The Year of the Barking Seal

Leave a comment

Have you ever woken up in the middle of the night, certain that your child has been replaced by a barking seal? If so, you’ve experienced croup. You can hear an example at

Croup, otherwise known as laryngotracheobronchitis, is inflammation around the vocal cords. In its mildest form, the child experiences a barky cough; in its worst form, the swelling closes off the airway and requires a breathing tube until the inflammation is resolved.

What causes it? It can be caused by a number of viruses, including RSV and influenza, but the vast majority are caused by parainfluenza virus. There are 4 types or strains of paraflu, and parainfluenza 1 is responsible for most major outbreaks. For reasons that are not entirely clear, the outbreaks occur in the fall of odd numbered years. Hence this year is the year of the Barking Seal.

Most children start with a runny nose and the cough becomes more barky on the second and third days of illness. The croupy sound is usually worse late at night. Again, the reason is not clear; some people say it’s because the body’s natural steroid levels are lowest in the early morning, others say it’s because gravity can’t help drain the swelling when the child is lying down,

If your child develops a barky cough, give him or her a dose of ibuprofen to help reduce the inflammation. Sometimes taking the child out in the cold air helps. Despite the numerous references in parenting magazines and even old medical textbooks, there is no proof that mist helps croup symptoms. (I had an attending in residency that went nuts every time the nurses went running for a humidifier for a kid with croup and we residents would have to listen to his lecture *again* about the endless studies showing it doesn’t help.) In kids with lots of nasal congestion, it can help clear their nose.

If your child starts making high-pitched noises while breathing (called stridor) or seems to be having trouble breathing, he or she needs to be seen by a physician right away. Unfortunately, since this is usually in the middle of the night, it often means a visit to the emergency room. Sorry, but that’s the way it goes. Depending on the level of distress, your child will receive a breathing treatment, steroids or both.

If it is just a barky cough, bring your child to the office in the morning to determine if he or she needs a dose of steroids to prevent worsening symptoms.

It is fairly contagious; 50% of kids of evidence of having parainfluenza infection by age 12 months. Kids can shed the virus from their nose for 1 week before and up to 2 weeks after the barking cough. Translation: wash your hands, wash your hands, wash your hands!


How to Save a Life Before You Are Even a Day Old

Leave a comment

Sounds like a pretty cool, huh?  It’s actually pretty easy.  Cord blood donation is an amazing thing.  Why would you want to do it?  Because it is a chance to save another person’s life, not just for a week or two, not just for couple of months, but potentially for DECADES to come. Umbilical cord blood contains cells that can be used for bone marrow transplants in patients with leukemia and certain other cancers and metabolic diseases.  Even better, the match or the sameness between the donor and the recipient does not have to be as good as in a traditional bone marrow transplant.

How does it work?  About 2 months before the baby is due, a mother talks to her OB or midwife to make sure that mom has no known communicable diseases.  A health form is sent to the cord blood bank and a collection kit is sent back to the mom.  When mom heads to the hospital to deliver, she brings the kit with her.  Be nice to the nurses and they will draw the necessary blood from mom when they start her IV.  The blood is drained from the umbilical cord after the baby is born (the baby doesn’t feel any pain with this procedure) and then is either mailed or picked up by courier.

The blood is then tested for disease and other things.  The donation is then posted (without any names) on the national registry for any cancer center to request and use.  Even if the volume is too small to use for donation, parents can consent to donate the blood for research on the use of cord blood for future cures.

I donated the cord blood from both of my daughters  and it was incredibly easy.  I couldn’t donate my son’s because he was a preemie.  Oh well, 2 out of 3 isn’t bad.

The cord banks do not charge mothers anything to donate even the cost to them is about $1500.  Some providers charge for drawing up the cord blood, so discuss that ahead of time.  Make sure you are clear that you are donating it, not banking it for personal use; that often makes a difference in the decision to charge for the service.

There are private cord blood banks out there.  With very few exceptions, it is so unlikely to be used by the donor or his/her family that it doesn’t justify the cost.  The American Academy of Pediatrics does not recommend private banking in most cases but encourages cord blood donations.  If you have specific questions, ask your doctor.

The National Marrow Donor Program states on their website that they urgently need donations from people of diverse racial and ethnic  backgrounds because of the current lack of donations from minority populations.

Interested or know a pregnant lady who might be?  Call the University of Colorado Cord Blood Bank at 303-724-1306 (before the 34th week of pregnancy) or visit their website at  For more information you can also go to the National Marrow Donor Program at

And make your baby a superhero from day one!