Monthly Archives: July 2014

Cough in Children: What to do ?

 

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Cough is the most common symptom and in all probabilities every child has had it once.  Important fact which I would like to share is that COUGH is a Protective reflex. It protects the spread of infection to airways in lung. But on certain occasions it needs a doctor’s visit; especially if the child is having breathing difficulty and not able to sleep at all at night.

Different types of Cough:

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Cough with barking sound:

Swelling in upper airway leads to barking cough i.e. swelling of Voice box (Larynx) or Windpipe (trachea) or whole of upper part in LTB (Croup). Croup is due to viral infection in most cases. It is sudden in onset and severe in younger kids with narrow airway. It has harsh, noisy character which occurs when child inhales.

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Cough with whistling (or musical sound):

When lower airway is involved it leads to musical or whistling sound. It can be sometimes audible from a distance too. Common causes are viral infections like Bronchiolitis in young children, WALRI & Asthma. Foreign body is also important cause in kids.

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Cough with Fever:

Cough associated with mild fever & running nose is mostly due to common cold. But if cough is associated with high grade fever and no running nose and breathing difficulty than Pneumonia needs to be ruled out. You should visit your child specialist soon.

 

Cough with vomiting:

Post tussive vomiting is very common in young children and should not be a cause a worry. As babies are not able to throw up mucus and secretions from lungs naturally by taking deep breath voluntarily, so vomiting with cough might relieve the child for some times . It occurs as cough can sometimes trigger gag reflex.

Persistent Cough:

Viral infections can last for 2 weeks. Children with asthma, allergies or chronic infections or repeated viral infections can cause persistent cough but if cough persists for more than 3 weeks than doctor visit is needed.

Prevent triggers: Cold Air, perfumes, Smoke, ice creams etc can start or prolong the cough in children.

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When is the right time to visit Child Specialist?

If your child is having any of the below features, you should contact your pediatrician

  • Fast breathing
  • Deep and effortful breathing
  • Bluish color on lips, face
  • High grade fever and no running nose
  • Young child less than 3 months old especially with fever
  • Special sound with cough. Eg Whopping cough, Stridor (noisy), musical sounds/ wheezing etc
  • Blood with cough
  • Child is very weak, irritable and cranky
  • Poor oral intake, decrease urine output and looks dehydrated.

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Expected treatment from Doctor?

Listening to the sound of cough can help doctor, besides History and clinical examinations.

Doctor should try to find the cause of cough and treat that. If it is viral infection, it will have its own course and will settle down with time only (usually around 2 weeks in children). No need of any cough syrup (medicine), unless the cough is disturbing sleep or child is coughing continuously for few minutes at a stretch and his life is disturbed significantly.

If cough medications are to be used than it is better to avoid combination drugs.

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Home remedies:

  • Honey at bed time can have soothing effect and prevent cough.
  • Warm milk with Haldi
  • Warm saline gargles
  • Steam inhalation can be given in certain cases. But in small kids , need to be very careful that they do not get burn injury with hot water. Best way is to generate steam via hot water in closed room or bathroom. And sit with your child in that room and let the child breath normally.
  • Cool-mist humidifier in your child’s bedroom might help with sleep.
  • Keep child well hydrate
  • Avoid over the counter medications and give them only on prescription of a child specialist.

 

Feel free to contact MAYA CLINiC for any queries.

Regards

Dr Rahul Varma

“Healthy Kids, Happy Family”

 

Breath-holding spells

Breath-holding spells

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Your child cries, and stops breathing, and almost turns blue. It is one of the scariest situations for parents. The episode seems life threatening but in reality, it is relatively benign (not serious). And it does not pose any risk to the health of the child.

It’s a very challenging situation for the caregiver, and needs to be handled with patience rather than panic. One thing which parents need to understand is that breath-holding spells are an involuntary reflex. The episodes usually last less than a minute (though it may seem like ages to the anxious parent), and after that the child regains consciousness and starts breathing normally.

Usual age of occurrence is from 6 months to 6 years but they can occur at earlier age too. Few cases have been reported in newborns also, but in such small babies, other factors need to be ruled out. Family history may be positive in some cases.

Episodes typically start after excessive crying.  Children usually outgrow this disease by the time they start going to school.

Breath holding spells are of two types

  • Cyanotic:  Child turns blue in face
  • Pallid:       Child turns pale, almost white

In both the cases the child stops breathing and loses consciousness for few seconds. In very rare cases seizures might occur, but these are benign and do not cause any long term harm.

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What to do if your child stopped breathing during a spell

  • Stay calm
  • While your child is in the brief unconscious phase, just check she is safe and has fallen flat on the ground
  • Remove any sharp object in vicinity which can cause damage to child.
  • Once she is awake, try to appear normal and unaffected by the whole thing.

When to See your Child Doctor

  • After first episode
  • These episodes are not harmful but proper check up and investigations might be needed to rule out underlying medical condition.
  • Consult your child specialist to determine triggers of spell and to know how to prevent future spells and how to deal with it if it happens again.

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How to prevent Future Spells

  • Try to prevent the trigger
  • You should try not to give in to tantrums of children
  • No special attention after spells, otherwise in a way we might reinforce the behavior.
  • Iron supplementation might help in decreasing the incidence, more so if child is anemic.
  • Reassure yourself and find a way to discipline your child in a way that does not provoke another spell
  • As the child grows old he develops better coping skills
  • With experience, courage and guidance from your child specialist you should be able to provide a safe and structured environment to your child.
  • In some cases when episodes are very frequent, some medications (like Piracetam) might be needed. But in most cases it can be avoided.

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Condition that should be ruled out

  • Heart conditions with rhythm disturbances like Arrhythmia etc via ECG or ECHO.
  • Anemia (Get Hemoglobin done)
  • Seizure like episodes and Seizure Disorder.

 

Feel free to contact Maya Clinic for any queries or discuss with your pediatrician.

Regards

Dr Rahul Varma