FAQ

Respiratory Problems (See Also URI, Coughs)

Shortness of Breath at Night (Spasmodic Croup)

Occasionally a child will be put to bed well or mildly ill and awaken at night very scared and short of breath. He/She may have difficulty breathing and make a sound when he breathes in that many parents call "wheezing" but is actually something called stridor. Sometimes there will be a barky cough. This is called spasmodic croup. Often a family dashes to the emergency room only to arrive with a well appearing child who no longer has symptoms. Treatment consists of the following:

Calm the child as much as possible
Offer sips of a clear cool liquid
If the symptoms persists have the child sit in the cool night air for a few minutes
A bathroom full of water vapor from a steam shower or warm tub is another way to try to break the spasm
Call 911 or go to the ER if the shortness of breath is accompanied by high fever or seems progressively worse.

Croup (See Also Croup and Bronchiolitis)

Typical viral croup comes on more slowly than above with runny nose, hoarseness, a cough that initially sounds productive and then becomes more brassy developing into a seal or dog like bark. Treatment consists of

Tylenol or Advil for discomfort or fever
Encourage liquids, do not worry about solids
Increase humidity using a vaporizer or humidifier.
Frequent baths or showers especially before bedtime will offer some relief
For more some cases physicians sometimes prescribe oral steroids
Severe cases may require hospitalization and oxygen
Go to the emergency room if your child is listless, a bluish tint to his lips, or has great difficulty breathing using extra muscles just to breathe.

Wheezing (See Also Croup and Bronchiolitis)

Many people mistake the stridor of croup for wheezing. Stridor is a noise that is more predominant when breathing in. Wheezing is a higher pitches musical noise that is more predominant on exhalation. Generally children who wheeze have a frequent chesty chough and the chest may seem to rattle. Follow the treatment suggestions for croup. If you have albuterol available this can also be used. (See Medication doses). Seek emergency care if:

a child under one year is breathing faster than 60 times a minute
a toddler is breathing over 50 times a minute
your child is grunting with respirations
your child is listless and uncomfortable with the wheezing
your child choked on something and wheezing began immediately after choking

Pneumonia

Think about pneumonia in the following circumstances

a young child with wheezing who also has high fever--particularly if this occurs several days into the illness
grunting respirations and high fever
high fever and chest pain or pain in the back in an older child

Sore Throats

Children may complain of pain or a raw feeling. Children less than 2 years of age usually don't know how to complain about a sore throat and may refuse to eat or drink.

Most sore throats are caused by viruses that will resolve in a few days. The is particularly true in the summer.

How do I tell whether it is strep? (See Strep).

Treatment of sore throats:

Give Tylenol or Advil for pain
A young child's sore throat can be helped with warm broth or apple juice
Children over age 4 can use throat lozenges or sprays.
A child who is old enough may gargle with salt water or swish chilled benadryl or antacids around and then spit it out.

If the sore throat is strep, the child can return to school after 24 hours on antibiotics. Most children with sore throat can return to school/childcare when fever is gone and feeling better.