CROUP or Why Does My Child Have a “Barky Cough”?
Croup, or laryngotracheobronchitis, is caused by many viral infections and falls into the category of upper respiratory infection along with the common cold. Croup tends to occur in the autumn and early winter months. In croup, the major areas affected are the ones referred to in the long name of this illness (above); the larynx, trachea and bronchi, which are all structures that convey air from the mouth and nose down toward the lungs. As with all colds or upper respiratory infections there is inflammation of the mucosa (most superficial covering) of the inside of the nose, mouth, throat and upper respiratory tract, leading to mucous production and irritation of those sites.
In croup, the area of the upper respiratory tract most prominently affected is the larynx, or the voice box area located very close to the firm lump in the front of your neck, the “adam’s apple”. When vocal cords are irritated and swollen, adults merely get hoarse or raspy talking and a “normal” sounding cough. Children have a much narrower windpipe and therefore with even the slightest swelling of their vocal cords, there is less room for air to get by and they also get hoarseness along with a cough and raspy breathing. There is also a characteristic barky (yes sounds like a animal barking) kind of cough and occasional difficulty breathing. All symptoms tend to be worse at night, a time when all illnesses seem to worsen.
For the most part this illness remains mild and the only treatment needed is a cool mist humidifier, fluid intake, elevated head at night and reassurance for the child and parents. Rarely a child may progress to real difficulty breathing, with a characteristic whooping noise when taking a breath in versus a wheezing sound when breathing out found more commonly in those with asthma. So if your child exhibits difficulty breathing along with the above symptoms, call your doctor for further instructions.
Once a child has had croup, parents seldom forget what the barky cough sounds like and can make the diagnosis themselves. Usually, as with other upper respiratory viral infections there is a mild amount of fever and the child is not real sick. If there is sudden high fever with the onset of “croup” and your child is drooling, cannot swallow or speak, and is very anxious, you must call your doctor immediately or call 911. This symptom complex describes a rare but life threatening illness called epiglotitis which can be very dangerous. I stress that this is a rare illness which used to be far more common before we were able to vaccinate against the bacteria which causes this illness.
Kid-friendly Foods That Soothe
When children are under the weather, they usually turn to Mom for comfort. This season, be prepared with tasty treats that do double duty – they soothe symptoms and help speed up the healing process.
“Runny noses, coughs and intermittent fevers can all be soothed at home,” says Dr. Ben Lee, a hospitalist at Children’s Medical Center of Dallas and an assistant professor of pediatrics at University of Texas Southwestern, in Dallas. “The old adage of a bowl of chicken noodle soup does have some truth, as it provides necessary fluids and calories to help kids feel better.”
There are other options too. Here are a few unexpected, inexpensive and tasty treats to have on hand for your kids this cold and flu season.
Oatmeal Cookies
Every mom knows that extra sleep is key for sick children, but getting an unhappy child to climb into bed is seldom an easy task. Oats contain high levels of tryptophan, the amino acid best known for making you feel sleepy after eating a big turkey dinner on Thanksgiving. A bowl of oats may be a bit heavy on the stomach, especially for a sick kid, but eating one or two oatmeal cookies will produce the same effect and help kids settle down and get the rest they need to feel better.
100 Percent Juice Drinks
It’s normal for most kids to become mildly dehydrated while sick with the flu. Watch for signs, which include a dry or sticky mouth, dry skin, irritability and dizziness. “Liquids are important to prevent dehydration,” says Lee.
The right liquids make all the difference, though. Avoid caffeinated beverages and hydrate kids with 100 percent juice. All-natural juice drinks are fat-free and nutrient-dense, and are loaded with vitamins and immunity-boosting antioxidants that many of their sugary counterparts lack. If the juice is too sweet or strong, mix it with an equal amount of water to dilute the taste without washing away the nutrients. Kids younger than 1 year should hydrate with a beverage that contains electrolytes.
Ginger Ale or Ginger Candies
Many studies have shown that ginger curbs nausea and alleviates an upset stomach. The trick is to find foods and beverages that actually contain pure ginger. Look for the words “ginger” or “ginger extract” on the ingredient list. Some sodas, especially those available in natural food stores, are going to be your best bet. Ginger candies made from real ginger can also help provide relief for older children.
Ice Pops
A cool ice pop can numb irritated nerve endings to help soothe an inflamed sore throat and provide fluids to quell dehydration. Seek out ice pops made from 100 percent juice or fruit puree, and avoid unnecessary artificial sweeteners and additives. Ice pops made from 100 percent juice are loaded with healthy antioxidants, and those fortified with extra vitamins and minerals can give added boost to the immune system to help speed recovery time.
Honey
Honey is extremely effective at soothing coughs, according to research from Penn State College of Medicine. In fact, a small dose of buckwheat honey before bedtime reduced the severity and frequency of coughs and provided significant relief to participants in a recent study.
“Honey has been reported to reduce coughing by coating the throat to help reduce irritation,” says Lee. One to two teaspoons thirty minutes prior to bedtime should do the trick, he says. An important warning: Children under 2 years old should avoid this sweet soother to prevent the risk of a botulism infection.
Pneumonia, Bronchitis and Kids – More Common Than You Think
Pneumonia in kids is probably more common than we all realize. It represents an infection of the lung tissue which can be caused by viral illnesses, bacterial illnesses or a type of organism that is somewhere between a virus and bacteria called mycoplasma. The most common cause of pneumonia is usually viral, but viral illnesses can predispose lung tissue to become infected with bacteria. Other ways of acquiring pneumonia are by inhalation (this is unusual but certain illnesses such as
tuberculosis and anthrax may be acquired in this manner).
The best way to diagnose kids with pneumonia is through a thorough history and physical exam that your doctor will perform on your child. Another way that can be used to diagnose pneumonia is through the use of a chest X-ray, but small areas of pneumonia or early pneumonia might not show up on X-ray. Your Doctor will be able to diagnose this early on by piecing together what you tell him and his observation and examination of your child.
One thinks of pneumonia as an illness with high fever and severe productive cough but this is not always the case and sometimes all that is seen are the symptoms created by the body to help compensate for the changes occurring in the lungs. If a large amount of lung tissue is involved and it becomes difficult for the gas exchange (oxygen in and carbon dioxide out) to take place then a signal is sent to the brain to increase the rate of breathing so that more air is forced in and more oxygen can be extracted. When it is even more difficult to breathe the child may use muscles not ordinarily used to help with breathing such as abdominal muscles and neck muscles and one can observe this. With further progression of the disease less oxygen will reach the body and mild blueness or cyanosis will be seen in the skin.
OK we’ve talked about the more severe problems with pneumonia but let’s get back to the beginning and restate that most pneumonia is mild and might very well be a natural progression of a cold. In a considerable amount of children with mild pneumonia the diagnosis might never be made because it is not severe. And because most of these are viral in nature, they will clear up as the cold clears without the use of an antibiotic, and the child never exhibits the signs and symptoms mentioned in the previous paragraph.
If your Doctor pieces together the parts of the history and physical exam and decides your child might have pneumonia, and if your child appears sick or ill, he might very well begin an antibiotic because the exact nature of the pneumonia might be difficult to determine. Most of the time pneumonia can be adequately treated at home without the need for hospitalization and he/she will recover fully without any subsequent problems.
Bronchitis is a wastebasket term describing what is thought to be inflammation and mucous collection in the tubes that lead from your nose and mouth down into your lungs due to many causes- again usually viral. Any cold with a significant loose cough probably represents some degree of bronchitis or tracheitis (higher up). Generally, it also does not necessarily need an antibiotic to “cure” it because bronchitis, like mild pneumonia, will also go away as the cold resolves. There are instances, again, when your child’s doctor might very well decide to use an antibiotic for your child and those would include when your child looks sick or ill (because significant bronchitis and pneumonia can look exactly the same) or if your child has any sort of chronic lung condition such as asthma or cystic fibrosis where the chance of bacterial infection is increased.
So, especially during the winter months, if your child is diagnosed with pneumonia or bronchitis, you needn’t panic or assume the worst. Just follow your child’s doctor’s advice and he/she will be just fine.
Is Thirteen Too Old for a Pediatrician?
A board-certified, properly trained pediatrician offers the best medical care for all teens. Unlike other primary care providers, a pediatrician spends three to four years or more of intense study and preparation to take care of all kids — including adolescents. None of the other primary care doctors has this level of education and training in dealing with the unique problems of teenagers. The massive physical and emotional changes brought on by puberty aren’t seen in any other age group. Teens, despite their protestations, are not young adults — and there’s no benefit to switching from a pediatrician to an adult’s physician until they are!
How Mouthwash Can Benefit You and Your Family
A mouthwash is a mouthwash is a mouthwash – or so you may think. Sure, some may be green or blue or extra-minty, but really, how different could they be?
Turns out there’s a key difference: Some rinses help you more than others, and some even contain ingredients you should avoid, says Ingvar Magnusson, D.D.S., Ph.D., a research professor in oral biology at the University of Florida College of Dentistry in Gainesville. For example, many rinses have sodium lauryl 
sulfate, which tends to dry and irritate the mouth – especially if you suffer from canker sores. And some studies have found a link between rinses with a high alcohol content (25 percent or more) and oral cancers.
It’s smart to ask your dentist for rinse recommendations that suit your family’s specific dental hygiene needs. But in the meantime, here’s a cheat sheet for your next trip down the mouthwash aisle:
WANT TO …
Help prevent cavities?
- LOOK FOR….Fluoride. Its ability to prevent tooth decay is well-established.
Fight gum disease?
- LOOK FOR….Cetylpyridinium chloride (CPC) or chlorhexidine gluconate. Recent research has shown these ingredients help prevent gingivitis and dental plaque.
Moisten the mouth?
- LOOK FOR….Carboxymethylcellulose or hydroxyethylcellulose, both of which simulate natural saliva. Bonus points if the rinse also contains fluoride, since dry mouth contributes to cavities.
Soothe canker sores or mouth abrasions?
- LOOK FOR….Hydrogen peroxide. It’s a safe bet because it’s antimicrobial without being overly abrasive.
Freshen breath?
- LOOK FOR….Methyl salicylate and chlorhexidine gluconate. These antiseptics help fight the bacteria that contribute to bad breath. Additional herbs, scents and flavorings help mask odor.
Finally, remember that no rinse can take the place of flossing and brushing, which physically scrapes the plaque off your teeth. Rinses may have some impact on preventing gingivitis or tooth decay, but only if used as part of a solid dental-health routine, says Magnusson.
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Editor’s Note: Mouth rinses can be great for kids. Our pediatric dentist recommended adding a mouthwash to my 9-year old son’s dental routine for added protection, especially on those days when he rushes the brushing (because, hey, we know it’s happening!). But they specifically recommended a rinse like Crest Pro-Health because it contains the cetylpyridinium chloride (CPC) mentioned above. It’s working great for him and I’ve started using it too. It is quite minty/spicy, but he handles it by making it into a game – jumping or dancing after he’s rinsed, until the spice eases!
