My Baby Is Sick... What is RSV?

When children are sick our mommy (and grandma) senses are on high alert, especially if the child is small. You take your baby to the doctor or the ER and he/she tests positive for something called "RSV"... what the heck is RSV? 

Respiratory syncytial virus (RSV)
Respiratory syncytial virus (RSV) is a very common virus that leads to mild, cold-like symptoms in adults and older healthy children. It can be more serious in young babies, especially those in certain high-risk groups, such as premature infants, very young infants, or a child with health conditions that affect the lungs, heart or immune system. 

Respiratory syncytial virus (RSV) causes mild, cold-like symptoms in adults and older healthy children. It can cause serious problems in young babies, including pneumonia and severe breathing problems. Premature babies and those with other health problems have the highest risk. A child with RSV may have a fever, stuffy nose, cough, and trouble breathing. Lab tests can tell if your child has the virus. There is no specific treatment. You should give your child fluids to prevent dehydration. If needed, you can also give a pain reliever (not aspirin) for fever and headache.

RSV easily spreads from person to person. You can get it from direct contact with someone who has it or it by touching infected objects such as toys or surfaces such as countertops. Washing your hands often and not sharing eating and drinking utensils are simple ways to help prevent the spread of RSV infection. There is currently no vaccine for RSV.

(Centers for Disease Control and Prevention)

Quick Facts

• RSV typically causes cold-like symptoms such as a runny nose, cough, and congestion. Fevers are common. The infection can progress to the lower respiratory tract to cause more severe illness such as bronchiolitis (inflammation of the small airways in the lung) or pneumonia in otherwise healthy infants and young children.
• RSV is highly contagious through close contact with infected people, and it can live on toys and other surfaces for several hours.
• Most children will have an RSV infection by the time they are 2 years old, and most will get better on their own within 8 to 15 days.
• Every year, 75,000 to 125,000 children in the United States are admitted to the hospital for RSV infections.
• For most children, fluids are the best treatment. Bronchodilators, medicines prescribed to help reduce airway resistance, may ease breathing in some cases. Antibiotics do not work against RSV, but a healthcare provider may prescribe them for complications that develop because of RSV.
• Although deaths are relatively rare, RSV can be life-threatening for immune-compromised people, including premature infants, young children with heart and lung problems, and the elderly.
• Researchers are working toward a vaccine, but none currently exists.

What can I do, I feel helpless.

Having a small child that is sick can leave you feeling helpless, they are so pitiful and feel so bad.

Here are some things you can do to help them feel better:

• Give plenty of fluids. Avoid dairy - tends to thicken secretions and from my experience it will come back up a lot faster (yuck) If you breastfeed, continue to nurse.. breast-milk is healing and hydrating for little ones. 
• Use a cool-mist humidifier/vaporizer during the winter months to keep the air moist. (Be sure to clean the vaporizer regularly.) Cool mist, not warm (warm mist grows more bacteria faster)
• Blow little noses frequently (or use a nasal aspirator for infants). You need a really good nasal aspirator or "booger sucker", as the nurse at the pediatricians office or the ER for a good one. Keeping nasal passages clear will make small children feel much better, if they can't suck, they will be very unhappy. 
• Give non-aspirin pain reliever, such as acetaminophen. Aspirin should not be used because it has been linked to Reye syndrome, a disease that affects the brain and liver.
• Home remedies such as essential oils may help ease the symptoms, make sure to dilute these for small children and ask your homeopathic dr or pediatrician for recommendations. Use a diffuser at night and rub essential oil on child's feet to aid absorption (a little goes a long way with infants)  
• Plenty of cuddling with mommy and daddy will make them feel safe and soothe their fears. 

When to Call the Doctor or Visit the ER

Children may need treatment if they show any of the following symptoms:

• Great difficulty or fast breathing
• Excessive wheezing or high pitched noises
• Retractions, sucking in of chest wall or under sternum
• Gray or blue skin color
• High fever - greater than 101 or number your pediatrician has given you
• Thick nasal discharge that is yellow, green, or gray
• Worsening cough
• Extreme tiredness (especially during times they are normally active)
• No wet diapers in 8 hours or more
• Anything you think is abnormal, you are the best judge of your child

I hope this helps you as a parent, grandparent or nurse. Education can empower us and make us feel more in control of scary situations. 

Croupy cough- Barking noises, nighttime surprises

Croup seems to be on the rise early this season. I have seen many children brought into the Emergency Department with this scary ailment. Most commonly seems to awaken kids at night with this horrible sounding seal like barking noise. If you have ever heard a croupy cough or stridor coming out of a small child's mouth you will remember it well.
If your child wakes up barking loudly do you need to bring them to the Emergency Room? Well, that's a very good question. Not all children need to be rushed to the ER for a croupy cough. You can try a couple of things at home first.
Ask yourself these things first 

• Does my child have a high fever? ( check it rectally if they can not hold the thermometer in their mouth well, of course you are the parent and you know when your child has a temp. Go ahead and medicate them for fever, it will help with discomfort also. 
• Does my child have any breathing trouble, like retractions (look at them with no shirt on, does it seem like they are sucking in hard to breath?
• Does my child have stridor-- a high pitched noise when they breath, not just the barky cough?
• Are you freaking out and just don't know what to do (its ok if you are, better to bring them in to be checked out than not)

OK-- If your child is limp, lethargic and turning blue around the lips, call 911!! 

IF your child is happy, playful, and looks normal, but still has that terrible sounding cough- take a deep breath and calm down, its gonna be just fine.

Try these methods at home if your child seems ok at home first:

• Turn on the shower water to hot--get the bathroom nice and steamy (of course don't put your child in the hot water) take your child in the bathroom and stay with them, help them to breath in the nice steamy air in the bathroom for around 5-10 min or so.
• Take them immediately outside into the cool nighttime air (its ok, you are not gonna make them sicker doing this--no matter what your grandma told you) 
• The alternating of the steam and the cool air will most of the time help stop the bronchospasm-like coughing  and help them calm down and settle back to sleep.
• Don't medicate your child with any sedating cough syrups, alcohols or home remedies. Cool mist vaporizers or humidifiers in their room is fine. I use the old Vicks vapor rub on their chest and feet remedy myself (unless they are infants)
• Call your peds doctor or advice line if you want more advice before traveling to the ER, they are a wealth of good information.

So What is Croup?? 

Croup is a condition that causes an inflammation of the upper airways — the voice box (larynx) and windpipe (trachea). It often leads to a barking cough or hoarseness, especially when a child cries.

Most cases of croup are caused by viruses, usually parainfluenza virus and sometimes adenovirus or respiratory syncytial virus (RSV).Viral croup is most common — and symptoms are most severe — in children 6 months to 3 years old, but can affect older kids too. Some children are more prone to developing croup when they get a viral upper respiratory infection.

Most cases of viral croup are mild and can be treated at home. Rarely, croup can be severe and even life threatening.

The term spasmodic croup refers to a type of croup that develops quickly and may happen in a child with a mild cold. The barking cough usually begins at night and is not accompanied by fever. Spasmodic croup has a tendency to come back again (recur).

Treatment of symptoms is the same for either form of croup.

Signs and Symptoms

At first, a child may have cold symptoms, like a stuffy or runny nose and a fever. As the upper airway (the lining of the windpipe and the voice box) becomes more inflamed and swollen, the child may become hoarse, with a harsh, barking cough. This loud cough, which is characteristic of croup, often sounds like the barking of a seal.

If the upper airway continues to swell, it becomes even more difficult for a child to breathe, and you may hear a high-pitched or squeaking noise during inhalation (called stridor). A child also might breathe very fast or have retractions (when the skin between the ribs pulls in during breathing). In the most serious cases, a child may appear pale or have a bluish color around the mouth due to a lack of oxygen.

Symptoms of croup are often worse at night and when children are upset or crying. Besides the effects on the upper airway, the viruses that cause croup can cause inflammation farther down the airway and affect the bronchi (large breathing tubes that connect to the windpipe).

Hope this helps you understand Croup a little better, have questions? Feel free to post in the comments.

RSV : What is it? Is my child going to be ok?

credit to KidsHealth.org 

About RSV

Respiratory syncytial virus (RSV), which causes infection of the lungs and breathing passages, is a major cause of respiratory illness in young children.

In adults, it may only produce symptoms of a common cold, such as a stuffy or runny nose, sore throat, mild headache, cough, fever, and a general feeling of being ill. But in premature babies and kids with diseases that affect the lungs, heart, or immune system, RSV infections can lead to other more serious illnesses.

RSV is highly contagious and can be spread through droplets containing the virus when someone coughs or sneezes. It also can live on surfaces (such as countertops or doorknobs) and on hands and clothing, so it can be easily spread when a person touches something contaminated.

RSV can spread rapidly through schools and childcare centers. Babies often get it when older kids carry the virus home from school and pass it to them. Almost all kids are infected with RSV at least once by the time they're 2 years old.

RSV infections often occur in epidemics that last from late fall through early spring. Respiratory illness caused by RSV — such as bronchiolitis or pneumonia — usually lasts about a week, but some cases may last several weeks.

Doctors typically diagnose RSV by taking a medical history and doing a physical exam. Generally, in healthy kids it's not necessary to distinguish RSV from a common cold. But if a child has other health conditions, a doctor might want to make a specific diagnosis; in that case, RSV is identified in nasal secretions collected either with a cotton swab or by suction through a bulb syringe.

Preventing RSV

Because RSV can be easily spread by touching infected people or surfaces, frequent hand washing is key in preventing its transmission. Try to wash your hands after having any contact with someone who has cold symptoms. And keep your school-age child with a cold away from younger siblings — particularly infants — until the symptoms pass.

To prevent serious RSV-related respiratory disease, at-risk infants can be given a monthly injection of a medication consisting of RSV antibodies during peak RSV season (roughly November to April). Because its protection is short-lived, it has to be given in subsequent years until the child is no longer at high risk for severe RSV infection. Ask the doctor if your child is considered high risk.

Treating RSV

Fortunately, most cases of RSV are mild and require no specific treatment from doctors. Antibiotics aren't used because RSV is a virus and antibiotics are only effective against bacteria. Medication may sometimes be given to help open airways.

In an infant, however, an RSV infection can be more serious and may require hospitalization so that the baby can be watched closely. He or she may require fluids and possibly treatment for breathing problems.

At home, make a child with an RSV infection as comfortable as possible, allow time for recovery, and provide plenty of fluids. The last part can be tricky, however, because babies may not feel like drinking. In that case, offer fluids in small amounts at more frequent intervals than usual.

To help your child breathe easier, use a cool-mist vaporizer during the winter months to keep the air moist — winter air can dry out airways and make the mucus stickier. Avoid hot-water and steam humidifiers, which can be hazardous and can cause scalding. If you use a cool-mist humidifier, clean it daily with household bleach to discourage mold.

If your child is uncomfortable and too young to blow his or her own nose, use a nasal aspirator (or bulb syringe) to remove sticky nasal fluids.

Treat fever using a nonaspirin fever medicine like acetaminophen. Aspirin should not be used in children with viral illnesses, as such use has been associated with Reye syndrome, a life-threatening illness.

When to Call the Doctor

Call the doctor if your child has any of these symptoms:

• high fever with ill appearance
• thick nasal discharge
• worsening cough or cough that produces yellow, green, or gray mucus
• signs of dehydration
• trouble breathing

In infants, besides the symptoms already mentioned, call the doctor if your baby is unusually irritable or inactive, or refuses to breastfeed or bottle-feed.

Seek immediate medical help if you feel your child is having difficulty breathing or is breathing very rapidly, is lethargic, or if his or her lips or fingernails appear blue.

Reviewed by: Catherine L. Lamprecht, MD
Date reviewed: September 2012

Yes most often with early recognition of symptoms and visit to your doctor, your child will probably be just fine. Keeping them comfortable and hydrated will be your challenge. Try your best to keep them at home so not to spread the virus to others or have them pick up other infections while they are already sick and their little immune systems and down. 

The ER is not the place for them unless you have a true emergency, trouble breathing, fever that will not come down with Tylenol/Motrin, lethargic or listless, not peeing or wetting diapers for 8 hrs or more, blue lips or nailbeds. Attempt to call or consult your peds doctor via the phone first before you come to the ER, they might have suggestions for you instead.