Growing Up Healthy - A pediatric specialist talks about lumps and bumps on your child's head or neck

As a parent, you may sometimes notice a lump or bump on your child’s head, neck or face. And, you may worry about the cause and whether you should seek medical attention. The good news is most of these masses are not serious. However, it’s smart to check with your child’s doctor if you have a concern or question.

February is Kids ENT (ear, nose and throat) Health Month. If you are a parent or have children in your family, take time to read this last in a four-part series on children’s ENT problems. The information is intended to help parents and families keep kids as healthy as possible and know what to do when illness strikes.

Usually a Lymph Node

“It is pretty common to find a lump on a child’s head or neck, and it’s usually an enlarged lymph node,” said Dale Tylor MD, MPH, a pediatric ear, nose and throat specialist with Washington Township Medical Foundation. “These most often related to a cold or other nearby infection and will resolve on their own without antibiotics.”

Lymph nodes are not glands, Dr. Tylor pointed out. They are part of the lymphatic system, which is an important aspect of the body’s immune system. The lymphatic system includes about 100 lymph nodes on either side of the neck.

When your child fights an infection, such as a cold or strep throat, lymph nodes in the neck may swell and feel tender. This means the child’s immune system is working the way it should to fight the infection. It is usually a temporary condition, and the swelling will go down in a week or two.

“However, you should be concerned if the lymph node continues to swell and becomes more painful. You child may also develop a fever,” Dr. Tylor cautioned. “This could be an abscess, which may require antibiotics, or a doctor may have to perform a minor drainage procedure.”

There are times when a lymph node stays enlarged, and this is not necessarily a bad thing, according to Dr. Tylor. However, if more and more lymph nodes become enlarged, you should check with the doctor.

“There is a possibility of lymphoma, which is cancer of the lymph nodes, but this is rare,” she added. “Parents frequently bring their child to our office concerned about an enlarged lymph node. We usually observe the lump over time to make sure it goes down. Sometimes, we do a biopsy to confirm it’s not cancer, which is usually the case.”

Common Lump in Babies

One lump that can appear on a baby’s scalp, face or neck is a hemangioma. This is not cancer but is made up of blood vessels. Most hemangiomas are not visible at birth and appear within the first six months of a child’s life. You may first notice it as a small bite, pimple, bruise or soft bump.

“A hemangioma can grow impressively over a period of months and then be stable for up to a few years,” described Dr. Tylor. “Then, it slowly goes away over the next few years. We usually recommend to parents that we do nothing, and it will get better by itself.”

However, if the hemangioma interferes with a child’s ability to breathe, eat, or swallow, or if it is very unsightly and in a prominent place, there are ways to treat it. In the past, treatment required risky surgery or high doses of medication, both of which are not good for the child.

Now, experts have discovered that a well-known oral medication used to treat blood pressure in adults can often shrinks a child’s hemangioma magically without surgery.

“I work with a pediatric cardiology doctor to administer this treatment, which is also used for heart problems in some children,” Dr. Tylor reported. “The dosage is weight based and very safe.”

Other Types of Lumps

Some other common childhood lumps are related to development of the fetus before a baby is born. A thyroglossal duct cyst may appear in a child’s neck from tissue left behind after the thyroid gland was formed. The cyst can be treated with antibiotics if infected, but usually must be removed surgically.

Other sources of lumps on a child’s neck or head include:

• Cat scratch disease, a neck infection that can be caused by a cat scratch
• Atypical microbacterial disease, which can infect different parts of the body, including the lymph nodes.

“The bottom line is, if you find any lumps or bumps on your child’s head or neck, you should feel free to ask their doctor,” concluded Dr. Tylor. “Most are very treatable as an outpatient, but they can be very worrisome for parents. If there are any concerns or potential complications, your child may be referred to a pediatric specialist.”

Learn more. To find out more about lumps and bumps on children’s head and neck, visit www.aboutkidshealth.ca/En/Pages/default.aspx. To learn more about Washington Township Medical Foundation, visit www.mywtmf.com.