Hello, I understand your concern ISurgery (adenotonsillectomy) is considered only if: Child has frequent throat infections: ≥7 in 1 year, ≥5 per year for 2 years, or ≥3 per year for 3 years Obstructive sleep apnea (OSA) – disturbed sleep, restless nights, poor growth, behavioral issues Persistent mouth breathing/snoring affecting sleep or feeding Difficulty in swallowing or speech As the child is currently stable, no fever/cold episodes in 4 months, and only mild snoring/mouth breathing: You may continue with medical management and observation for now.

Children with enlarged adenoids and tonsils are generally more prone to recurrent episodes of fever, upper respiratory infections, and snoring. In many cases, the size of the adenoids naturally decreases with age, and symptoms improve without the need for surgical intervention-often by the age of 12. However, if the child is experiencing significant symptoms such as persistent nasal obstruction, loud snoring, sleep disturbances, mouth breathing, or recurrent infections that are not responding to medical treatment, surgical removal (adenoidectomy and/or tonsillectomy) may become necessary

Benefits of tonsillectomy usually outweigh the risks, especially if: • ≥7 infections/year in past year • ≥5/year for 2 years • OSA symptoms (snoring, apneas, poor growth)