Babies coughing while feeding
Aspiration in Babies and Children
ABOUT CAUSES DIAGNOSIS TREATMENT NEXT STEPS
What is aspiration in babies and children?
Aspiration is when something enters the airway or lungs by accident. It may be food, liquid, or some other material. This can cause serious health problems, such as pneumonia. Aspiration can happen when a person has trouble swallowing normally. This is known as dysphagia. It can also happen if a child has gastroesophageal reflux disease (GERD). This is when the contents of the stomach come back up into the throat.
When your child swallows food, it passes from the mouth down into the throat. This is called the pharynx. From there, the food moves down through a long tube (esophagus) and into the stomach. This journey is made possible by a series of actions from the muscles in these areas. If your child has dysphagia, the muscles don’t work normally. They cause problems with the swallowing process.
The pharynx is also part of the system that brings air into the lungs. When a person breathes, air enters the mouth and moves into the pharynx. The air then goes down into the main airway (trachea) and into the lungs. A flap of tissue called the epiglottis sits over the top of the trachea. This flap blocks food and drink from going down into the trachea when your child swallows. But in some cases, food or drink can enter the trachea. It may go down as your child swallows. Or it may come back up from the stomach. A child with dysphagia is much more likely to aspirate. A child with a developmental or health problem is more likely to have dysphagia.
Aspiration can happen during a feeding or meal. And it can happen after a feeding or meal. This is common in babies and children with certain health conditions. Aspiration can also happen at any time when your child swallows saliva.
If your child aspirates a small amount of material, it may not cause much harm. This can happen in children who don’t have a health problem. It can happen when eating, sleeping, or talking. But aspiration that happens often or in a large amount can be serious.
What causes aspiration in babies and children?
Aspiration is often caused by dysphagia. This is when the muscles don’t work normally in the throat and lead to swallowing problems. Different medical conditions can lead to this, such as:
- Abnormal anatomy, such as a cleft palate or a problem in the esophagus
- Delayed growth, from premature birth or a condition such as Down syndrome
- Brain damage or other problems, such as from cerebral palsy or infection
- Problems with the cranial nerves that control the muscles of swallowing
- Neuromuscular disease, such as spinal muscular atrophy
- Medical procedures, such as a nasogastric tube or a tracheostomy
Gastroesophageal reflux disease (GERD) can also cause aspiration. This is when the contents of the stomach come back up into the throat.
What are the symptoms of aspiration in babies and children?
Aspiration can cause signs and symptoms in a baby such as:
- Weak sucking
- Choking or coughing while feeding
- Other signs of feeding trouble, like a red face, watery eyes, or facial grimaces
- Stopping breathing while feeding
- Faster breathing while feeding
- Voice or breathing that sounds wet after feeding
- Slight fever after feedings
- Wheezing and other breathing problems
- Repeated lung or airway infections
And aspiration can cause signs and symptoms in an older child such as:
- Choking or coughing while eating
- Voice that sounds wet after eating
- Slight fever after meals
- Complaints of food feeling stuck or coming back up
- Wheezing and other breathing problems
- Repeated lung or airway infections
Signs and symptoms can happen right after eating. Or they may happen over time. Your child may not have all of these signs and symptoms. The signs and symptoms may depend on the age of your child, and how often and how much your child aspirates.
Some children who aspirate do not have any signs or symptoms. This is called silent aspiration.
How is aspiration in babies and children diagnosed?
Your child will need to be checked for aspiration if he or she has:
- Any signs or symptoms of aspiration
- Health problem that can cause trouble swallowing
The healthcare provider will ask about your child’s medical history and symptoms. This may be done by a speech-language pathologist (SLP). The SLP may ask about what foods or drink cause problems, and when your child’s symptoms happen. He or she may want to watch your child during a feeding.
Your child may also need tests. These can check for problems and show if food and fluid is going into your child’s lungs. The tests may include:
- Chest X-ray or CT scan
- Modified barium swallow test (MBS)
- Fiber optic endoscopic evaluation of swallowing (FEES)
How is aspiration in babies and children treated?
Treatment for aspiration may vary depending on the cause and severity. Treatments for your child may include:
- Making changes in position and posture during meals
- Changing the thickness of liquids
- Changing the types of foods in your child’s diet
- Doing exercises to help with swallowing (for an older child)
- Medicines for GERD
- Medicines or Botox injection for children who make excess saliva
- Surgery to reduce reflux
- Surgery to correct a problem such as a cleft palate
If your child still has a high risk of aspiration despite these methods, he or she may need a special tube to help with eating for a while. The feeding tube will help your child get good nutrition until his or her risk of aspiration improves. Your child will not eat or drink normally until the tube is removed. A thin tube may be put through the nose down into the stomach. This is called a nasogastric tube. This may be used for a short time while other treatment is considered. Or a tube may be put directly into your child’s stomach during a surgery. This is called a gastrostomy tube.
In some children, aspiration lessens over time. In other cases, a child may need more treatment to address the cause. Your child’s healthcare providers will carefully watch your child so that he or she can return to normal eating as soon as possible.
Talk with your child’s healthcare provider if your child has a tracheostomy tube. You may need to suction food or liquid from the tube.
What are possible complications of aspiration in babies and children?
A major complication of aspiration is harm to the lungs. When food, drink, or stomach contents make its way into your child’s lungs, it can damage the tissues there. The damage can sometimes be severe. Aspiration also increases the risk of pneumonia. This is an infection of the lungs that causes fluid to build up in the lungs. Pneumonia needs to be treated with antibiotics. In some cases, it may cause death.
Other possible complications from aspiration include:
- Weight loss
- Increased risk of other illness
When should I call my child's healthcare provider?
Let your child’s healthcare provider know right away if your child has any signs or symptoms of aspiration. It needs to be treated as soon as possible.
Key points about aspiration in babies and children
Aspiration is when something enters the airway or lungs by accident. It may be food, liquid, or some other material. This can cause serious health problems, such as pneumonia. Aspiration can happen when a child has trouble swallowing normally. This is known as dysphagia.
- Your child might have aspiration caused by problems with growth, development, or certain health conditions.
- Your child may have a signs such as breathing problems and a wet-sounding voice after meals.
- Some children with aspiration don’t have any signs or symptoms. This is known as silent aspiration.
- If your child has any symptoms of aspiration, he or she needs to be checked and treated right away.
- Aspiration may be treated by addressing the cause of dysphagia. It can also be managed with methods to help your child feed better.
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
- Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.
Help! My Baby Is Choking on Milk!
Many parents look forward to feeding time with their baby. It’s a chance to bond and also gives you a few minutes of peace and quiet.
But for some, bottle feeding or breastfeeding can lead to gagging or choking sounds, which are alarming if you’re a new parent. Fortunately, there are things you can do to help prevent your baby from choking on milk or formula.
If your baby seems to gag a lot while eating, don’t panic. “Choking and gagging during feeding is common in young infants,” says Robert Hamilton, MD, FAAP, a pediatrician at Providence Saint John’s Health Center in Santa Monica.
Hamilton says babies are born with an exaggerated but protective “hyper-gag reflex,” which can cause gagging while feeding. Plus, babies gag easily due to their own neurologic immaturity.
“Babies are growing and learning new ways to use their body (and mouths) every day,” says Amanda Gorman, CPNP and founder of Nest Collaborative, a collection of International Board Certified Lactation Consultants.
“Often, just stopping the feed and positioning the baby upright with good head and neck support will give them a few seconds to manage the problem. ”
Gina Posner, MD, a pediatrician at MemorialCare Orange Coast Medical Center, says if your baby begins to choke, let them stop feeding for a little bit and pat their back. “Typically, if they’re choking on liquids, it will resolve quickly,” she says.
The most common reason a baby chokes during breastfeeding is that milk is coming out faster than your baby can swallow. Usually, this happens when mom has an oversupply of milk.
According to the La Leche League International (LLLI), common signs of oversupply include restlessness at the breast, coughing, choking, or gulping milk, especially at let down, and biting on the nipple to stop the flow of milk, among others.
You might also have an overactive let down, which causes a forceful flow of milk into your baby’s mouth. When your breasts are stimulated by your baby suckling, oxytocin causes the let-down reflex that releases the milk.
If you have an overactive or forceful let down, this release happens too fast for your baby to respond appropriately, causing them to gulp or choke while breastfeeding.
How do I prevent my baby from choking on milk when breastfeeding?
One of the first things you can do to help prevent your baby from choking while eating is to change the feeding position.
“For breastfeeding mothers who appear to have overactive let down, we typically recommend they nurse in a laid-back position, which reverses gravity’s effect and allows baby to have more control,” says Gorman.
Posner recommends pulling your baby off the breast every once in a while to help them catch their breath and slow down. You can also take your baby off the breast for 20 to 30 seconds when your milk first lets down.
In addition to a laid-back position, the LLL recommends lying on your side so your baby can allow milk to dribble out of his mouth when it flows too quickly.
Furthermore, expressing milk for 1 to 2 minutes before bringing your baby to your breast can help. Doing so allows the forceful let down to happen before baby latches. That said, be careful with this technique, as pumping for too long will tell your body to make more milk and worsen the problem.
When your baby gags when drinking from a bottle, it’s often due to the positioning. Lying your baby on their back while bottle feeding will lead to a faster milk flow, making it harder for your baby to control the rate of feeding.
“Tilting the bottom of the bottle higher than the nipple increases the rate of milk flow, as will a nipple with too large of a hole for the infant’s age,” Gorman advises. Tilting the bottle too high can lead to involuntary increases in intake and contribute to problems like reflux.
Instead, when bottle-feeding an infant, try using a technique called paced bottle-feeding. “By keeping the bottle parallel to the ground, the baby remains in control of the milk flow, as they are at the breast,” Gorman says.
This technique allows your baby to actively pull milk out of the bottle using their sucking skills and lets them easily take a break when needed. Otherwise, gravity is in control.
For babies who are bottle-fed by multiple caregivers, Gorman says all of the people who administer feeds should be educated on paced bottle-feeding.
Finally, you should never prop the bottle up to feed your baby and walk away. Since they can’t control the flow of the milk, it will keep coming even if your baby is not ready to swallow.
“The mechanism of swallowing is complicated and requires several muscle groups working together in concert and in the right time sequence,” Hamilton says. Fortunately, gagging usually diminishes as children get older and become better at swallowing.
Still, if you’re a new parent or caregiver, it’s smart to take infant cardiopulmonary resuscitation (CPR). While rare, a choking episode that caused your baby to turn blue or lose consciousness would be an emergency.
If you’re having problems related to breastfeeding, contact a LLL leader or International Board Certified Lactation Consultant (IBCLC). They can help you with your baby’s latch, positioning, oversupply issues, and forceful let-down problems.
If you’re having problems related to bottle feeding, contact your child’s pediatrician. They can help you with bottle and nipple selection, as well as feeding positions that prevent choking on milk or formula.
If your baby continues to choke even after slowing down the rate of feeding, you should contact your pediatrician to rule out any anatomical reasons why swallowing may be challenging.
When you hear your baby gagging or choking during feeding, don’t panic. Take baby off the nipple and prop them up to help them clear their airway.
Often it will take a little time for your baby to learn suckle with ease. In the meantime, try keeping your baby upright during feedings and make the flow of milk slower, if possible. Soon enough, feeding time will be a sweet snuggle session!
Why is the child coughing? | 1DMC
Cough is a sudden explosive expiration, the task of which is to clear the paths of the respiratory system. This is the wording of pulmonologists. Cough is a protective mechanism that clears the larynx, trachea, bronchi.
Types of cough
Cough can be physiological or pathological.
1. Physiological is short-term, there are no other symptoms of diseases, there is no discomfort or inconvenience.
This type of cough is completely natural and does not require treatment! A physiological cough is needed to clear the airways of mucus and foreign particles that accumulate in the child's airways. The mechanism of physiological cough is as follows: air under high pressure leaves the respiratory tract, taking mucus and foreign bodies (dust, crumbs, etc.) with it. Healthy children cough up to 20 times a day, and infants even more often.
Signs of physiological cough:
- The child is active and the cough does not interfere with his daily activities (continues to play active games when coughing is present)
- Short-term physiological cough - lasts a few seconds and does not recur soon
- Cough may recur throughout the day, but its tone and duration remain unchanged
- Absence of lethargy, temperature, preservation of appetite (no well-known symptoms characteristic of the onset of the disease)
2. If the cough is pathological in nature, attacks cause a lot of inconvenience. There are additional unpleasant symptoms, including shortness of breath. Various factors can provoke the development of cough in children. Before proceeding with treatment, it is imperative to establish the cause of this symptom, this will help to prescribe therapy most competently.
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:
- 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.
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.
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.
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.
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.
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.
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.
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.