Adenoid Hypertrophy in Young Children is Associated with Increased Respiratory Morbidity and Might be Connected to Supine Feeding Position - Abstract
Background: The pathogenesis of adenoid hypertrophy is unknown. The purpose of the study is to describe the increased morbidity associated with adenoid hypertrophy in young children and to evaluate the connection with reported supine feeding position in the first year of life. Methods: 298 young children with adenoid hypertrophy were retrospectively compared to 338 children of the same age range with gastrointestinal or urinary tract infection during years 2003-2018. All the children were followed at Clalit Health Services by one of the co-authors (AA). Results: Children with adenoid hypertrophy showed a male preponderance and a significantly increased general morbidity (primary physician visits, urgent medical care center and emergency room visits/hospitalizations), performed more chest X-rays, had more ICD-9 respiratory related diagnoses, more recurrent pneumonias and purchased higher amounts of antibiotics, bronchodilators and steroids. There was no significant difference in the occurrence of gastro-esophageal reflux and no significant difference in eosinophil or IgE levels between the groups. There was no significant correlation between the different feeding positions and the degrees of adenoid hypertrophy, but the supine-fed children had significantly more bilateral perihilar infiltrates than those fed in upward/semi-supine position Within the group of adenoid hypertrophy, the great majority (88.5%) of the children fed in a semi-supine or supine position during the first year of life had moderate to severe adenoid hypertrophy. Conclusions: Adenoid hypertrophy in young children is associated with increased respiratory morbidity and supine feeding position should be considered as a possible contributing factor in the pathogenesis of adenoid hypertrophy.