When your baby has a cough, it’s hard to know what to do. Should you call the doctor? Give her medicine? Do nothing?
The inside story: “A cough is the body’s way of clearing and protecting the airways from irritating mucous and other secretions,” says Charles Shubin, M.D. It serves a valuable purpose. Yet coughing can also clue you in to the nature of your child’s illness.
What does your baby’s cough mean? Use this doc-approved guide to figure out what’s worrisome and what’s not based on your baby’s sound effects.
COUGH CLUES: A distinctive, shrill, dry, seal-like bark, which frequently starts in the middle of the night. “The sound is unlike any cough you’ve ever heard before,” says pediatrician Mark Widome, M.D., author of Ask Dr. Mark.
Other symptoms: Your child’s illness follows a circadian rhythm: better during the day, worse at night. She may have a slight fever. In severe cases, your child may develop stridor, a harsh, high-pitched sound every time she inhales—similar to the noise kids make after a long crying jag.
Likely culprit: CROUP, a contagious wintertime viral infection that causes the throat and windpipe to swell and narrow. It typically affects kids between 6 months and 3 years.
Dr. Mom/Dad to-do tactics/croup:
–Sit with your child in a steamy bathroom for five minutes; the humidity will help move mucus from her lungs and calm her cough.
–After that, bundle her up in warm pajamas, such as a sleep sack and “take her out into the cool night air for a few minutes or open the freezer in the kitchen and have your child breathe in the frigid air,” says pediatrician Bonnie Kvistad, M.D. The combination of steam then cool air can help reduce airway inflammation.
–At bedtime, run a cool-mist humidifier in the room; the cold, moist air may reduce airway swelling as well. Call your doctor right away if your baby is less than 2 to 3 months old, her cough worsens or she’s having trouble breathing. She may need medicine to reduce inflammation. Otherwise, croup often runs its course in three to four days.
COUGH CLUES: A wet or dry, hacking cough without wheezing or fast breathing, day or night.
Other symptoms: Sneezing, a runny nose, watery eyes, and a mild fever (usually less than 101.5 degrees F).
Likely culprit: COMMON COLD, a viral infection of the nose, sinuses, throat, and large airways of the lungs. Coughing usually lasts the entire length of the cold (about seven to ten days) but can linger twice as long, with mild improvement each day.
Dr. Mom/Dad to-do tactics/cold:
–Keep your baby’s nasal passages as clear as possible; congestion and postnasal drip worsen his cough. Use a cool-mist humidifier in the nursery to help moisten airways to reduce the coughing caused by post-nasal drip.
–Blow your baby’s nose for him with nasal saline drops and a nasal aspirator. Or, better yet, use the Nose Frida Snot Sucker, which you’ll place against your baby’s nose (not inside the nostril) to suction a runny nose. (It’s easier to clean and use than a traditional nasal aspirator.)
–Children’s Tylenol or Ibuprofen can keep him comfortable if he has a fever. Be sure to check with your doctor for the exact right dose. To administer just the right amount, the Pacidose can help. Developed by Agnes Scoville, MD, the Pacidose has a soft nipple just like a pacifier that attaches to a standard, pharmacy-calibrated oral syringe for precise measurement.
–If your child’s cough and stuffy nose persist for more than 10 days without improving, see your pediatrician. Your baby could have asthma, allergies or even enlarged adenoids, which inhibit breathing. Older kids could have sinusitis (a bacterial infection that’s often brought on by a cold).
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COUGH CLUES: Dry, hacking coughing fits—as many as 25 coughs in a single breath. When your child inhales sharply to catch her breath, she makes a high-pitched whooping sound.
Other symptoms: Before the cough starts, your child has a week of cold-like symptoms but no fever. In infants, the illness can be severe and cause mucus to bubble from the nostrils. It can also lead to convulsions and make a baby stop breathing if she gets tired.
Likely culprit: WHOOPING COUGH (also known as pertussis), a highly contagious bacterial infection of the throat, windpipe and lungs. Babies routinely get their pertussis shots 2, 4, and 6 months and additional booster at 15 months and again between 4 and 6 years. Children who haven’t received their full immunizations are most vulnerable. Adults can carry the virus and unwittingly pass it onto infants.
Dr. Mom/Dad to-do tactics/whooping cough:
–See the pediatrician if your child’s cough worsens instead of getting better after a week. Babies usually need to be hospitalized to control the cough and have mucus suctioned from their throat.
The illness is treated with antibiotics, though the cough can last for many weeks or even months. “Whooping cough is very contagious so children who are not fully immunized who have been in contact with somebody with whooping cough should see their pediatrician. They may be given prophylactic antibiotics,” Dr. Kvistad says.
COUGH CLUES: A wheezy, crackly, persistent cough after your child eats. Coughing episodes typically worsen when she’s lying down.
Other symptoms: She may feel a burning sensation or may vomit or belch when swallowing. A baby might be fussy or have been labeled as colicky. Toddlers may develop wheezing and picky eating habits.
Likely culprit: GERD (gastroesophageal reflux disease), caused by a weak or immature band of muscle between the esophagus and stomach that allows acid to flow back up. Sometimes the irritating juices can enter the lungs, causing a chronic cough.
Dr. Mom/Dad to-do tactics/GERD:
–See your pediatrician if your child’s wheezy cough lasts longer than two weeks. He may recommend keeping your baby upright for at least 30 minutes after feedings and elevating the head of her mattress while she sleeps. Prescription medicine can also control GERD symptoms.
COUGH CLUES: A phlegmy or wheezy cough that’s often accompanied by fast, shallow, or difficult breathing.
Other symptoms: Your child starts out with cold symptoms, such as sneezing or a stuffy or runny nose, that last about a week, and may develop a fever up to 103 degrees F. He’s lethargic and makes a wheezing sound when he exhales.
Likely culprit: BRONCHIOLITIS, an infection of the tiny lower airways in the lungs called bronchioles. It’s usually caused by respiratory syncytial virus (RSV).
Not to be confused with bronchitis (a frequent upper-respiratory infection in older kids and adults), bronchiolitis is common among babies and toddlers. “RSV is different than the common cold, but it’s not pneumonia.
Almost all kids will get a bout of it by age 2,” says Paul Checchia, M.D., an RSV specialist. RSV typically runs its course in five to seven days. But kids can get RSV year after year because the body doesn’t build immunity to the virus. The virus can stay alive on surfaces for hours. “You can’t put your child in a bubble so the best you can do to avoid infection is wash your hands often,” Dr. Checchia says. If soap and water isn’t available, hand sanitizer will do.
Dr. Mom/Dad to-do tactics/bronchiolitis:
–Call your pediatrician right away if your little one seems to be struggling to breathe or is too irritable to eat or drink. Infants with bronchiolitis sometimes need to be hospitalized to receive oxygen treatment.
–If your child’s symptoms are mild (a wheezy cough without breathing trouble), blow his nose for him with a Nose Frida Snot Sucker.
–Put a cool-mist humidifier in his room to help loosen mucus in his lungs, and make sure he drinks plenty of fluids (for infants–that means breast milk or formula).
COUGH CLUES: A persistent cough that’s often whistling or wheezy, lasts longer than ten days, and worsens at night or after your child exercises or is exposed to pollen, cold air, animal dander, dust mites, or smoke.
Other symptoms: Your child is wheezing or has labored, rapid breathing.
Likely culprit: ASTHMA, a chronic condition in which small airways in the lungs swell, narrow, become clogged with mucous, and spasm, making breathing difficult. Common asthma triggers include environmental irritants, viral infections, and exercise. “Children with asthma, in essence, have sensitive lungs,” says Dr. Widome. In mind asthma cases, a chronic cough may be the only symptom, Dr. Widome says.
Dr. Mom/Dad to-do tactics/asthma:
–See your doctor and mention any family history of allergy, asthma, or eczema, which can increase your child’s likelihood of the disease.
COUGH CLUES: A mildly hoarse, throaty cough that comes in frequent spells and can be either wet or dry.
Other symptoms: Your child feels listless; older children may complain that their throat is scratchy and sore, their head hurts, and the muscles in their back and legs ache. He may also have a runny nose, fever, and nausea.
Likely culprit: FLU, a viral respiratory illness that’s most common from November through April.
Dr. Mom/Dad to-do tactics/flu:
–Call your doctor if your child has a fever above 101.5 degrees F, is throwing up, has diarrhea, or is uninterested in eating or drinking (your doctor will recommend steps to prevent dehydration).
–Give your child plenty of fluids, and use a humidifier to congestion in his airways.
–To ward off future bouts of the flu, ask your pediatrician about getting your child an annual flu shot; it’s recommend for children 6 months of age and older.
Hot News: High Tech Temp Takers
A recent study underscores that rectal thermometers remain the gold standard for measuring your baby’s body temperature, especially for infant 3 months of age or younger, which is an important vital sign. A fever is 100.4 degrees F or higher. But if taking a rectal temp isn’t in your job description, the latest thermometers, such as the Temp Traq, Infanttech SmartTemp and Fever Frida–make taking your baby’s temperature whole a lot easier because they’re wearable.
How wearable thermometers work: They contain a sensor that continuously monitors your baby’s body temperature for 24 hours . They’re powered by a flexible battery and use wireless 4.0 Bluetooth technology to communicate with your mobile device through a free app (such as the Temp Traq app, the Infanttech SmartTemp app or the FeverFrida iThermometer app). If your baby’s temperature rises above a pre-determined level, you get high-temp alerts on your smart phone (iPhone or Android)
Using a wearable thermometer is easy.
Here’s the gist:
1. Press the start button on your phone to activate the thermometer and connect it to its corresponding free app.
2. To apply a wearable thermometer, stick the flexible patch thermometer under your baby’s arm. It’s similar to a Bandaid. It will monitor your baby’s temperature every 10 seconds for 24 hours.
3. Stay in range. You’ll need to stay within 40 feet of your baby to receive and review data on your phone or iPad.
4. Share your data if you want to with the pediatrician. TempTraq, Fever Frida and Infanttech SmartTemp wearable thermometers allow you to e-mail your baby’s body temperature trending data to your pediatrician.
More to Know:
Accuracy is an issue with any thermometer.
–Temp Traq has been vetted by researcher at Akron Children’s Hospital. Each TempTraq thermometer is single use and disposable. It’s a one-shot deal. TempTraq is FDA approved as a medical device.
–Infanttech’s SmartTemp thermometer has a battery with a three-year life; no charging is required. The adhesive patches that hold the SmartTemp thermometer in place are disposable. 10 adhesive package come in the complete package and they’re not sold separately, to date.
–Fever Frida is endorsed by Boston Children’s Hospital. The thermometer comes with five adhesive bandages. Additional Fever Frida adhesive patches are available.
Pros: With a wearable thermometer, there’s no need to wake your baby up to take her temperature.
Cons: These wearable wireless devices may possibly expose your baby to radiofrequency (RF) energy. Right now, RF energy is presumed to be safe. Still, before buying any wireless wearable product for your baby, the possible risks should be on your radar. Here’s some suggested, required reading. Read this too, from Consumer Reports.
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By Sandra Gordon, copyright 2016 Baby Products Mom