I think it’s really important to know the difference – one is fairly common, and the other is much more rare – and can be deadly.

Croup is a common viral infection I see daily. It is caused by a virus, and can cause a high fever, runny nose, sore throat, and cough.

It can be scary sounding, and can show up out of nowhere. Your kiddo will SEAL BARK when they cough – it really does sound just like a seal. I can often hear it and diagnose it in the waiting room!

This virus makes the area around the voice box and the windpipe swell up. This makes them hoarse, and sometimes they have loud breathing with inhalation.

We treat it with comfort – kids often get scared of their own breathing and cough sounds, and it really makes their throat hurt – so give them ibuprofen or Tylenol, steamy showers, cool humidified air, popsicles, cold drinks. Your doc may prescribe steroids for it if they seem particularly hoarse or loud with breathing.

Most kiddos with croup do just fine at home – and they can get it more than once. However, very rarely the swelling of the windpipe is severe. If they are having a hard time breathing, seem short of breath, lethargic, won’t drink, some kids have to be seen at the hospital for support, breathing treatments, and care.

Whooping cough, or Pertussis, is a whole different beast. The word “whooping” came from the sound that babies make when they’re trying to inhale during the coughing fits of this awful bacterial infection.

Cough-cough-cough-WHOOOOOOOOP (catching breath)

Cough-cough-cough- WHOOOOOOOOP

It starts as a cold, then gets worse in a week or two. It is absolutely heartbreaking to see a baby struggle with whooping cough (watch a Youtube video of “Infant with Whooping Cough” like the one down below, courtesy of the Mayo Clinic and try not to tear up), and it can be deadly to them. They often stop breathing, and almost always must be hospitalized.

Pertussis is easily caught from others via coughed droplets in the air. Older kids and adults can catch it too, and it causes long fits of coughing – to the point of turning blue, or vomiting. Patients cough so much they commonly break ribs.

Antibiotics are given to make the person less contagious, but do not cure the illness or stop the symptoms.

The best protection from whooping cough is VACCINATION. We start this series at age 2 months, so that children are protected as young as possible.

Adults should get their pertussis booster – a.k.a. the Tdap or Tetanus shot at least every 10 years, or with every pregnancy (I and my husband both got it for both our kids).

Hope this helps clarify those confusing words we use for these special cough sounds!

More On This Topic:

• Why Children Like Olivia Need You To Immunize
• Let's Learn About Whooping Cough
• "Croupy" Cough
• 7 Facts About Whooping Cough You Should Know

I get the question all the time at my office in Forest Park - "When can my baby safely have a blanket/pillow/lovey/stuffed animal in the crib with her?" I'll try to answer that here.

Don't we pediatricians seem silly sometimes? We're always lecturing you about what not to do. DO NOT put your baby on their stomach to sleep. DO NOT put anything in your child's crib. DO NOT sleep with your baby in your bed! DO NOT use those darn crib bumpers!

We seem mean, right? And strict. And out-of-touch with surviving the sleep deprivation involved in raising a small person.

I'm here to tell you that the reason we tell you these things is because we don't want your baby to die. Dramatic, I know. And I'm not trying to fear-monger. Hear me out.

A recent study by the American Academy of Pediatrics found that over half of American sleep environments for babies under 1 do not follow recent "safe sleep" recommendations. That's so scary to me.

Babies have died by suffocating under stuffed animals, blankets, and bumpers in bed. I know it seems silly, but it's happened. Open up your web search engine and do a quick search. I've personally done CPR on a 4-month-old infant who had gotten their little head trapped between a bumper and a crib rail. I will never forget the look on the mother's face of another child, a newborn who suffocated on a pillow in the crib. These memories haunt us, folks. These babies' deaths were preventable.

The reason these tragedies happen, and the reason we harp on "safe sleep environments" is because before age one, babies still have not developed the muscle strength and coordination to deal with crib items the way an older child or adult can. And their brains are still not old enough or developed enough to wake them up to change a dangerous situation, like their face being mashed into a soft mattress, or a blanket covering their head. They are not coordinated enough or strong enough to unwrap a tangled loose sheet, or unwedge their head from a loose bumper.

I don't think you should put anything in the crib with your baby, other than a wearable/zip-up blanket and a pacifier, until they are 12 months old.

After that, have at it. My 3 year old sleeps with no less than 15 animals/blankeys in his bed at night. My 18 month old has a small blanket and a lovey she adores and needs right now to soothe herself to sleep. The incidence of crib deaths drops drastically after age 1 - typically if a toddler dies suddenly in bed, it is due to a medical issue (though there are very rare exceptions out there).

Before age 1, put a wearable blanket on your baby. They're in all the baby stores and online, are washable, and they're affordable. They should have arm holes and a hole for the head, and should zip up. They come in linen, fleece, you name it. They keep kids warm enough in the winter.

Pacifiers are OK in the crib anytime. In fact, studies in recent years have shown a paci used at night drastically reduces the chance for SIDS death.

Loveys are a tough one. I consider a "lovey" to be one of those small pieces of cloth with a little soft animal head attached. I think they're safe to introduce around 12 months - when a child's core muscles are nice and strong and they're easily able to roll, prop up to sitting, and self-soothe. Some of them are bigger than others. I'd be worried if one was long enough to wrap fully around a child's head or neck.

You could do a little experiment to see if your baby is ready for a lovey. After they fall asleep, take the lovey and put in on their face, then observe. Do they breathe easily? Do they eventually swat it to the side? If the answer is yes, it's ok to keep it around!

I am a big believer in healthy baby sleep practices and children learning to self-soothe when they are ready. I hope this helps guide you in what can safely go in the crib!

Hugs,

Dr. Diane