Babies coughing while feeding

Here are some of the most common causes of pathological cough:

• an infectious process or an allergic reaction that irritates the receptor apparatus of the mucous membrane of the respiratory system;
• development of broncho-obstructive syndrome;
• penetration of a foreign object into the respiratory tract;
• enlarged regional lymph nodes that compress the airways;
• diseases of the digestive system, cardiac apparatus or vascular system, neurological pathologies.

Why does the cough appear?

1. The most common cause of coughing fits is inflammatory process of viral or infectious etiology .

Cough can develop in the organs of the upper or lower respiratory system or affect the entire respiratory system. Depending on the localization, the type of this symptom is determined. It can be dry or wet. Also, the type of cough is determined by the type of pathogen.

Cough will be dry if it develops:

• parainfluenza;
• respiratory syncytial infection;
• whooping cough;
• cytomegalovirus infection.

With these diseases, there is a violation of the production of bronchial secretions. There is a dry cough. It is usually intense, hacking, painful. If an adenovirus infection develops, this is accompanied by swelling of the mucous membrane, its surface becomes loose. This causes an increase in the amount of sputum and mucous contents. In this case, the cough is wet, productive, a large amount of sputum is separated.

With the development of rhinosinusitis, sinusitis, adenoiditis, a prolonged cough appears. The cause is postnasal syndrome, that is, mucus from the nasopharynx flows down the back wall of the larynx. In such a situation at night, the cough is wet . In the morning, after the child wakes up, the cough is also wet, but sputum also leaves. During the examination of the patient, the doctor notes the flow of mucus along the back of the pharynx into the respiratory tract. It irritates the cough receptors.

If bronchitis or pneumonia develops, with proper treatment, dry cough becomes productive, wet, sputum begins to separate from the lower respiratory tract. In such cases, it is very important to carefully prescribe cough medicines or to thin sputum. Only a doctor can determine whether, in a particular case, an antitussive drug is needed to suppress the reflex or a mucolytic to reduce the viscosity of the mucus and more quickly discharge it.

Inhalation therapy should also only be prescribed by a doctor. Not in every case, with the help of inhalations, it is possible to reduce the manifestations of symptoms and alleviate the course of the disease. In some cases, after inhalation therapy, the child's condition worsens.

2. Broncho-obstructive syndrome

Another cause of coughing fits is broncho-obstructive syndrome. This is accompanied by lengthening of the exhalation, the appearance of whistling noisy breathing, attacks of severe suffocation. Cough is most often unproductive, hacking.

Broncho-obstructive syndrome develops due to the development of viral respiratory infections. Also, the cause of development is contact with an allergen, this is one of the signs of bronchial asthma.

To diagnose broncho-obstructive syndrome, doctors prescribe chest x-ray, spirometry. To exclude the allergic origin of the disease, an allergist's consultation is prescribed. An effective method of treatment is inhalation therapy.

3. Foreign object in the respiratory tract

A foreign object entering the respiratory tract can provoke the development of coughing attacks. In this case, the child has a strong anxiety. There is shortness of breath, the cough is painful, dry, reflex.

In this case, it is very important not to panic. It is necessary to calm the baby, so he will breathe more calmly. Further, it is imperative to call emergency care as soon as possible, since the effectiveness of treatment depends on how timely parents turn to specialists.

How to determine the cause of a cough in a child

If the cough is not associated with diseases of the respiratory system, additional symptoms appear. For example, pain in the abdomen, in the heart, headache. In this case, you will need to consult a neurologist, gastroenterologist, cardiologist. Only a doctor can determine why a child has a cough. You should not engage in self-treatment and use medications or use dubious methods of alternative medicine.

In order to determine the cause of the cough, it is necessary to consult a doctor in time. From the timely appeal to a specialist will depend on how correctly the diagnosis is made, as well as how correct and timely the therapy is. The doctor will be able to prescribe rehabilitation courses in time - physiotherapy, massage, halotherapy. It is also necessary to undergo preventive procedures in order to reduce the risk of re-development of the pathological process.

Emergencies

Cough

Cough is probably the most common problem parents face. Very often, a cough, even if it sounds scary, has a harmless cause and goes away on its own. Sometimes coughing is a serious symptom. Let's try to figure out how to behave when a child coughs and when to start sounding the alarm.

What is a cough?

Cough is a protective reflex designed to clear the airways. During a cough push, the air abruptly leaves the lungs and forces everything that interferes with breathing - sputum and foreign bodies - to come out. If you think about the mechanism of coughing, it becomes clear that it is far from always necessary to “suppress” it.

What causes and how does a cough occur?

The most common cause of cough is a viral infection. Viruses can cause damage to the respiratory tract at different levels - from the nose (with a common cold) to the bronchi, bronchioles and lungs, and coughing is a common symptom in all these diseases. For example, sore throat and nasal discharge flowing down the back of the throat irritate the mucous membrane of the upper respiratory tract and stimulate the cough reflex. Due to irritation of the mucous membrane of the pharynx, a dry, hacking cough occurs, which will definitely pass without treatment, but in the acute period it can be quite frequent and painful, and even disrupt night's sleep. A runny nose and discharge along the back of the throat provoke a wet cough, while the child begins to cough when changing position of the body, especially in the morning and at night when he gets up, lies down or rolls over. If the virus infects the mucous membrane of the larynx, a false croup develops, that is, swelling and, as a result, narrowing of the lumen of the larynx, which is accompanied by a "barking" cough, hoarseness, and a characteristic noisy breath (the so-called stridor). With inflammation of the bronchi, bronchioles and alveoli - bronchitis, bronchiolitis and pneumonia, respectively - sputum accumulates in the lumen of the respiratory tract, swelling of the mucous membrane occurs, resulting in cough and shortness of breath. Unlike viral bronchitis and bronchiolitis, pneumonia is more commonly caused by bacteria and is accompanied by fever in addition to coughing and shortness of breath. In bronchial asthma, bronchospasm and accumulation of thick sputum in them occur after contact with an allergen, which also provokes a cough.

When should an ambulance be called for a child with a cough?

• If the child has the following symptoms along with a cough: it is very difficult for the child to breathe: you can see that the child is breathing with difficulty, it is difficult for him to speak (or scream, if we are talking about a baby) due to difficulty in breathing, the child has "groaning" or "groaning" breathing;
• the child has lost consciousness and/or has stopped breathing;
• the child's lips turned blue.

If the child does not have the most severe symptoms, but the child is concerned, see a doctor. An important sign of trouble is the appearance of the child - if he is lethargic, looks sick and if you cannot attract his attention and catch his eye. Shortness of breath, that is, rapid breathing, accompanied by an effort of the respiratory muscles and retraction of the intercostal spaces and the jugular fossa (depression above the sternum), is a sign that indicates damage to the lower respiratory tract. If you notice shortness of breath in a child, be sure to consult a doctor. Increased body temperature, especially fever above 39- 40 ° C, also requires that the child be examined by a doctor, as cough and fever can be symptoms of pneumonia.

Special attention should be paid to children in the first months of life, because in young children, serious illnesses can be erased, and the condition may worsen suddenly. If you have a fever (that is, if the child's rectal temperature is > 38 ° C) in children under three months old, you should definitely consult a doctor.

Should yellow or greenish sputum cause concern?

Yellow or green sputum does not always indicate a bacterial infection. With viral bronchitis and bronchiolitis, the yellow-green color of sputum is associated with the fact that cells of the mucous membrane of the respiratory tract, which the virus has damaged, enter the sputum. As a new mucous membrane is formed, the desquamated cells come out with sputum, so there is no need to be scared if the child coughs up yellow or even greenish sputum, since in most cases this is a normal manifestation of a viral infection that does not require antibiotics.

What should I do if my child coughs at night?

Most often, nocturnal cough is associated with the fact that when the child lies in bed, discharge from the nose and paranasal sinuses drain into the throat and cause a cough reflex. When a child rolls over in bed or gets up from a horizontal to an upright position, a coughing fit occurs. In such cases, the doctor will prescribe a topical treatment for the child to reduce the runny nose and, as a result, reduce the cough.

Night cough also occurs with pathology of the lower respiratory tract. Therefore, if your child is concerned about a nighttime cough, consult a doctor.

What if the child coughs to vomit?

If your child has a paroxysmal cough before vomiting, contact your pediatrician, as this may be a symptom of whooping cough. Whooping cough is especially dangerous for children in the first months of life. Sometimes whooping cough develops even in children who were vaccinated against it, but a lot of time has passed since the last revaccination.

Some children have a very easy gag reflex and may vomit when they cough, even if the cough is simply due to a runny nose. If vomiting occurs against the background of coughing, feed the child more often, but in small portions.

Prolonged cough

It is not uncommon for a prolonged cough to be caused by several successive viral infections. The child does not have time to recover from one infection and picks up another. In this case, the cough can last for several weeks and greatly frighten parents, although its cause is trivial.

However, a prolonged cough may be associated with allergies, including bronchial asthma, as well as whooping cough and other diseases of the respiratory tract and ENT organs (chronic cough may even be due to earwax plugs in the ears!), so in case persistent cough, consult your doctor.

How to treat a cough?

Cough can have many causes, and each case is treated differently. Show the child to the doctor to understand what the cough is connected with and how to help the child.

If the cough is accompanied by sputum production (wet, productive cough), sputum production should be stimulated to facilitate expectoration. Give your child more fluids (for example, apple juice or warm chicken broth can be given if age-appropriate and not allergic to these foods). If the air in the children's bedroom is dry, install a humidifier.

Non-productive (dry) cough can be controlled by reducing upper respiratory irritation. To soften the cough and soothe the airways, give the child a drink of water or apple juice, this also helps with a coughing fit. Avoid giving carbonated drinks or citrus drinks as they can irritate inflamed mucous membranes. If the child is intolerant of honey, try giving it. Children over 6 years old can suck on cough drops. If a cough interferes with sleep, going to kindergarten and school, consult a doctor, he will prescribe an antitussive.

Bath steam can help with a coughing fit. Go into the bathroom, close the door, turn on the hot shower and wait a few minutes. After the bath is filled with steam, go there with the child, sit for about 20 minutes. Try reading a book or playing with the child so that he is distracted.

Smoking is strictly prohibited at home! This contributes to frequent respiratory infections in the child and aggravates their course.

Medicines such as antibiotics and inhalations with bronchodilators, anti-inflammatory and mucolytic drugs are prescribed only by a doctor and are not required in every case.

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Fever

Fever is an increase in body temperature of more than 38 ºС. Some symptoms and laboratory and instrumental studies help to understand the cause of the fever and prescribe the necessary treatment.

If a fever is accompanied by a runny nose, cough, and "red throat", a viral infection is the most likely cause. Since antibiotics have no effect on viruses, antibiotic therapy in case of a viral infection is not prescribed.

High fever (greater than 39°C) with chills should alert. Other symptoms that require immediate medical attention are the refusal of the child to eat and drink, severe lethargy, lack of "eye" contact with the child.

Parents should know how to help a child with a fever .

Only ibuprofen (10 mg/kg per dose) and paracetamol (15 mg/kg per dose) are allowed for use in children. From drugs based on ibuprofen in a pharmacy, you can buy nurofen, and from drugs based on paracetamol - panadol, cefecon, efferalgan. Metamizole sodium (or analgin), including as part of a "lytic mixture", can cause severe blood complications, and nimesulide (nimulide, nise) can cause life-threatening liver damage. If the child does not have a severe background pathology, such as heart disease or epilepsy, and if he satisfactorily tolerates fever (is interested in others, does not refuse to drink, does not complain of pain), antipyretic drugs are given at a temperature of 38.5 - 39ºС and above.

And there is no need to achieve a decrease in body temperature immediately to 36. 6 ºС! A good effect is considered to be a decrease in fever to 38 ºС. Safe and effective methods of physical cooling are rubbing with water at room temperature (not alcohol or vinegar!), which allows you to reduce body temperature by 0.5 - 1.0 ºС in a few minutes. However, if the child has chills, if he has cold hands and feet, rubbing will not be effective. In such cases, massage of the hands and feet helps, which reduces vasospasm and improves peripheral circulation, and antispasmodic drugs, such as no-shpa, are also used.

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False croup

In babies, false croup occurs quite often, so mothers need to know about it. Only parents can notice the first signs of a narrowing of the larynx in time and help the child in time. The reason is viral infections. In children under 5 - 6 years of age, the airways are narrower than in adults, and therefore croup develops much more often.

If a baby with a cold has a "barking" cough and a hoarse voice, it is necessary that he breathe steam over hot water in the bathroom. If this does not help, and the breath becomes noisy and difficult, call an ambulance without stopping the inhalation of steam.

What is false croup?

Croup is difficulty in breathing due to constriction of the larynx. To feel where the larynx is, you can put your hand on the front of the neck and make any sound - the larynx will vibrate.

This part of the airway is quite narrow, and if the mucous membrane swells, it can completely block the lumen of the larynx, and air will not enter the lungs. In children under 5 - 6 years of age, the airways are narrower than in adults, and therefore croup develops much more often.

Unlike false, true croup begins with diphtheria, when the lumen of the larynx is blocked by dense films. Thanks to vaccinations (DPT, ADS-M), this disease, fortunately, has become rare.

Pseudocroup is caused by acute viral infections (eg parainfluenza virus or respiratory syncytial virus). The mucous membrane becomes inflamed, swells, and although films do not form, as in diphtheria, the result is the same - it is difficult for the child to breathe.

How does it all start?

Usually, the usual symptoms of acute respiratory infections appear first, i.e. runny nose, cough, fever. The first signs of the proximity of a false croup arise or intensify in the evening - this is a growing dry "barking" cough and a hoarse voice.

Then the breath becomes "noisy" - at first only during crying or anxiety, that is, when the baby breathes deeper and faster. After a while, these symptoms persist even in a calm state.

With croup, it is difficult for the baby to inhale exactly, that is, the inhalation turns out to be noisy, with effort, and the exhalation remains normal. During inhalation, you can notice how the jugular fossa (depression in the lower part of the neck between the collarbones) is drawn inward.

Is it possible to prevent false croup?

There are pathogens that most often cause croup: parainfluenza virus, influenza virus and respiratory syncytial virus. If a child has contracted this particular infection, the risk of developing croup is high, and, unfortunately, there are no remedies that protect against it.

There are children who tolerate colds without this complication, but in some the mucous membrane is more prone to edema, and if there has already been one episode of difficulty in breathing with ARI, such conditions are likely to recur. Parents need to be ready for them - until the child grows up, and the croup ceases to threaten him.

What to do with false croup?

If you notice its signs, first of all, you need to calm yourself and the child, because when you are excited, the muscles of the larynx contract and it becomes even harder to breathe.

For a "barking" cough, as long as breathing is quiet and not labored, steam inhalation may help. Turn on hot water in the bathroom, let the child breathe in moist air for a few minutes.

If this does not help and breathing becomes difficult (noisy breathing, jugular fossa retraction), call an ambulance and continue to do steam inhalation until it arrives. The doctor will prescribe special inhalations with a local hormonal preparation for croup. Don't let the word "hormonal" scare you, because this drug works only in the respiratory tract, eliminating inflammation, and no other medicine for false croup will not be so effective. In severe cases, the doctor will inject a hormone (prednisolone or dexamethasone) intramuscularly. Don't worry about side effects because short cycles of hormones are safe and life-saving in these situations.

If you are offered to hospitalize your child, do not refuse, because after temporary relief, breathing problems may recur.

There are conditions that can be confused with false croup, such as inflammation of the epiglottis (cartilage that closes the larynx when swallowing). This disease is called epiglottitis: the child's temperature rises above 39 degrees, there is a severe sore throat, the mouth is difficult to open, and hormonal preparations do not help the child.

If the epiglottis is inflamed, the child is admitted to the hospital and treated with antibiotics. But this disease is rare, and false croup is caused by viruses, so it makes no sense to take antibiotics.

Is it possible to stop an attack of croup on your own?

If false croup in a child occurs not for the first time, you can take home a special device for inhalation - a nebulizer (choose a compressor model, since ultrasonic can destroy drugs used for croup). Your doctor will tell you what medication to have at home and how much to use if needed.

The child can return to kindergarten as soon as the body temperature returns to normal and the child feels well.

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Vomiting and diarrhea

Acute gastroenteritis is characterized by an increase in body temperature (from subfebrile condition to high fever), vomiting, stool thinning. Rotavirus is the most common cause of gastroenteritis. The most severe is the first episode of rotavirus gastroenteritis in children from 6 months to 2-3 years. The peak incidence of this infection occurs in the winter - spring.

The danger of viral gastroenteritis is associated with rapid dehydration and electrolyte disturbances due to loss of water and salts in loose stools and vomiting. Therefore, feeding the child is of fundamental importance. In order not to provoke vomiting, you need to drink fractionally (1 - 2 teaspoons), but often, if necessary, every few minutes. For convenience, you can use a syringe without a needle or a pipette. In no case should you drink the child with just water, this only exacerbates electrolyte disturbances! There are special saline solutions for drinking - rehydron (optimally ½ sachet per 1 liter of water), Humana electrolyte, etc.

The daily need for fluid is presented in the table:

The child's daily need for liquid
2 - 10 kg 100 ml/kg
10 - 20 kg 1000 ml/kg per kg over 10 kg
> 20 kg 1500 ml + 20 ml/kg for each kg over 20 kg

In addition, ongoing fluid losses with loose stools and vomiting are taken into account - for each episode of diarrhea / vomiting, an additional 100 - 200 ml of fluid is given.

Intravenous rehydration (fluid replenishment with drips) is done only for severe dehydration and persistent vomiting. In all other cases, you need to drink the child - it is safe, effective and painless.

Smecta (but do not give smecta if it induces vomiting), espumizan or Sab simplex are used as adjuvants. Enterofuril is not recommended for use, as it is not effective either in viral infections or in invasive bacterial intestinal infections. In the diet during the acute period, fresh vegetables and fruits (except bananas), sweet drinks are excluded, and whole milk is limited only in older children.

For parents, you need to know the first signs of dehydration - a decrease in the frequency and volume of urination, thirst, dry skin and mucous membranes. With increasing dehydration, the child becomes lethargic, stops urinating, thirst disappears, the skin loses turgor, and the eyes “sink”. In this case, there is no time to waste, it is necessary to call a doctor and hospitalize the child.

The appearance of blood and mucus in the stool in a child should be alerted, because this is typical for bacterial enterocolitis. Stool with such infections is not large (in contrast to copious watery stools with rotavirus infection), false urge to defecate and abdominal pain may be noted. Drinking water in such cases may not be enough, and, as a rule, antibiotics are required.

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Pneumonia

One of the serious diseases in children is pneumonia, or pneumonia. Pneumonia can pose a threat to a child's life. Fortunately, modern medicine has learned to cope well with pneumonia, and this disease can be completely cured in most cases. Therefore, if your baby gets sick with fever and cough, contact your pediatrician. If pneumonia is suspected, a doctor may order an x-ray of the lungs to confirm the diagnosis.

What is pneumonia?

Pneumonia is an inflammation of the lung tissue, that is, the deepest part of the respiratory system. Normally, gas exchange occurs in the lungs, that is, oxygen from the air enters the blood, and carbon dioxide is released from the blood into the environment. When part of the lung is inflamed, the breathing function in the affected lung is affected and the child develops shortness of breath, that is, rapid and labored breathing. Substances produced during the immune system's fight against bacteria cause fever (if the body temperature rises above 38 ° C, this is called a fever). The accumulation of sputum in the alveoli and bronchi and swelling of the mucous membrane stimulate the cough reflex, and a cough occurs. If the focus of pneumonia is near the lining of the lung, called the pleura, chest pains may occur when breathing and coughing.

What causes pneumonia?

There are many infections that can cause pneumonia. Streptococcus pneumoniae is the most common cause of so-called "typical" pneumonia. Pneumococcal pneumonia is accompanied by fever, cough, shortness of breath, lethargy, and decreased appetite. Less commonly, pneumonia is caused by other pathogens - hemophilus influenzae (Haemophilus influenzae) type b, pyogenic streptococcus (Streptococcus pyogenes) and Staphylococcus aureus (Staphylococcus aureus). "Atypical" pneumonia, which is usually milder and quite contagious, is caused by mycoplasmas and chlamydia. Less commonly, pneumonia is caused by viruses (adenovirus, RS virus) - such pneumonias are rare and can be very difficult. Pneumonia can develop suddenly or be a complication of the flu.

What are the symptoms of pneumonia?

The most important symptom of pneumonia is fever. In a young child, fever may be the only manifestation. Fever above 39.5°C with chills and fever that is poorly reduced after taking antipyretic drugs should be especially alert. Although not always a high fever that does not respond well to antipyretics is a symptom of pneumonia. This may be a manifestation of a respiratory viral infection.

The second important symptom of pneumonia is a cough. The nature of the cough matters. Particularly alarming are the "deep" cough, cough at night and cough before vomiting.

Severe pneumonia is usually accompanied by shortness of breath, that is, rapid and labored breathing. Sometimes a symptom of pneumonia is pain in the abdomen, which occurs due to irritation of the pleura (lung membrane) during inflammation of the lung area adjacent to the pleura and due to frequent coughing and, accordingly, tension in the abdominal muscles.

Very important signs that speak in favor of pneumonia are symptoms of intoxication, such as fatigue, weakness, refusal to eat and even drink. At the same time, unlike pneumococcal pneumonia, with mycoplasmal pneumonia, the child may feel well.
Coughing and wheezing in the lungs are symptoms not only of pneumonia, but also of bronchitis. It is very important that the doctor distinguishes pneumonia from bronchitis, since antibiotics are not always required for bronchitis and only if its mycoplasmal etiology is suspected.

What can happen if pneumonia is not treated?

This is fraught with complications that are more likely to occur if pneumonia is left untreated. Complications of pneumonia are inflammation of the pleura (pleurisy) and the formation of a cavity in the lung filled with pus (lung abscess). In such cases, a longer course of antibiotics will be required, and sometimes the help of a surgeon.

How to treat pneumonia?

If you have bacterial pneumonia, your doctor will prescribe an antibiotic. The doctor will decide which antibiotic to choose depending on the suspected cause of the pneumonia. In most cases, the child can be given the antibiotic by mouth (as a suspension or tablets) rather than by injection. The effect of the antibiotic occurs within 24-48 hours. If after 1 - 2 days the child does not feel better and the temperature rises, consult a doctor again.

Usually a child with pneumonia can be treated at home. Hospitalization is required for severe and complicated pneumonia, when the child needs intravenous antibiotics, supplemental oxygen, pleural punctures, and other serious medical interventions.
Give the child an antipyretic (ibuprofen or paracetamol) if the body temperature rises above 38.5 to 39°C. Antitussives, such as butamirate (Sinekod drug), are contraindicated in pneumonia.

Can pneumonia be prevented?

There are vaccines designed to protect against pneumococcus and Haemophilus influenzae, which cause the most severe forms of pneumonia (against pneumococcus - vaccines "Prevenar", "Pneumo 23", against Haemophilus influenzae - "Act-HIB", "Hiberix", a component against Haemophilus influenzae sticks are part of the Pentaxim vaccine, components against pneumococcus and Haemophilus influenzae are simultaneously part of Synflorix). Since pneumococcal pneumonia often develops as a complication of influenza, influenza vaccination is useful.

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