Category: Infants and Toddlers

Acute Bronchitis

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What is acute bronchitis?
Acute bronchitis is inflammation of your bronchial tree. The bronchial tree consists of tubes that carry air into your lungs. When these tubes get infected, they swell and mucus (thick fluid) forms inside them. This makes it hard for you to breathe.

Acute bronchitis only lasts a short time (several weeks or less). Chronic bronchitis is long lasting and can reoccur. It usually is caused by constant irritation, such as from smoking.

Symptoms of acute bronchitis
The symptoms of acute bronchitis can include:

sore throat
fever
cough that brings up clear, yellow, or green mucus
chest congestion
shortness of breath
wheezing
chills
body aches.
Your cough can last for several weeks or months. This happens because the bronchial tree takes a while to heal. A lasting cough may signal another problem, such as asthma or pneumonia.

What causes acute bronchitis?
Viruses most often cause acute bronchitis. They attack the lining of the bronchial tree and cause inflammation. The same viruses that cause colds can cause acute bronchitis. You can catch a virus from breathing it in or skin contact. As your body fights these viruses, swelling occurs and mucus is produced. It takes time for your body to kill the viruses and heal damage to your bronchial tubes.

Lesser-known causes are bacteria or fungal infections. Exposure to irritants, such as smoke, dust, or fumes, also can cause acute bronchitis. You are at greater risk if your bronchial tree already has damage. If you have GERD (gastroesophageal reflux disease), also known as heartburn, you can get acute bronchitis when stomach acid gets into the bronchial tree.

How is acute bronchitis diagnosed?
Your doctor can confirm acute bronchitis. They will do a physical exam and review your symptoms. They might order an X-ray to rule out pneumonia.

Can acute bronchitis be prevented or avoided?
You can help prevent acute bronchitis by staying healthy and avoiding germs. Wash your hands often to kill any viruses. If you smoke, the best defense against acute bronchitis is to quit. Smoking damages your bronchial tree and puts you at risk for infection. Smoking also slows down the healing process.

Acute bronchitis treatment
Most cases of acute bronchitis can be treated at home.

Drink fluids, but avoid caffeine and alcohol.
Get plenty of rest.
Take over-the-counter pain relievers to reduce inflammation, ease pain, and lower your fever. Acetaminophen (Tylenol) also helps ease pain and lower your fever.
Use cough medicine, if your child is age 6 or older.
Increase the humidity in your home or use a humidifier.
Do not hold in a cough that brings up mucus. This type of cough helps clear mucus from your bronchial tree. If you smoke, you should quit. It will help your bronchial tree heal faster.

Antibiotics do not help treat viruses. They can help treat cases caused by bacterial infections. Some people who have acute bronchitis need medicine that treats asthma. You might need this if you are wheezing. It can help open your bronchial tubes and clear out mucus. You usually take it with an inhaler. An inhaler sprays medicine right into your bronchial tree. Your doctor will decide if this treatment is right for you.

Living with acute bronchitis
Most cases of acute bronchitis go away on their own. You should call your doctor if:

You continue to wheeze and cough for more than 2 weeks, especially at night when you lie down or when you are active.
You continue to cough for more than 2 weeks and have a bad-tasting fluid come up into your mouth. This may mean you have GERD. This is a condition in which stomach acid gets into your esophagus.
Your cough produces blood, you feel weak, you have an ongoing high fever, and you are short of breath. These symptoms may mean you have pneumonia.
Questions to ask your doctor
What is causing my acute bronchitis?
Are there over-the-counter medicines or prescriptions that can help relieve my symptoms?
Am I contagious?
Am I at risk for getting pneumonia or other lung infections?
What should I do if my couth doesn’t respond to treatment or gets worse?
Resources
American Lung Association, Acute Bronchitis

Abusive Head Trauma

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What is abusive head trauma?
Abusive head trauma is also called shaken baby syndrome. It’s a form of child abuse that can be deadly or leave a baby seriously injured for a lifetime. Most often, victims of this kind of abuse are less than 1 year old, but it can happen with children up to age 5.

Symptoms of abusive head trauma
A severe case of abusive head trauma in your baby or young child can cause unconsciousness, seizures, or shock.

Other initial symptoms of abusive head trauma can include the following:

vomiting
irritability
unusual drowsiness
trouble sucking or swallowing
no interest in eating
stiff appearance
changes in consciousness
no smiling, babbling, or talking
differently sized pupils
inability to lift his or her head
inability to focus eyes or track movement
In many cases, abusive head trauma also leaves a child with long-term problems that affect him or her physically and intellectually. A survivor of abusive head trauma may be dependent on medical, special education, and social services for the rest of his or her life.

What causes abusive head trauma?
Abusive head trauma happens when a baby is shaken violently, hit in the head, thrown, or dropped on purpose. It usually happens at the hands of an overwhelmed parent or caregiver who can’t cope with a baby’s long periods of crying and the demands of caring for a young child.

Violently shaking a young child or hitting him or her in the head causes the child’s brain to shake back and forth inside the skull. This is especially true in babies whose neck muscles aren’t fully developed. The movement causes your child’s brain to swell, bruise, and bleed from the tearing of blood vessels, nerves, and tissue.

How is abusive head trauma diagnosed?
You should go to the emergency room right away if you suspect your child is suffering from abusive head trauma. Because some symptoms of abusive head trauma (for example, vomiting or irritability) are also common in other illnesses, it is important for the doctor to know if your child may have been shaken or hit in the head. The doctor will ask questions about what happened. Unfortunately, the person responsible for the abuse may not be honest about his or her actions.

The doctor will use a number of visual clues and tests to make the diagnosis and find out how severe the damage is. Visual clues include checking the child’s eyes for bleeding; looking for marks on the skull, arms, or legs; and checking for bruises around the child’s neck or chest. Certain imaging tests (for example, an X-ray, CT scan, or MRI) can show evidence of swelling or bleeding in the brain. These tests also can show skull or rib fractures.

Can abusive head trauma be prevented or avoided?
Because this happens due to a caregiver’s actions, it is absolutely possible to prevent abusive head trauma. It is important for everyone who takes care of your baby or young child to learn how to handle stressful situations (for example, when your baby cries for a long time).

One way to handle stress is taking several deep breaths, finding a safe place for your child (for example, the crib), and walking to another room for 10 to 15 minutes to calm yourself. When you feel out of control, call a friend or family member to help with your child or help you regain control. Understanding the consequences of abusive head trauma can help you take an active role in preventing this with your child.

Soothing a crying baby is not easy. However, there are a number of things you can try to calm the baby, including the following:

sing
rock
swaddle
take him or her for a ride or a walk
offer a bottle or pacifier
breastfeed
lay the baby on his or her stomach across your lap and gently rub or pat the baby’s back
Combining these strategies with “white noise” or rhythmic sounds (for example, music, a hair dryer, or a clothes dryer) can help. You also can try putting your child down for a nap on his or her left side to help with digestion, or on his or her back. If all else fails, be sure to consider whether your child could be sick. Call your doctor for advice.

If you have a caregiver for your child, it’s important to teach your caregiver about the dangers of shaking a baby or young child. Be sure he or she knows what to do if he or she feels stressed while caring for your child. Choose a caregiver carefully and continue to monitor your child’s safety under his or her care.

Abusive head trauma treatment
For more mild cases of abusive head trauma, your child may need medicine, a hospital stay, and at-home observation. In the most severe cases, treatment may begin in the hospital emergency room or operating room with life-saving steps. These steps might include inserting a breathing tube down your child’s throat or doing surgery to stop bleeding or reduce swelling in your child’s brain.

Living with abusive head trauma
Depending on how severe the trauma is, your child may have to be monitored over time. Survivors of abusive head trauma may suffer long-term health problems, such as:

permanent hearing loss
visual impairment (including blindness)
seizures
developmental, speech, and academic delays
severe intellectual disability
memory and attention challenges
cerebral palsy
Questions to ask your doctor
How can I tell whether my baby’s symptoms are caused by abusive head trauma or a normal illness?
Can brain damage be reversed?
What are some local resources for helping parents cope?
Resources
The National Center on Shaken Baby Syndrome