There is a wide variety of color and consistency of bowel movements.  In my glamorous job as a pediatrician, I discuss this hot topic every day.

A change of pattern can throw the most confident mom for a loop and can even confuse an experienced pediatrician.  Babies have blood in their stool fairly often and it virtually never is the sign of serious illness, but I pay a lot of attention to this because it alarms parents and requires that a reason be found.

We shouldn’t be any more surprised to see a variety of bowel movements in our babies than we would in anyone of any other age.  In breastfed babies, the mom’s diet can affect the color or consistency of a baby’s stools, particularly if the baby is showing an allergic reaction to a certain food or food group.

Sticky, tar-like and green or black
This is meconium. The first stools of a newborn will be this consistency and color. It is what is present inside the bowels of a newborn upon birth and will clear itself out within the first couple of days and represents the “byproducts” of building an entire human being for nine months.

Greenish or Yellow/Brown, grainy or seedy
This is the transition between meconium and a regular breastfed stool and begins as mom’s milk is coming in on the second, third or fourth day of life.  There may be three stools each day, ten, or even twenty.  Occasionally, even a baby in the first week of life will skip a day and have no bowel movements at all.  Call your doctor to discuss this even though it is normal.  This does not require a dietary change or supplementation of a breastfed baby.

Light yellow to bright green, loose/runny, curdy, lumpy, seedy, creamy, mustard-like
These are normal breastfed stools.  The consistency, frequency and color vary from day to day.  My wife described the smell as “curried yogurt”.  Opinions on this odor description differ widely.

Frequent Watery Stool often “Greener” than usual
How can you spot diarrhea in a baby who has loose frequent stools every day?  This type of poop is “diarrhea” in a breastfed baby.  It can be due to a virus, a bowel infection, stress, anxiety or a food intolerance.

Hard, pellet – like, presence of blood or mucous
This is constipation in a breastfed baby and is so very rare that I cannot recall ever seeing it in a baby who is receiving breastmilk as a sole source of nutrition, as are most babies in the first six months.  It could be related to a food allergy.  Formula fed babies get constipated much more often and may even have harder bigger stools like older kids and adults.  Getting these stools softer is a balancing act of great proportions.

Black stools often accompanied by constipation
This is the result of iron supplementation. Iron fortified infant foods and infant vitamins can cause constipation. A healthy breastfed baby does not need iron supplementation. The iron in breastmilk is much more bioavailable than any other form.

Red streaked stools
This usually comes from bleeding in the lower intestine or rectum.  Most often it is caused by rectal fissures which are tiny “cuts” around the circumference of the anus.  This can be a reaction to dairy in mom’s diet.  Elimination of all dairy is the first line of defense in this situation.  I have seen countless babies who had blood in their poop which resolved when mom stopped all dairy products and returned with even a small amount of milk or cheese.  Other dietary changes may be needed for breastfeeding moms.  Formula fed babies lose blood from the lower intestine when they drink cow milk formula and some have the same losses on soy formula.  Occasionally, this “micro-hemorrhaging” can become visible as blood streaking on the surface of the stool.  Persistent or increasing blood in the stool or blood mixed with mucus (described as “currant jelly” stool in the texts) requires an immediate call to your doctor.

Green, frothy stools
This can be a result of a hindmilk/foremilk imbalance. A true imbalance is rare. It is often seen accompanying a forceful letdown. Lactation consultants will help moms find a nursing pattern which works to combat this problem.  If letdown it too forceful in the early weeks, the solution can be to allow milk to leak into a cloth diaper during letdown, then latch baby back on.  Feeding two to three times off the same side may also show improvement. Caution should be used with same side feeding as it can decrease supply.

Green, mucousy stool
This can be a result of a virus. Often the only sign we see of a virus is in the green stool. This is evidence of malabsorption in the intestines. Watch for how many days and with what consistency it is occurring. With a virus, it will run its course over a few days and begin to improve.

Another cause of malabsorption in the intestines can be teething. The profuse saliva of a teething baby can cause irritation in the intestines interfering with proper absorption.  When babies teethe, we can see lots of drooling.  Large quantities of saliva is swallowed which can irritate the intestines causing runny, acidic stools. This can also cause a rash in the diaper area.

There is something important to point out regarding frequency of stooling in an exclusively breastfed baby.  Many parents are concerned when after the early weeks where they may have been seeing a little bowel movement in almost every diaper, they suddenly begin to see days go by without any.  This is perfectly normal.  There is a great range of frequency of bowel movements with exclusively breastfed infants, ranging from a couple of times a day to several days.  There are completely healthy nursing babies that have a bowel movement once a week, once every ten days, or even a few that go a bit longer. If your baby is healthy, developing well, nursing well and the consistency of the bowel movement when it does make its appearance is soft or loose, then do not be concerned.  It is not constipation if it arrives in soft form.  Constipation would arrive in pellets and hard formed pieces.

In summary, stools in breastfeeding babies are predictably green, brown, yellow or orange.  It is runny and has curds almost every time.  It changes color with viruses, may have a small amount of blood (call your doc) and may come once a day and even taper off to once a week or more after a few weeks of age.  Formula feeding babies may show a little trickier set of changes involving constipation and diarrhea.  This is just one small reason to strongly recommend and support breastfeeding your baby.

Dentists wondered why, in the early 1900′s, in pockets of the Southwest USA, many residents’ teeth were permanently stained yellow, brown or black, some just had white blotches, some were crumbling. They called it “Colorado Brown Stain.” The culprit – high levels of tasteless, odorless fluoride in drinking water, from 2 – 13 parts per million (ppm), which also irrigated crops the locals ate.

These ugly, sometimes deformed, teeth were unusually cavity-free. Since fluoride stained teeth, dentists assumed fluoride also prevented decay. “Colorado Brown Stain” became known by the more scientific term, dental fluorosis. Unfortunately, dentists overlooked what’s obvious today, even to a layperson. They failed to factor in the calcium, magnesium and other teeth strengthening minerals also in the water supply.

During an era when doubting government was anti-American, when public health heroes of the day were idealists who believed they were saviors of their people, fluoridation began in the late 1940′s. One part per million fluoride added to “fluoride deficient” water supplies, reduced decay by 70% without unwanted fluorosis public health officials promised. Holding the paternalist values of their time, they believed mothers couldn’t be trusted to give their children their daily fluoride dose in pill form so they prescribed it into the drinking water. Children up to nine years old would benefit, they told us. Fluoride incorporated into their developing teeth to erupt with a shield against decay as long as they consumed 1 milligram fluoride daily via approximately one quart of 1 ppm fluoridated water.

Children, who didn’t live in fluoridated communities, were (and still are) prescribed fluoride supplements – a drug marketed before safety testing was required by the Food and Drug Administration.

At its inception, fluoridation, or these supplements, was virtually children’s only fluoride source. Now over 62% of US water supplies are fluoridated and so are the foods and beverages grown, bottled and manufactured with that water. There’s a glut of fluoridated dental products on the market, both over-the-counter and by prescription. Fluoridated pesticide residues remain on foods, medicines contain fluoride, and air is polluted by fluoride from industry.

Instead of bringing tooth decay rates down to that enjoyed by early Southwesterners who ate produce from their own gardens, children’s dental fluorosis rates have steeply increased. Yet, tooth decay is still a major problem for malnourished or poorly nourished Americans.

New research proves old-time dentists’ premise was wrong. Fluoride’s possible benefits, if any, are topical. So there’s no good reason to swallow fluoride or put it into the water supply.

The old dogma is beginning to unravel. British researchers report in the British Medical Journal that fluoridation studies are flawed. A Canadian Government report found fluoridation does more harm than good. A US National Institutes of Health Panel found most tooth decay studies, including hundreds on fluoride, scientifically invalid. Even UNICEF, the organization that protects children, reports, “more and more scientists are now seriously questioning the benefits of fluoride, even in small amounts.”

What’s more unbelievable is that the chemicals most used to fluoridate drinking water are silicofluorides, contaminated waste product of industry, that were never safety tested on humans or animals. Meanwhile we are conducting a massive toxicological experiment. Our children are the test subjects

Silicofluorides are linked with children’s increased lead absorption. Studies link fluoride chemicals to bone fractures, lowered IQ, thyroid dysfunction, cancer, allergies and more.

And the American Dental Association is working on a new and improved cavity fighter, even better than fluoride – calcium and phosphate – the minerals they overlooked in the early 1900′s.

• Fluoride Action Network
• Fluoride: Protected Pollutant or Panacea?
• The Fluoride Stop
• Take Action
• Pennsylvania Environmental Network
• Fluoride Journal
• Preventive Dental Health Association
• Gary Null, PhD
• Citizens for Health
• Fluorosis Education Resources, David Kennedy, DDS
• Suite 101 – Fluoridation
• New York State Coalition Opposed to Fluoridation
• UNICEF, Water, Environment & Sanitation – Fluoride In Water: An Overview
• After 50 Years, Fluoride Supplements have Never been Approved by the FDA

Carol S. Kopf is a freelance health writer who has written for many publications, including Reuters Health, WebMD.com, Onhealth.com, and Newsday. She has a BS in Biology and a master’s in Science and Environmental Reporting. As President of the Levittown Safe Water Association, she spearheaded a campaign that ended 29 years of fluoridation in her town in 1983. Carol can be reached via email at caru@earthlink.net.

Those patches are fluorosis, a condition that shocks many parents because of the cause — too much fluoride. “It was even a bigger surprise to his pediatric dentist — he’s Gradon’s father,” said the Canadian broadcaster. (1)

“We don’t really know how much fluoride it takes to cause fluorosis; and it’s not something we really knew much about ten years ago,” said the Canadian dentist in 1998.

Dental fluorosis is growing in prevalence and severity in American children (2) and can range from mild, white spotted teeth to moderate and severe fluorosis — yellow, brown or black and sometimes pitted and crumbling teeth.

American children are over-fluoridated. It’s hard to believe that dentists themselves are undereducated about fluoride and its adverse effects, but they are.

Some dentists and pediatricians wrongly prescribe fluoride supplements to children who live in fluoridated communities. Further, the Center for Disease Control (CDC) teaches dentists that fluoride supplements and fluoride treatments by dentists are only advisable for those with a high risk for tooth decay (3), although doctors usually prescribe supplements based on water fluoridation status, age and fluoride treatments based on insurance carriers’ willingness to pay. The only scientifically-valid predictor of future cavities is present tooth decay.

Fluoride treatments may be a money-maker for dentists, but there’s no proof it benefits children at low risk for tooth decay. (4)

Fluoride’s alleged beneficial effects are topical, not systemic as once believed. Scientists discovered that fluoride supplements discolor teeth but don’t reduce tooth decay. (5)

That is why mainstream dental groups such as the Canadian Dental Association, the Western Australia Health Department’s Dental Service and the German Scientific Dental Association stopped recommending routine fluoride supplementation, unlike the American Dental Association who still recommends supplements, not based on patient need, scientific evidence or CDC guidelines, but on water fluoridation status and age.

And to add insult to injury, fluoride supplements have never been approved or safety tested by the FDA (U.S. Food and Drug Administration), having been “grandfathered” in, (already being sold) before the law to test drugs was passed (6).

In the early 1900’s, Americans drinking naturally calcium-fluoridated water supplies displayed cavity-free but discolored teeth. Fluoride, the tooth staining culprit, was assumed the cavity preventer, also. But researchers overlooked calcium, magnesium and other teeth-building components in the water supplies.

Those early studies are dismissed as flawed. (7) But, still not ready to give up on fluoride, dentists claim fluoride must work topically. However, no well-done studies exist comparing cavity rates between similar populations of fluoride users vs. non-users.

Neither a nutrient nor essential to health, fluoride is simply used as a drug to treat tooth decay. Unlike vitamin and mineral supplements discouraged in favor of a balanced diet, fluoride supplements are promoted by the medical establishment and mandated into water supplies, even though slightly more than recommended leads to adverse effects such as dental fluorosis. Three to four times “optimal” can actually cause tooth decay. (8)

In larger amounts, fluoride is lethal. But some dentists are painfully unaware of this, too.

In order to convince California legislators to vote for fluoridation, a dentist swallowed a whole vial of fluoride tablets in front of them and then said, “Hey, guess what? I’m still alive.” (9)

Swallowing too many fluoride pills killed children. (10) Another child died after swallowing instead of expectorating his dentist’s fluoride treatment. The dentist didn’t think it was toxic. (11) People have become sickened and died because water engineers or machinery malfunction injected excess fluoride into water supplies. (12)

Warnings on the back of fluoridated toothpaste tubes and boxes are there because ingestion of the whole tube’s contents can be lethal to a small child. (10)

Over 65% of America is fluoridated, and virtually all Americans consume too much fluoride in their foods, beverages and dental products. With dental fluorosis increasing, one would expect tooth decay would be obliterated.
Instead tooth decay rates climb. (13)

The only virtual sure thing that’s linked to extensive cavities is poverty, which is also linked to poor nutrition, high rates of infant mortality, higher cancer death rates, and most other health disorders. Unlike nutrients which have deficiency health consequences, fluoride deficiency has no health consequences.

Dentist Weston Price discovered in the 1920s and ‘30s that “primitive” populations around the world who followed their traditional nature-based diets enjoyed decay-free teeth, while those that turned to the “civilized” diet of processed, sugar-laden foods had many missing and decayed teeth. (14)

There are ways to help prevent tooth decay in children. The American Dental Association (ADA) states, “Pregnant women can help ensure their children get a good start on their oral health by focusing on staying healthy, including a proper diet, because teeth begin developing between the third and sixth month of pregnancy.” (15)

Breastmilk is the healthiest choice for a young child’s overall development. It also has anti-cariogenic properties and is an important factor in keeping teeth healthy. Breastmilk contains bacteria fighting cells and enzymes, which may help destroy the germs that cause tooth decay. (16) (17)

As children begin eating solid foods, continuing to provide a well balanced diet, rich in fresh fruits and vegetables, is beneficial to good dental health.

References:

(1) CBC News, December 1998, http://cbc.ca/cgi-bin/templates/view.cgi?category=Sci-Tech&story=/news/1998/12/29/fluoride981229

(2)”Prevalence and trends in enamel fluorosis in the United States from the 1930s to the 1980s.” by Beltran-Aguilar, et al, Journal of the American Dental Association, February 2002

(3) “Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States” August 27, 2001, CDC
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5014a1.htm

(4)”Preventive dentistry: practitioners’ recommendations for low-risk patients compared with scientific evidence and practice guidelines,” Am J Prev Med Feb 2000 , by Frame et al http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&
db=PubMed&list_uids=10698247&dopt=Abstract

(5) “The case for eliminating the use of the dietary fluoride supplements for young children,” J Public Health Dentistry 1999 Fall by BA Burt
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&
db=PubMed&list_uids=10682335&dopt=Abstract

(6) Letter from New Jersey Representative Kelly to FDAhttp://www.citizens.org/Food_water_safety/Fluoridation/Materials/
web_pages/letter%20_%20to_FDA.htm and confirmed by Crystal Wyand, spokesperson, FDA’s Center for Drug Evaluation and Research, e-mail correspondence.

(7) “More Rigorous Studies Needed to Advance Emerging Dental Caries Diagnostic and Management Strategies, Says NIH Consensus Panel,” NIH News Release, March 28, 2001http://consensus.nih.gov/news/releases/115_release.htm and British Medical Journal (B.M.J.), October 7, 2000,McDonagh, et al

(8) “Dentistry, Dental Practice and the Community,” by Burt and Eklund.

(9) Journal of the California Dental Association, January 1997, “The Fluoride Victory,” by Joanne Boyd

(10) “The Metabolism and Toxicity of Fluoride,” by Gary Whitford and
http://pmeiers.bei.t-online.de/burton.htm

(11) http://pmeiers.bei.t-online.de/kennerly.htm

(12) “Acute fluoride poisoning from a public water system,” New England Journal of Medicine, Jan 1994, Gessner et al,
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd
=Retrieve&db=PubMed&list_uids=8259189&dopt=Abstract
and http://www.fluoridealert.org/leaks-spills.htm

(13) “Health Journal: As kids’ cavities rise, some dentists advocate using tooth sealants,”Wall Street Journal, Tara Parker-Pope, March 8, 2002http://www.sfgate.com/cgi-bin/article.cgi?file=/news/archive/
2002/03/08/financial1058EST0079.DTL

(14) “Nutrition and physical Degeneration,” by Weston A. Price D.D.S.

(15) http://www.ada.org/public/media/newsrel/0202/nr-01.html
ADA News Releases
February 2002
Good Oral Health Begins in the Womb

(16) Loesche WJ, “Nutrition and dental decay in infants.” Am J Clin Nutr 41; 423-435, 1985

(17) Lucas, A, Cole T, “Is Breast Feeding a Likely Cause of Dental Caries in young Children?” Journal of American Dental Assoc., 1979; 98:21-23

Fevers help to fight infections because white blood cells move faster and kill viruses and bacteria better at 102 degrees than they do at 98.6. Additionally, many germs have a limited range of viability and do not grow as well when the temperature is higher.

The problem is that most children do not eat, drink or sleep very well when they have high fevers. They are also not easy to assess medically at 102 either. To a parent or a doctor, a child with a high temp looks pretty bad even when the illness causing the fever is “just a cold.”

There are two reasons to bring down the temperature:

1. To make a child more comfortable so they have an easier time staying hydrated and getting a little more rest.
   
2. To be able to observe a child with a lower temperature and realize that it was a large fever and a small underlying illness making them look a lot worse than they really are.

In adults, the height of the fever often correlates well with the severity of the illness. In children, this is not always the case: a two-year-old can develop a 105 fever with a viral cold or could be sick with pneumonia but only have a 100.8 temp. Bringing the temp down on that first child will give you a fairly normal child for an hour or so but bringing the temp down for the kid with pneumonia or some other more significant illness won’t do anywhere near as much to make them feel a lot better.

I recommend long lukewarm tub baths as the best way to lower temperatures when you need to. Also, make sure to “unwrap” your baby or child to allow heat to radiate out from the body rather than being trapped underneath heavy clothing or blankets. This is much more important than many parents realize.

Most doctors also recommend Tylenol type drugs or Advil/Motrin type anti-inflammatory medicine. Some families also rely on a homeopathic medicine like belladonna. More natural approaches favor not bringing down the fever at all but just working for good hydration and comfort while allowing the immune system’s natural mechanisms (including fever) to work on the infection. This is not a bad course of action but a lot of parents I know are not very comfortable watching their child’s temp go up and stay up. If this is the way you feel, try lowering the temperature at least once to reassure yourself and your doctor that under this big fever is a small illness.

Aspirin must never be used in childhood or teenage years because of the statistical association with Reye’s syndrome, a potentially fatal liver disorder.

A word about febrile seizures: From about 18 months through age five years or slightly later, about 1 out of 50 children will have a convulsion with the fever. This is an innocent occurrence about 99.99% of the time but one of the most frightening things you’ll ever see. Remain as calm as you can, call your doctor right away, and do not put anything into your child’s mouth. Hold them upright and slightly tilted forward so that they have an easier time with secretion or vomit. The seizure will last 1-3 minutes (it will feel like an hour) and then your child will sleep or act very lethargic. Immediate medical evaluation is needed for at least the first of these seizures. Over half the kids go on to have a second convulsion with a fever but virtually none of them develop epilepsy or other complications. Call your doctor. Most families also call 911 and this is not a bad idea except that transporting your two-year-old by ambulance to the nearest hospital may put you in an ER inexperienced or over reactive to sick kids. Over reaction may be better than a laissez-faire approach by far, but it is not the best way.

To summarize: fever is natural, helps end the infection faster but may need lowering for the child’s comfort or the parents’ reassurance.

Most of these visits, with healthy, growing babies and children, are not needed at all. When I look in the ear with my otoscope, I am looking through the external canal to the ear drum which lies at the end of the canal and transmits sound vibration to the bones and fluid of the middle ear.

The bones of the middle ear are “lubricated” by a mucus-like fluid which then drains from the middle ear into the Eustachian Tube and into the throat. In adults and older kids, this is a nearly vertical drainage tube but in babies and younger kids, it’s nearly horizontal. As you might guess, horizontal drainage of middle ear fluid can be easily slowed or stopped if the mucus gets thicker or if the tube gets inflamed and narrowed.

This leads to a “stagnant puddle of water” in the middle ear which is prone to thickening and/or infection with viruses or bacteria. The fluid accumulates and, lacking the normal drainage through the Eustachian tube into the throat, causes pressure on the ear drum which hurts and shows visible inflammation when I look at it.

When viruses and/or bacteria manage to grow in the fluid, “acute otitis media” can be diagnosed. The traditional treatment with antibiotics has been shown to be quite ineffective and, as a matter of fact, not anymore effective than doing nothing at all during the first three to four days. Most experts now recommend pain control only during the first days of an ear infection, although I think thatsafe alternative care (homeopathy, ear drops, hot compresses, vitamin C, elderberry or echinacea) will improve the healing course.

Please understand that very small babies with fevers and obvious ear pain or children with special conditions and underlying problems deserve a visit to the doctor and your doc may want to use medicine right away even thought antibiotics don’t work as well as we have claimed for decades. The advice here is mainly for healthy full term babies and children whose main problem is fever and ear pain. For most illnesses like this, I tell parents that the best way to evaluate a sick child is from a few feet away when the fever’s down. Most kids will “bounce back” for a little while. They smile a little, play a little and are obviously not very sick.

Ear infections occasionally cause the ear drum to perforate which is in some ways analogous to a pimple popping: The infection may go away and the pain is gone. The ear drum heals and sometimes the fluid reaccumulates but often the infection is gone. The drainage and occasional blood from the ear looks frightening and your doctor may want to have a look. Don’t put drops in a draining ear without first talking to your doctor.

As an ear infection heals, the drum may not look 100 percent normal for weeks or months. The current recommendation is to tolerate the appearance of increased fluid behind the drum for 60 to 90 days.

Ear tubes have very little benefit in the long term and don’t even preserve hearing the way we pediatricians once believed. I have seen them seem to help a lot in the short term when the “ventilation” of the middle ear (a hole poked in the ear drum and kept open by a tiny tube for a year or so) led to a lot less pain, fewer doctor’s visits and less missed school and fun. However, tubes, for the most part, are not worth it.

Treat ear infections with pain control, “watchful waiting” and a call to the doctor when you are uncomfortable.

Croup is a viral infection that causes a swelling in the larynx (voice box), trachea (windpipe), and other airways leading to the lungs, making breathing noisy and difficult. The swelling is not visible in the tonsils and cannot be heard when a doctor listens to the lungs with a stethoscope, so you won’t know your child has it until he or she wakes up with the distinctive barking seal cough.

Most common in the fall and winter in children under four, the swelling is also accompanied by increased secretions in the air passageways that become dried out. The dried, thick secretions in turn block the respiratory tract and make breathing even more difficult. Children outgrow croup as the airway passages enlarge; it is unusual after age seven.

The best treatment for this swelling and narrowing of the respiratory tract is cool, moist air. The best way to get this “dose” is by driving towards or along the beach or another body of water with the windows rolled down. Dress warmly, including a hat, and take a late night ride for 20-40 minutes and your child will probably experience almost instant relief from the frightening sounding cough. As these dried, hard secretions are dissolved and the air can again pass freely into the lungs, the child’s discomfort will subside.

You may be thinking about your mother’s admonition that “You’ll catch your death of cold” if you go outside late at night, especially with your precious baby in your arms. Well, forget the idea that you’ll catch a cold from the brisk night air. That idea is a myth–you cannot catch pneumonia or any other illness from cold air. Colds, flu and pneumonia are spread by viruses which like to stay nice and warm… and in humans.

Another option is to steam up your bathroom to create a moist, soothing environment. Close all the doors and windows and run a warm shower to create steam, but avoid really hot water as it may scald the child. To avoid slipping while holding your child, do not stand in the shower. Remember too, that steam rises, so do not set the child on the floor, but hold him or her upright in your lap. Usually after ten minutes you’ll see improvement, but continue comforting the child.

You can also purchase a cool mist humidifier and place it in the child’s room for several nights. Position the humidifier as close to the bed as possible so the moist air can make its way to the child’s airway passages.

Croup is a “self-limited” viral illness, meaning you have to let it run its course. Unfortunately the second night is often worse than the first. There may be a few more scary nights of the barking cough, but continue with the car rides or steam treatments to relieve symptoms. The illness then changes into a long, mucousy cold which can last for another week or more. The fever rarely rises above 102 or 103 degrees and can be treated with anti-fever medications, long lukewarm baths, and light clothes to allow the body to cool itself.

Take your child to the emergency room if he or she:

• shows no improvement in breathing with either of these mist therapies after 30 minutes;
  
• cannot talk because of lack of breath;
  
• has difficulty swallowing, drools, and breathes with chin jutting out and mouth open, this could be a rare infection called epiglottitis;
  
• struggles when inhaling or appears to be in severe respiratory distress.