Question: My grandson, age 3, has had swollen lymph nodes in the back of his ear since he was an infant. Sometimes he gets them in other areas. He is otherwise in good health. He has never had a serious cold and has never taken antibiotics. His doctor doesn't seem concerned, but I am.

Dr. Hibberd's Answer:

These questions can usually be answered by discussing this concern with your doctor, and having the child re-examined.

Lymph nodes (commonly referred to as glands) are essential parts of our immune defenses. They serve as our first line of filtration defense. It is normal for these areas to enlarge when we have infection. They then shrink back to their usual size once the infection is resolved.

Continuous enlargement suggests ongoing stimulation, be it from repeated or unresolved infection or inflammation, in this case likely involving the middle ear or the external ear canal. Children often have prominent lymph nodes but persistent enlargement or tenderness is unusual and should be investigated.

Common allergies are also a common source of enlarged nodes, usually symmetric and not usually located to one side. Solitary Lymph node enlargement should always be addressed.

There are many conditions that do present as enlarged lymph nodes (some serious), so you are correct to question your doctor to be sure they are not missing an underlying condition.

If your doctor feels your grandson is normal, I recommend you seek a second opinion so you can relax knowing what you see is not reflecting an undiagnosed condition.