It is definitely fall and all around the country, the temperatures are cooling off and the chill is in the air at night. With the cooler temperatures more of those pesky viruses come out and once again I am seeing croup.
Croup is a viral upper respiratory infection that causes swelling of the trachea and larynx (voice box) which causes young children to cough and at times to bark like a seal. This hoarse raspy cough is most problematic in younger children who have smaller airways. Children often go to bed at night with nothing more than a little runny nose, and then suddenly awaken with this barking cough. Many times the noise emanating from the child's room sounds more like a sick animal than your previously healthy toddler and may be alarming to both parents and the child.
Whenever you awaken to a croupy child, the first thing to do is turn on the hot shower and shut the bathroom door as you head down the hall to your child's room. After getting your child, grab several of their favorite books and head back to the steamy bathroom. Sit in the bathroom and try to calm your child down and let the steam work.
Typically in several minutes (or until the hot water runs out) their coughing should improve and they will relax. Remember, they have suddenly awakened and are trying to figure out what is going on as well so they may appear to be tired and anxious as well.
In most cases the steam and humidity will help to relax the airway. If the steam doesn't seem to be working after 5- 10 minutes try going outside into the cool night air. Many times a frantic parent will put their child into the car for a trip to the ER, only to find the child perfectly calm and no longer coughing on arrival to the hospital. The reason being, the cool air has also helped to calm the coughing.
If your child is having stridor (a high pitched squeal) when they breath in and appears to be having any respiratory distress with pulling of their ribs when they are breathing (called retractions), then you need to call your doctor. If they are coughing and turning bright red while coughing be reassured that they are still moving air well. You should not see any duskiness or blue color and if you do call 911. (Remember the adage blue is bad, and red is good).
If by morning your child is having continued symptoms you may want to see your doctor as steroids (given orally or by injection) may be used to help shrink the airway swelling. Most cases of croup do not require hospitalization. After several days of croup your child will probably be well.
Lastly, older children and adults may also get the virus that causes croup, but with larger airways will simply show signs of laryngitis and being hoarse.
That's your daily dose for today. I'm Dr. Sue Hubbard from The Kid's Doctor.
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I recently received a question from a Twitter follower related to cradle cap and dandruff. She wanted to know if there was a difference in the two.
You know there really isn't as they are both to...
You know there really isn't as they are both due to seborrheic dermatitis, an inflammatory condition of the skin in which the skin overproduces skin cells and sebum (the skins natural oil).
Cradle cap is the term used for the scaly dermatitis seen on the scalp in infants. It is also seen on the eyelids, eyebrows, and behind the ears. It is typically seen after about three months of age and will often resolve on its own by the time a baby is eight to 12 months old. It is usually simply a cosmetic problem for a baby as it looks like a yellowish plaque on a baby's scalp and is often not even noticed by anyone other than the parents.
Unlike seborrheic dermatitis in adults, cradle cap typically doesn't itch. It is thought that cradle cap may occur in infancy due to hormonal influences from the mother that were passed across the placenta to the baby.
These hormones cause the sebaceous glands to become over active. In some severe cases an infant's scalp becomes really scaly and inflamed and causes even more parental concern, as it appears that the infant is uncomfortable and may be trying to scratch their head by rubbing it on surfaces.
The treatment for cradle cap is to wash the baby's scalp daily with a mild shampoo and then to use a soft comb or brush to help remove the scales once they have been loosened with washing. When washing the head make sure to get the shampoo behind the ears and in the brows (keeping the soap out of baby's eyes).
This is usually sufficient treatment for most cradle cap. In situations where the greasy scales seem to be worsening it may help to put a small amount of mineral oil or olive oil on the baby's head and let it sit (I left a small amount on my children's heads overnight) and then to shampoo the following day. The oil will help the scales to loosen up and come off more easily.
For babies that have very inflamed irritated cradle cap a visit to your pediatrician may be warranted to confirm the diagnosis. In persistent cases I often recommend shampooing several times a week with a dandruff shampoo that has either selenium (Selsun) or zinc pyrithione (Head and Shoulders) making sure not to get any in the infant's eyes. I may then also use a hydrocortisone cream or foam on the scalp that will lessen the inflammation and itching. In these cases it may take several weeks to totally clear up the problem.
As children get older, especially during puberty, you may see a return of seborrhea as dandruff. Again you can use dandruff shampoos. It also seems that with the overproduction of sebum there is an overgrowth of a fungus called malessizia so using a shampoo for dandruff as well as a antifungal shampoo (Nizoral) often works.
I have teens alternate different shampoos, as sometimes it seems to work better than always using the same shampoo for months on end. Teens don't like white flakes falling from their scalp and unlike a baby, a teen is worried about the cosmetic issues of seborrhea!
That's your daily dose, we'll chat again tomorrow.
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