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WHY IS MY CHILD BARKING?!?!

It’s croup.

Croup is a disease that can cause swelling in the airways and possible difficulty breathing.  It’s more common in the late winter and early spring months and is typically caused by one of several viruses.  Common viruses that cause croup are parainfluenza, influenza, RSV, adenovirus and enterovirus.  It affects approximately 3% of children in the US each year, more commonly in boys than girls.  Young children under the age of 5 years are more susceptible to croup because their airways are smaller.  Croup causes swelling of the tissues in the upper airway- the larynx (voice box) and trachea (windpipe).  Croup is more common between the ages of 3 months and 5 years, peaking around age 2.  The symptoms of croup include fever, runny nose, and a distinct cough.  The cough can be harsh or barky, even “seal- like”.  Occasionally, there will also be a high pitched whistling sound when the child breathes in, called stridor.  The cough is generally worse at night, and improves in the morning. 

Most episodes of croup are mild, and can be treated at home.  Home treatment includes using a cool mist humidifier, taking the child outside in the cool, moist night air, treating the fever, offering plenty of warm fluids, and helping the child stay calm and relaxed.  It’s important to monitor their breathing closely for signs of increased work of breathing or stridor.  If a child has a high pitched sound when breathing air in, they may need additional support and should be seen by their provider or in the emergency department.  Croup generally lasts about 3-7 days, and about 85% of cases are easily treated at home.  Occasionally, if the symptoms are severe, children may require oral steroids or other inhaled medications to reduce the swelling and make breathing easier. 

Children with croup are contagious for the first three days after the symptoms appear and the fever has resolved for at least 24 hours.  If you are concerned that your child may have croup, call your provider for additional guidance and to schedule a visit if needed. 

 

 ARE YOU SEEING SPOTS?

It might be Hand, Foot, and Mouth Disease

Hand, foot, and mouth disease (HFM) is a viral illness that causes sores in the mouth, a rash on the hands, feet, face, and possibly buttocks as well as fever and irritability.  It is highly contagious and spreads quickly through daycare and school environments.  The symptoms go away on their own, but there are things parents can do at home to ease discomfort and help get everyone through the illness. 

HFM is caused by viruses in enterovirus or coxsackie families.  These viruses are most common in the summer and fall months as temperatures are warmer.  It is highly contagious and can affect up to 50% of those exposed.  Although young children are most susceptible, it can be seen at any age (we’re looking at you, mom and dad!).  It’s spread through respiratory secretions as well as the oral- fecal route, so frequent hand washing is KEY in prevention.  Children are most contagious in the days immediately preceding symptoms and while the rash is still present. 

Children with HFM often have small, red bumps on their hands, feet, and buttocks, although the rash can also be seen over other parts of the body.  The rash is not painful, rarely itchy, and does not require any treatment.  The spots will fade on their own as the virus resolves.   They may also have sores in their mouths, on their tongues, and in the back of their throat.  These small sores are ulcer- like and can be very uncomfortable.  This may cause the child to refuse food.   Offering cold liquids and over the counter pain medications like acetaminophen can ease the pain and allow them to eat and drink comfortably.  Maintaining good hydration is important with HFM, so offer plenty of fluids.  If your child doesn’t have much of an appetite for a few days, it’s okay as long as they are well- hydrated and urinating at least every six hours. 

Another hallmark of HFM is irritability!  These little angels can get CRANKY!  Offer lots of snuggles, keep them as comfortable as possible, and remember that the virus typically lasts only a few days.  HANG IN THERE!