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decongestant (Pediacare, Dimetapp, Sudafed, etc.). Cough syrup with DM ^
(dextromethorphan) will not work for this type of cough.
^
4. Soasmotic Couch - Most coughs come in bunches. If your child has
P
spasms with whooping, orhasdifficulty catching his breath call theoffice. p
n
5. Nighttime Couch - This may be due to post-nasal drip. Decongestants
pm
(Pediacare, Dimetapp) may help.
^
6. Wheezy Couch - Wheezing is defined as difficulty breathing out and may be
associated with a high pitched almost musical sound. If you feel that your
child is wheezing please contact the office. Noise that is heard when your
child is breathing in is probably due to croup. See the Sections K. Croup

and D. Bronchioiitls.

If a cough is associated with difficulty breathing (straining, pulling or working
hard to move air in and out, or increased rate of breathing) call immediately. Ifa
cough persists more than 10 days or is associated with increasing fever 3-4 days
into the illness, call during office hours.

K. Croup
Croup is a common infection, caused by a virus which primarily affects the voice
box area. The result of this infection can vary from being hoarse, to "losing your
voice" (laryngitis), to a "barking cough" that sounds like a seal. Although
frightening to hear, most children with croup require only CALM reassurance and
support. There is NO specific treatment for croup, but you can do a few things to
make your child more comfortable until the illness resolves. Although
unpredictable, croup usually lasts less than one week, and is almost always
worse at night. Some important things to know:

1. A cool mist humidifier should be used in the child's bedroom. A steam

vaporizer is not recommended because it may be accidentally knocked over
by a child and scald him. Additives like Vick's Vaporub are not better than
plain water. (REMEMBER - all humidifiers require frequent and thorough
cleaning.) Simply steaming up a closed bathroom with hot shower water is
often very helpful. Taking the child outside into the damp cool air will also
help (remember to protect your child's face from the wind).

2. Elevate the head of the bed, or have your child sleep on your shoulder,
while you stretch out in a reclining type chair. Keeping your child at about a
45 degree angle will minimize his discomfort.

3. Make sure your child drinks plenty of fluids.

4. A cough medicine with dextromethorphan (DM or Delsym) may be of some
help in a few children.

5. REMEMBER the child's bark sounds the worst at night. What is important is
not how loud the cough is, but how fast your child is breathing. If your child
Is taking more than 50 breaths (in and out counts as one breath) in a minute
please call. Restlessness, agitation or irritability should be brought to a

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