symptoms that could signify enlarged adenoids:

  • Frequent breathing through the mouth
  • Noisy breathing
  • Nasally voice
  • Stuffy or runny nose despite no evidence of cold or other illness
  • Dry mouth
  • Cracked lips
  • Frequent, persistent ear infections
  • Snoring

Removing the adenoids may be beneficial if one or more of the following problems are occurring as a result of the above symptoms:

  • sleep apnea due to enlarged adenoids
  • recurring ear and adenoid infections that do not respond to antibiotics
  • a chronic buildup of fluid and pain in the ear
  • difficulty sleeping
Treatment for Enlarged Adenoids

At Pediatric ENT Associates, we assess your child as well his or her medical history and current overall health to determine the best course of action. Usually, medications are the first line of treatment, but if symptoms persist, an adenoidectomy is often required.

What is an Adenoidectomy?

An adenoidectomy is the removal of the adenoids, which can almost immediately make your child feel much better and breathe more easily, meaning they can sleep better, focus better, and be back to their fun, energetic selves!

Removal of both adenoids and tonsils

In many cases, a doctor may remove the tonsils along with the adenoids. The tonsils are also glands that help protect against germs. However, they sit in the back of the throat rather than behind the nose.

Sometimes, both the tonsils and adenoids become swollen and infected at the same time and require treatment. The removal of both glands at the same time is known as a tonsilloadenoidectomy.

Not everyone who needs an adenoidectomy will require tonsil removal and vice versa. Doctors base the decision to remove either or both of these glands on the child’s specific symptoms and medical history. Children who tend to have swelling of both the tonsils and adenoids may be good candidates for a tonsilloadenoidectomy.

For More Information, Schedule an Adenoid (and/or Tonsil) Consultation Today

If you suspect your child is having problems with their adenoids (or tonsils), schedule an appointment with an expert ENT pediatrician at Pediatric ENT Associates in Birmingham by completing our online contact form or calling (205) 831-0101 today.

Next Read, Is it Clumsiness or a Sign of Hearing Loss?

The post When Is It Time for an Adenoidectomy? appeared first on Pediatric ENT Associates.

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Are there any moments more precious than watching your baby take her first steps? She tries and tries again, succeeding, failing, falling.

Of course, it takes time for your baby to learn how to coordinate her muscles, movements and balance so that she can begin to walk properly. But what if she continues to fall, even after the normal learning period has passed?

Or if your toddler suddenly starts losing her balance at odd moments, or begins walking into tables or walls? Or an older child knocks into things, drops objects or seems unsteady in her gait?

Because a healthy inner ear is essential for maintaining our balance, persistent clumsiness in your child could be a sign of an ear infection or other ear problem, including hearing loss. How can you tell if your baby or child is experiencing a normal amount of clumsiness or if the health of their ears and hearing is in danger?

Possible Symptoms of Hearing Loss in Children

The board-certified ear nose and throat experts at Pediatric ENT Associates, part of Children’s of Alabama, share the following signs and symptoms to watch out for:

  1. Does Your Child’s Ear Hurt?

Babies and toddlers are susceptible to inflammation in their middle ear, a condition known as otitis media. Young children have short and straight Eustachian tubes — the little tunnels that connect the ear to the throat. In older children and adults, fluid that collects in the ear while swimming or because of an infection drains into the throat via the Eustachian tubes. Younger children’s tubes don’t drain as well, which leads to fluid build-up.

An inflamed or infected middle ear can affect balance. If your clumsy child seems cranky, rubs her ear, had a recent ear infection or is susceptible to swimmer’s ear, contact your pediatric ENT for an evaluation and treatment.

  1. Is Your Child Unresponsive?

Clumsiness and dizziness aren’t the only signs of potential hearing loss. If your baby doesn’t respond to your voice or to loud noises, her hearing may be impaired. Toddlers and older children who don’t understand what you’re saying, ask you to repeat yourself and have speech problems may also be struggling with their hearing.

Contact your pediatric ENT immediately if you notice the following in your son or daughter:

  • Reacts inconsistently to noises or sounds or doesn’t react at all (after age 6 months)
  • Reacts to your presence, but not your voice
  • Has delayed or unclear speech
  • Doesn’t follow directions
  • Turns up the volume on TVs, radios and other devices
Schedule an Appointment for a Pediatric Ear Screening

The best way to prevent hearing loss and middle-ear problems in babies and children is regular screening at Pediatric ENT Associates. Babies who aren’t screened at birth should have their first hearing test by 1 month old and no later than 3 months. Older children should be screened again before starting school and then annually as part of their wellness exams.

At Pediatric ENT Associates, our skilled doctors have the experience and training to diagnose and treat a broad range of ear abnormalities and hearing problems using the most advanced treatment options available. To set up a screening or consultation, contact the pediatricians at Pediatric ENT Associates. You can reach us by calling our offices in Birmingham, Alabama or via this online form.

Next, read My Toddler Snores at Night. Should I Be Concerned?

The post Is it Clumsiness or a Sign of Hearing Loss? appeared first on Pediatric ENT Associates.

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Almost all children snore sometimes, especially when they’re in deep sleep. But about one in 10 kids snores regularly. Does that mean she or he has sleep apnea — a disorder that shuts off breathing and can lead to daytime fatigue and trouble in school?

Not necessarily. Snoring in kids can have lots of different causes and sleep apnea only affects about 1 to 3 percent of snorers. As ear, nose and throat experts, we at Pediatric ENT Associates, part of Children’s of Alabama, know how important a good night’s sleep is for all kids and for parents, too.

Typical Reasons for Children Snoring

The following are some common causes of snoring and suggested remedies so you and your child can both get a good night’s rest:


If your child tends to have allergies, swollen nasal passages may be obstructing their airflow when they sleep. Wash their bedding in hot water at least once a week. Remove stuffed animals and pillows from the bed at night. If the snoring persists, visit Pediatric ENT Associates for a snoring evaluation.

Colds and Sinus Infections

Mucus from a common cold can block a child’s nose, forcing her to breathe through her mouth. At night, this may result in snoring. Over-the-counter decongestants may give your child relief.

When a stuffed nose persists, it could be a sign of a sinus infection. Your pediatric ENT may treat a sinus infection with antihistamines to relieve sneezing and congestion, or antibiotics to kill bacteria.


Children who have asthma may also snore at night. Research has shown that adults with asthma have a higher risk for obstructive sleep apnea. If your child with asthma snores, she should be evaluated for possible sleep apnea at Pediatric ENT Associates.

Physical Obstructions

Anything that impedes the constant and easy flow of air through your child’s airways at night may cause snoring and may also cause a type of sleep apnea called obstructive sleep apnea. Your child may have obstructive sleep apnea if she is overweight or has one or more of the following anatomic variations that can impede breathing:

  • Large neck that shuts down throat during sleep
  • Large adenoids or tonsils that block airflow
  • Deviated nasal septum that blocks air in one nostril
  • Recessed chin that prevents proper air flow

If your child has any of these physical variations or tends to sleep with her mouth open or chin extended, contact the specialists at Pediatric ENT Associates for a sleep apnea evaluation.

Treating Obstructive Sleep Apnea

The specialists at Pediatric ENT Associates are experts at helping your child get the restful sleep she needs. Leaving sleep apnea untreated can put your child at risk for daytime drowsiness and difficulties with concentration and memory that could affect her school performance, too.

Depending on the cause, your specialist at Pediatric ENT Associates in Birmingham may treat obstructive sleep apnea by surgically removing your child’s overly large tonsils or adenoids. In rare cases, your child may need to use a continuous positive airway pressure (CPAP) machine to facilitate night breathing. Your doctor may also recommend weight loss and other treatments, especially if your child has complicating factors such as Down syndrome.

Occasional snoring is normal, but if your child snores consistently and you suspect she may have sleep apnea, contact the board-certified doctors at Pediatric ENT Associates for evaluation and treatment.

Next, read This Summer, Watch Out for Swimmer’s Ear

The post My Toddler Snores at Night. Should I Be Concerned? appeared first on Pediatric ENT Associates.

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Summer break is a great time for kids to get plenty of sunshine and exercise by swimming in lakes, rivers, pools, and oceans. It’s also a great time for them to pick up a not-so-great condition called swimmer’s ear.

Swimmer’s ear is simply an ear infection that arises after bacteria-rich water gets trapped in the ear canal. Kids have ear canals that are shorter narrower, and less angled than adults’ ears, making children more susceptible to swimmer’s ear and other kinds of ear infections. However, adults can get swimmer’s ear, too.

Got a Bug in Your Ear?

Ear infections, also known as otitis externa, can be caused by fungi or viruses, but the most common cause is trapped bacteria. You’re more likely to get swimmer’s ear if you’re swimming in lakes or other non-chlorinated bodies of water due to their high bacteria count.

Initial symptoms are mild and include an itchy, red or uncomfortable ear. You may notice some clear discharge. If your baby has swimmer’s ear, he may tug at or rub his ear.

If the infection progresses, the itching and pain worsen. You may see a lot more fluid draining from the ear. Your child may also have trouble hearing or feel pressure in the affected ear.

Left untreated, an ear infection can progress to severe pain and fever, swollen lymph nodes and a blocked ear canal. When your baby or child seems cranky or fussy, shakes her head, pulls at her ear or exhibits other signs of swimmer’s ear, you should see the pediatric ENT specialists at Pediatric ENT Associates, part of Children’s of Alabama.

Treatment Goes Swimmingly

If the experts at Pediatric ENT Associates diagnose swimmer’s ear, they choose from various therapies to resolve the pain and promote the ear’s health, including:

  • Acids to restore the ear’s antibacterial properties
  • Steroids to resolve inflammation
  • Antibiotics to kill the bacteria

They also ensure that no other underlying problems are contributing to your child’s discomfort. Your child should stay out of the water for about a week to 10 days while their ear heals.

Keep Their Ears Safe

As always, it’s best to prevent swimmer’s ear rather than cure it. A few simple steps can help you and your children stay pain-free this summer.

Your ear already has natural defenses, including the waxy substance that lines the ear canal, trapping bacteria and dust. That’s why you should never remove ear wax with a cotton swab or finger — you’re actually removing your ear’s protection! If you or your child have trouble with waxy buildup, ask your pediatric ENT specialist for ear drops or other cleaning aids.

Here are some tips for avoiding swimmer’s ear:

  • Keep your kids’ ears dry. Even excess perspiration can get caught in the canal and cause an infection. Use a soft towel to gently wipe the outside of the ear after sports or swimming.
  • Ask your Pediatric ENT Associates expert about antibacterial rinses you can use before swimming.
  • Don’t scrape out the ear canal with cotton swabs, fingers, hairpins or anything else!
  • If you or your child needs to use hairspray or spray-on sunscreen, protect your ear canals with a cotton ball first.
  • Keep earplugs, headphones and hearing aids clean.

When you suspect swimmer’s ear or another type of ear infection, contact the board-certified pediatricians at Pediatric ENT Associates for a consultation and evaluation. You can reach us at our offices in Birmingham, Alabama or via this online form.

Next, read My Child is Tugging at Her Ears? What Does This Mean?

The post This Summer, Watch Out for Swimmer’s Ear appeared first on Pediatric ENT Associates.

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