Croup is an often-suprising middle-of-the-night malady that produces a barky seal-like cough in children who seemed just fine at bedtime.
Any virus that causes cold-like symptoms of runny nose, cough, runny eyes, and sometimes fever, can also cause croup. Think parainfluenza, influenza (flu), RSV, adenovirus, rhinovirus, and now Covid-19. Any of these viruses can land in a child’s larynx, or voice box, and cause hoarseness, barky cough, and a weird gutteral sound on breathing inward, called “stridor.” Croup is the name we give the constellation of symptoms, not the name of the virus that causes it.
An adult with the same exact illness would sound hoarse, but would likely not have the strange barky cough or noisy breathing.
We have a great podcast on this subject, but for those who prefer to read medical advice, please read on.
Ways to help your child when they wake up with croup
Have you wondered, when your child gets a headache or suffers a sprained ankle, if you should give your child ibuprofen (e.g. brand names Motrin or Advil) or acetaminophen (e.g. brand name Tylenol)? What about for those middle-of-the-night fevers? Does it matter which one you give?
“My daughter called me from the stairwell of her dorm crying.”
“My son is texting me and wants to come home for the weekend. What would you do?”
“Does anyone else have a kid who is struggling?”
These are quotes from actual parents, posted in online forums for the collegiate Class of 2025. After the stressful application process during the pandemic, the preparation, the move-in process, and the emotional goodbyes, many adults are blindsided by the homesickness that their newly minted freshmen may experience. This issue is not just limited to freshmen. Students who spent last year doing college virtually may be away from home for the first time. Seeing our children unhappy after so much eager anticipation leads to worry, sadness, and a general uncertainty among us parents about what to do. This bodes the question: How do we best support homesick kids?
A recent article written by Amy Baldwin, founder of Higher Ed Parent, talks about what she describes as “the three pillars of a satisfying and successful college experience” – Emotional Support, Social Support, and Academic Support. Having worked with many teens and college students in my practice, I agree that these areas are all essential for a smooth transition to and overall positive experience of college life. While we want to foster independence in our young adults, we most likely will need to guide them through building each of these pillars.
Wondering what to do when your child has a fever? With schools and daycares now back in full swing, many more illnesses are circulating. Please read our fever advice in the Children’s Hospital of Philadelphia Health Tip with updates on what do do when your child has a fever.
More often than not, splinters are teensy-weensy and too small to grab with tweezers. Wondering how to remove tiny splinters? If the splinters in your child are near the skin surface and do not cause much discomfort, simply soak the affected area in warm soapy water several times a day for a few days. Fifteen minutes, two or three times a day for four days, works for most splinters.
Our bodies in general dislike foreign invaders and try to evict them. Water will help draw out tiny splinters by loosening up the skin holding the splinter. Soaking works well particularly for multiple hair-like splinters such as the ones obtained from sliding down an obstacle course rope. A helpful old home remedy is to put a paste of baking soda and water over the splinters for a few hours, which also softens the skin around a tiny splinter. Oil-based salves such as butter will not help pull out splinters. However, an over-the-counter hydrocortisone cream will help calm irritation and a benzocaine-based cream (for kids over two years of age) can help with pain relief.
If a splinter seems easy to grab, then first gently wash the area with soap and water and pat dry. Don’t soak an area with a “grab-able” wooden splinter for too long because the wood will soften and break apart. Next, wash your own hands and then clean a pair of tweezers with rubbing alcohol. Use the tweezers to grab hold of the splinter and with the tweezers pull smoothly. Take care to avoid breaking the splinter before it comes out.
If the splinter does break, or if you cannot easily grab the splinter’s end because it does not protrude from the skin, here is another approach:
Sterilize a sewing needle by first boiling it for one minute.
Next, clean the needle with rubbing alcohol.
Wash the area with the splinter well.
Using the sterilized needle, pick away at the skin directly above the splinter. Use a magnifying glass if you have to, make sure you have good lighting, and for those middle-age parents like us, grab those reading glasses.
Be careful not to go too deep- you will cause bleeding which makes visualization impossible.
Continue to separate the skin with the needle gently until you can nudge the splinter out with the needle or grab it with your tweezers.
Since any break in the skin is a potential source of infection, after you remove the splinter, wash the wound well with soap and water. Flush the area with running water to remove any dirt that remains in the wound. See our post on wound care for further details on how to prevent infection. If the splinter is particularly dirty or deep, make sure your child’s tetanus shot is up to date. Also, watch for signs of infection over the next few days: redness, pain, or thick discharge from the wound are all reasons to take your child to his doctor for evaluation.
Some splinters are just too difficult for parents to remove. If you are not comfortable removing it yourself of if your child can’t stay still for the extraction procedure, head over to your child’s doctor for removal.
The splinter near the baby’s eye pictured above did not bother her, but it certainly frustrated the child’s mom and the Emergency Room doctors who finally plucked it out.
Our social media feed is full of parents trading ideas on what to pack for college. In honor of all of those who are taking a leap into the collegiate world, including Dr. Kardos’s own children, we share again the letter Dr. Lai wrote for her child the night before kindergarten. As Gretchen Rubin said, “the days are long but the years are short.” As time moves forward, your child’s transitions may differ, yet they still will feel the same.
As we sit, the night before kindergarten, your toes peeking out from under the comforter, I notice that your toes are not so little anymore.
Tomorrow those toes will step up onto to the bus and carry you away from me. Another step towards independence. Another step to a place where I can protect you less. But I do notice that those toes have feet and legs which are getting stronger. You’re not as wobbly as you used to be. Each time you take a step you seem to go farther and farther.
I trust that you will remember what I’ve taught you. Look both ways before you cross the street, chose friends who are nice to you, and whatever happens don’t eat yellow snow. I also trust that there are other eyes and hearts who will watch and guide you.
But that won’t stop me from worrying about each step you take.
Won’t stop me from holding my breath.
Just like when you first started to walk, I’ll always worry when you falter.
I smile because I know you’ll hop up onto the bus tomorrow, proud as punch, laughing and disappearing in a sea of waving hands. I just hope that at some point, those independent feet will proudly walk back and stand beside me.
Maybe it will be when you first gaze into your newborn’s eyes, or maybe it will be when your child climbs onto the bus.
This spring, kids with allergies are scratching their noses, and parents are scratching their heads. With the overlap of allergy symptoms and COVID symptoms, many parents wonder how to tell the difference between COVID and allergies. While there is an overlap in symptoms between allergies and viruses (COVID or otherwise), there are a few distinguishing features:
Itchy nose, itchy eyes, itchy throat. If your child is doing a lot of facial rubbing or throat clearing, you can more confidently blame allergies. If needed, treat these annoying itches with allergy medicine such as cetirizine (brand name Zyrtec), loratadine (brand name Claritin), or fexofenadine (Brand name Allegra). You can also read our prior post about spring allergies. Allergy medicine does not improve these symptoms if your child has a virus.
You find cottage cheese like curds coating the inside of your baby’s tongue and inner cheeks and try to wipe them off to no avail. It’s not breast milk, not formula. It’s thrush.
Thrush, fancy medical name Oral Candidiasis, is caused by an overgrowth of yeast, called Candida. Although not painful, it may cause discomfort akin to having a film of cotton coating the inside the mouth.
We ALL have yeast, which is a type of fungus, on our bodies. Usually we have enough bacteria on our bodies to suppress the growth of yeast, but in cases when there is less than usual bacteria present such as in young babies or in kids who are on antibiotics, Candida can emerge. For older kids using inhaled steroids for asthma, failure to rinse out the mouth after medication use also promotes an environment conducive to thrush.