My experience with Croup

A little over a week ago Robbie, my 4 year old son, started coughing and had a runny nose. He didn’t have any other symptoms, but since his cough was persistent, we decided to take a COVID-19 test. It was negative, so he went back to school one he was feeling better. A few days passed, and my baby boy Antonio, who is 12 months old, started having a runny nose as the only symptom (this was 4 days after my firstborn started coughing). Antonio had a bit of a cough the next day, and I don’t recall noticing any coughing on Day 3. On Day 3 at night he went to sleep, and at midnight his situation was completely different. He had croup.

According to the Mayo Clinic, croup causes swelling of the larynx, trachea, and bronchial tubes, creating breathing difficulties, and a barking cough. Likewise, taking a breath often produces a high-pitched whistling sound (stridor). Symptoms usually worsen at night, exactly what happened to Antonio. Croup cough is medically known as laryngotracheobronchitis.

Fourth day with symptoms
At midnight, Antonio woke up crying, and each time he breathed he would have stridor, which is a wheezing sound when baby breaths in. We got him from his crib, used saline spray in his nose, he nursed, and then he fell asleep. We also placed the cold vapor humidifier on our bedside table. I placed Antonio on our bed, using my arm as his pillow so that he was a bit elevated, and so that he could breath well. At 2am he woke up crying, but this time was more alarming. He was visibly having trouble breathing, so we did some home remedies that are recommended in this case:

  1. Stay calm
  2. Use a nasal spray with saline solution and suck the boogers if you notice baby’s got a stuffy nose
  3. Take baby to the bathroom and run the shower or bath with hot water so that the steam clears their airways
  4. If it’s cold outside, bundle baby and take them outside
  5. If baby has a fever, use the proper dose of acetaminophen or ibuprofen and keep monitoring temperature

We followed the first 3 steps. Outside wasn’t cold, and we noticed that the remedies weren’t really working, so we decided to take him to the ER. We arrived at 3am, and after my baby was admitted, Robbie and papá waited in the car. Robbie had croup once when he was around Antonio’s age. We’d taken him to the clinic, and his pediatrician gave him steroids in his throat to avoid it from swelling more. Robbie, unlike Antonio, had a fever, so we had to control it at home, and we just had to wait for his body to fight the virus. We thought this would be Antonio’s case.

Emergency Room
After having waited for a while for a room for my baby, we were given one, and they started evaluating his state quickly. He neededd a dose of epinephrine and oxygen. This treatment was given to him using a nebulizer attached to the oxygen mask. It’s really hard when a baby goes through this. They don’t understand what’s going on, and they want to take off the oxygen mask. We had to hold him down and wrap him like a burrito with the help of three medical assistants and myself. Also, Antonio got a steroid shot to help his throat from swelling. The advantage of having had all this situation happen in the middle of the night is that Antonio would fall asleep at times, and I was there on the floor by his bedside comforting him any time he’d wake up.

After 3h of having gotten the treatment, the pediatrician in charge said Antonio needed one more dose of epinephrine, and that he’ll be monitored expecting improvement, but if he didn’t, they mentioned he’d have to be transferred to a children’s hospital for observation. After this dose he didn’t need more oxygen, so I had to nurse him and let him rest. This time I was able to lay down with him on the stretcher. Thanks heavens that after 3h more he was so much better. The pediatrician in charge then decided to discharge him with commitment to take him back to the ER if he worsened, and we also had to take him to the pediatrician for a follow up on Monday, since this happened on Saturday.

At home
We were lucky my brother in-law gave us a hand taking care of Robbie because my husband had to go to work, so he picked us up from the hospital. My mother in-law was on her way from Michigan to be with us in case there was an emergency. That night Antonio was really well, and he slept soundly. During the day we had given Antonio 3 steam baths, and I motivated him to drink more water, and nurse more. He also ate super well. The next day, on Day 6, my mother in-law took my sons out so that I’d shower. Antonio started having symptoms again. We think it was because of the heat. She brought them back, and I immediately took him to the bath and started running hot water. He had stridor when he was breathing, but he seemed well, and he was playing. After that he had some popsicles, nursed a lot, and he drank lots of water. It is really important to offer babies more breastmilk or formula, and to increase water intake (or breast milk) in older children.

The early hours of Day 6 we had another session of coughing with wheezing sounds and stridor. My husband spent a good chunk of time with Antonio sleeping on his shoulder on the bathroom floor. We monitored him all night and kept him vertical. In the morning we took him to the clinic to his follow up. Antonio seemed to have left that night behind, and he was looking well. His pediatrician talked to her medical team, and they said they couldn’t prescribe him more steroids. Instructions were the same, to keep giving him steam baths if needed, to offer him popsicles, and to make sure his liquid intake was good.

Antonio kept getting better, even though sometimes he has a barking cough, so typical of croup. Children between 6 months to 3 years old are more at risk when getting croup since their throats are so small. In rare cases children need to go to the ER, and it is really important to follow your instinct. Doctors told me we had done the right thing by taking him in.

If your little one starts making a weird sound when they breath (stridor) or when coughing it sounds like a barking cough, call their pediatrician. The sound of their cough and/or stridor are a sign that their larynx and trachea are swollen. If you followed the home remedies for 20-30min and you don’t see and improvement, take them to the ER, specially if your baby seems lethargic. Stridor while at rest is not normal.

 Michelle | con limón, please

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Here you’ll find some links to read more about it, and you can also hear the characteristic sound of the barking cough and stridor.

Croup (for parents) – Kid’s Health

Croup: Causes, Symptoms, Management, and Prevention – Cleveland Clinic

What is Croup? What Causes It? – WebMD LLC

Sounds of Croup – YouTube Medzcool

Mi experiencia con crup

Hace poco más de una semana Robbie, mi hijo de 4 años, comenzó con tos y con secreciones nasales. No tenía ningún otro síntoma, pero ya que la tos era persistente, decidimos tomar prueba del coronavirus para él, y mi esposo y yo. Fue negativa, así que cuando se sintió mejor regresó al preescolar. Pasaron unos días, y mi bebé Antonio, de 12 meses de edad, comenzó a tener secreciones nasales como su único síntoma (a los 4 días de que mi primer hijo presentara síntomas). Tuvo un poco de tos al día siguiente, y no recuerdo haber notado más tos en el día 3. El día 3 en la noche lo pusimos a dormir, y en la medianoche ya era un caso totalmente diferente. Tenía tos crup.

De acuerdo con la Biblioteca Nacional de Medicina de EU, crup causa inflamación en la laringe y la tráquea, trayendo consigo dificultad para respirar, tos seca con un ladrido muy característico. Los síntomas suelen empeorar en la noche, así como nos pasó con Antonio. La tos crup es médicamente conocida como laringotraqueobronquitis.

Cuarto día con síntomas
En la medianoche del cuarto día, Antonio se despertó llorando y cada vez que aspiraba presentaba estridor, que es un ruido al respirar hacia dentro. Lo levantamos, le pusimos solución salina en atomizador en su nariz, amamantó, y se durmió. También pusimos el humidificador de vapor frío en la mesa de al lado de la cama. Lo dejé en mi cama usando mi brazo como almohada para que pudiera respirar sin problemas. A las 2am se despertó llorando y esta vez fue más alarmante. Se notaba que tenía dificultad para respirar e hicimos los remedios caseros que te recomiendan en estos casos:

1. Mantén la calma
2. Usa atomizador con solución salina y aspira la nariz si escuchas que hay mocos
3. Llévalo a la regadera o baño con agua caliente corriendo para que el vapor le ayude a respirar
4. Si está haciendo frío afuera, cúbrelo bien y llévalo afuera. Verás que le ayuda
5. Si presenta fiebre, ofrécele la dosis adecuada para su edad de acetaminofén o ibuprofeno, y sigue monitoreando

Hicimos los primeros 3 pasos ya que afuera no estaba haciendo frío, y notamos que no nos estaba funcionando, así que decidimos llevarlo a emergencias. Llegamos a las 3am, y después de que admitieron a mi bebé, Robbie y papá fueron a esperar en el carro. A Robbie le había dado crup cuando tenía más o menos la misma edad que Antonio, y lo habíamos llevado a la clínica y el médico le puso esteroides en la garganta para evitar que se inflamara más. Robbie a diferencia de Antonio, sí había presentado fiebre, así que lo que hicimos fue controlorarla en casa, y esperar a que su cuerpo luchara contra el virus. Pensamos que así sería con Antonio.

En el ER del hospital
Después de esperar un rato a que hubiera un cuarto para mi bebé, pasamos y lo comenzaron a evaluar rápidamente. Necesitaba una dosis de epinefrina y oxígeno. Este tratamiento fue administrado con un nebulizador y oxígeno en mascarilla. Es difícil cuando un bebé pasa por esto. Lo único que quieren es quitarse todo de la cara, así que tuvimos que enrollarlo como burrito entre tres asistentes médicas y yo. Asimismo, le pusieron una inyección de esteroides para ayudar a que su cuerpo no inflamara más la garganta. La ventaja de haber acudido en el medio de la noche fue que Antonio se quedaba dormido por episodios, y yo estaba ahí en el piso a su lado tratando de confortarlo cuando se despertaba, y tratando de ayudar a mantener la mascarilla en su lugar.

Después de que habían pasado 3h de que había comenzado el tratamiento, el pediatra en curso dijo que necesitaría una dosis más, y que si después de las 3h volvía atrás, lo iban a tener que transferir a un hospital infantil para observación. Después de esta dosis ya no requirió oxígeno, así que le tenía que dar teta y dejarlo descansar. Esta vez me recosté con él en la camilla. Gracias al cielo después de las 3h ya se veía mucho mejor, y el médico tomó la decisión de darlo de alta con compromiso de chequeo dependiendo de su evolución, y con instrucciones de llevarlo a emergencias de nuevo si decaía, así como llevarlo tambien a la cita de seguimiento con su pediatra el lunes, ya que todo esto ocurrió en sábado.

En casa
Tuvimos la suerte que mi cuñado nos apoyara cuidando a Robbie porque mi esposo tenía que ir a trabajar, así que él nos recogió del hospital. Mi suegra venía en camino de Michigan para estar con nosotros en caso de alguna emergencia. Esa noche Antonio estuvo muy bien, y durmió tranquilamente. Durante el día hicimos 3 baños de vapor, y lo motivé a tomar más agua y teta, y estuvo comiendo súper bien. Al día siguiente, en el día 5, mi suegra llevó a los niños al parque mientras yo tomaba un baño, y Antonio decayó, creemos por culpa del calor. Lo llevé al baño de vapor, y aunque presentaba estridor él estaba jugando, y tenía buen ánimo. Le ofrecimos paleta de hielo, y mucha teta y agua. Es importante ofrecer mucha leche materna o fórmula en bebés, y aumentar la ingesta de agua (o leche materna) en mayores de 12 meses.

La madrugada del día 6 tuvimos de nuevo otra sesión de tos y estridor, y mi esposo pasó tiempo sentado en el baño con él para que pudiera estar en el vapor caliente. Lo monitoreamos toda la noche, y por la mañana lo llevamos a cita que agendé esa mañana con su pediatra. Antonio ya andaba como si nada hubiera pasado, y después de revisar y checar con su equipo médico, la pediatra dijo que no le podrían dar más dosis de esteroides. La indicación era la misma, seguir con baños de vapor de ser necesarios, ofrecerle paletas de hielo, y asegurarnos de que ingiriera suficientes liquidos. Si se presentaba el estridor teníamos que seguir los pasos mencionados, e incluso me comentó la pediatra que podría ponerlo enfrente del congelador abierto.

Antonio siguió bien, aunque de repente presenta un tosido con sonido perruno tan característico del crup. Los niños entre 6 meses y 3 años de edad están en mayor riesgo porque sus gargantas son más pequeñas. En raras ocasiones necesitan visita a emergencias, pero es importante seguir tu instinto. Los médicos en emergencias me dijeron que hicimos lo correcto al llevarlo.

Si tu pequeño comienza con un sonido extraño al aspirar (estridor) o al toser su tos suena a tos perruna, llama al pediatra. El sonido de su tos y/o el estridor indican que su laringe y tráquea están inflamadas. Si ya seguiste los remedios caseros por 20-30min y tu bebé sigue igual, llévalo a emergencias, especialmente si tu bebé se ve aletargado. El estridor sin actividad por parte de tu pequeño no es normal.

 Michelle | con limón, please

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Te dejo estos links aquí para que leas más al respecto, y para que escuches cómo es el sonido tan característico de la tos con crup, y del estridor.

El crup en su niño pequeño – Healthy Children

Crup (para padres) – Kid’s Health

Crup: Medline Enciclopedia Médica

Sonidos de crup – YouTube Medzcool

My Second Pregnancy Journey. I’m in the Third Trimester!

I can’t believe I’m in my third trimester of my second pregnancy! I sometimes feel that time goes flying but that at the same time I’m still ways away from getting to term.

I’ve been focusing my “writing energy” to write for Project Alive & Kicking blog. I was invited to write about my experiences monthly, which has made me really happy to share my journey.

Undoubtedly, each pregnancy is different, and even though experiences are similar, they’re not the exact same thing. I’m currently on week 29, and in 8 more weeks my pregnancy gets to term, and in 11 weeks I’ll reach my due date. Amazing!

Likewise, all of us in the world are experiencing the Coronavirus pandemic in different ways. In my case, my family and I have been super diligent with social distancing, and staying home. Being pregnant puts us at higher risk since our immune system goes down just because were expecting.

First Trimester

At the beginning of my pregnancy I had vaginal bleeding due to the fact that I had a subchorionic hematoma, which thanks heavens dissolved. Everything went well after that. Since March I’ve been attending my appointments on my own. Also, during the first trimester we went to an appointment with a maternal-fetal medicine (MFM) specialist. When I was pregnant with Robbie I developed a pregnancy condition called Intrahepatic Cholestasis of Pregnancy (ICP). ICP is cause by a liver disorder, and this condition makes your pregnancy a high risk one. Another reason to visit the MFM specialist was because Robbie was born prematurely, at 33 weeks. We’d talk about appropriate treatment during this pregnancy, which basically is the use of progesterone, mainly.

Second Trimester

I think that due to the pandemic, Telehealth appointments, and the progesterone treatment I started at 16 weeks, among other things, the second trimester felt endless. I started progesterone treatment since week 16 of my pregnancy to help avoid a premature birth. Robbie was born at 33 weeks without an apparent reason. Actually, a day after he was born, my previous OBGYN told me about this treatment for my following pregnancies. I get weekly shots at the clinic behind my upper arms, alternating them each week. I have to go to these appointments on my own, thanks to COVID-19.

A little bit about my experience during a Pandemic.

Third Trimester

What a blessing it is to be 28 weeks pregnant! Now I’m almost 30. I feel strong and confident that everything will keep going well for the rest of my pregnancy. I haven’t gained a lot of weight, and my OBGYN congratulated me about it. She says women struggle to gain the right amount of weight in subsequent pregnancies. Besides, it’s during this trimester that babies double or almost triple their weight! I feel this baby is tiring me even more now, haha! But well, it might be the combo of being pregnant, taking care of Robbie, and our home.

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28 weeks pregnant

Now, I can’t do anything else but to wait, and to trust everything will be OK, to keep eating as healthy as I can (obviously, without counting the occasional craving), and to stay well hydrated. Thanks heavens ICP hasn’t showed up, even though I do get itchy from now and then. I hope it all stays like it is, and I do hope that this baby stays in my belly for at least 7 more weeks!