What Can I Do About This Cough?

Updated on Dec 20, 2023 | Mount Sinai Doctors, Primary Care, Your Health

Coughs can take days or even weeks to go away. While a stubborn cough is annoying and sometimes even painful, it is your body’s natural way of clearing out harmful irritants and secretions—but that doesn’t mean you have to be uncomfortable or lose sleep.

In this Q&A, Jacqueline O’Boyle, DO, a primary care physician at Mount Sinai Doctors-Manhasset, explains what over-the-counter cough medicines and at-home remedies can help soothe your cough, and when it’s time to see a doctor.

Jacqueline O’Boyle, DO

What over-the-counter cough syrups do you recommend?

It depends on whether you have a dry cough or a wet cough. For most patients, I typically suggest guaifenesin (Mucinex®), which can help relieve both wet and dry coughs.

Wet coughs: These are caused by excess fluid or mucus in the airways, and are often caused by a post-nasal drip that tickles your throat. Treatments that dry up the nose and nasal passages are helpful. These include nasal steroid sprays, such as fluticasone (Flonase®) or mometasone (Nasonex®), which reduce inflammation. Antihistamines, which are anti-allergy drugs, are also good for drying up the nasal passages. Some popular over-the-counter antihistamines include loratadine (Alavert® and Claritin®) and fexofenadine (Allegra® Allergy, Aller-ease®, and Aller-Fex™).

Dry coughs: These don’t produce mucus. Remedies that stimulate saliva production and moisten the dry areas are very helpful. These include nasal saline sprays (Ayr® or Simply Saline™), lozenges, tea with honey and lemon, and humidifiers.

When should I see a doctor for my cough?

If you are experiencing any shortness of breath, tightness in your chest, persistent fever, or if your cough has gone on for more than three weeks or is causing chest pain, you should see a doctor. Most coughs are caused by viruses, which antibiotics don’t treat, but your doctor may prescribe an antibiotic if your cough is more likely bacterial. If your cough is interfering with sleep or your ability to function, there are certain medications that are effective, regardless of the cause of your cough.

What cough medications might the doctor prescribe?

Your doctor may prescribe you medications like benzonatate (Tessalon Perles®), which can both suppress your cough and allow you to sleep better. Benzonatate works well when used in combination with guaifenesin (Mucinex®). If you’re experiencing wheezing or tightness in your chest, or have a history of asthma, your doctor might prescribe inhaled steroids, or inhaled beta-2 adrenergic receptor agonists such as albuterol, or an oral steroid. If your cough is very disruptive, your doctor may prescribe a cough syrup with promethazine or codeine. While there is no evidence that cough syrup with promethazine or codeine will be more effective than placebo for people with cough from acute infection, some people find it allows them to sleep better and reduces symptoms.

What at-home remedies soothe a cough?

Good remedies for a dry cough are: lozenges, a spoonful of honey, or honey stirred into tea. Honey has been proven to reduce cough symptoms more so than most medications, and contains antibacterial properties (but never give honey to an infant younger than one year old.) There are a number of other at-home remedies to try. If you have a wet cough, elevating the head of your bed and using a humidifier can help. Elevating your head will prevent irritation from postnasal drip, and the humidifier will moisturize the air as well as your throat and sinuses, so you can sleep better at night. Rest, in turn, will help boost your immune system. Additionally, nasal irrigation rinses (such as NeilMed® Sinus Rinse or Neti Pot) can reduce swelling and flush out mucus (make sure to use only clean/sterile water).

Any other suggestions?

Sitting in a steamy bathroom with a hot shower running can help clear your nasal passages and throat. You can also try chest physical therapy, an airway clearance technique in which someone you know manually performs chest percussion on your chest wall to loosen mucous and phlegm. Strengthening your immune system with good nutrition, keeping yourself hydrated, and getting lots of rest are also important.

Quick Tips:

  • Mucinex, a common over-the-counter medicine, is generally good at relieving any type of cough.
  • Treatments that dry up the airways (nasal steroid sprays and anti-allergy drugs) are ideal for treating wet coughs, whereas remedies that moisten the airways (nasal saline sprays, lozenges, humidifiers), help relieve dry coughs.
  • If you are having trouble sleeping, elevate the head of your bed (prevents post-nasal drip) and put a humidifier in your bedroom.
  • Never give medications to a child without consulting their pediatrician, or honey to a child under one year old.
  • See a doctor if you are experiencing shortness of breath, tightness or pain in your chest, persistent fever, or if your cough has gone on for more than three weeks. If you have health issues, do not take over-the-counter medications without consulting your doctor.

How can I soothe a child who is too young for cough medicine?

Never give children under the age of 12 cough medications unless instructed by the child’s doctor, as they are at a much greater risk of side effects. Never give a child under one year old honey, which can cause botulism. Instead, put a humidifier in their bedroom and elevate the top of their bed to keep their airways moist and to reduce the effects of post-nasal drip. If their cough is very bad, have them sit in a steamy bathroom with a hot shower running. If they are over one year old, you can give them half to one teaspoon of honey or over-the-counter remedies containing honey that are specifically made for children. Have them drink plenty of water to help flush out mucous and secretions. If your child is over three months old, consider using Vicks® BabyRub™. Unlike the adult version (Vicks VapoRub™), Vicks BabyRub does not contain camphor (dangerous if ingested), but uses holistic ingredients like aloe, eucalyptus, and lavender oil, which are safe for kids. You can rub it on their feet and chest. Be sure to consult your child’s doctor before putting them on Vicks BabyRub or other mediations, especially if they are under 12.

Are there cough medications that people with high blood pressure, or other health issues, should avoid?

Consult a doctor before taking any over-the-counter medications if you have health problems. For most people, dextromethorphan (Robitussin®), a common cough suppressant, is fine, but can cause dizziness, restlessness or drowsiness in some. Other cough medications, such as pseudoephedrine (Sudafed® or SudoGest™), can raise blood pressure and heart rate. Always read the labels of over-the-counter cough suppressants, as many should be taken with caution if you take other medications, such as the category of antidepressants known as SSRI/SNRIs (selective serotonin reuptake inhibitors/serotonin–norepinephrine reuptake inhibitor). A lot of them have multiple ingredients, so you want to make sure you’re not doubling up on any ingredients that could potentially harm you.

 

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Patients Can Now Order Movies, Video Chat With Family, Access Translation Services, and More at Mount Sinai West

Updated on Dec 19, 2023 | Featured, Mount Sinai West, Your Health

Mount Sinai West has launched an innovative, in-room patient digital experience called MyRoom Connect, which is now available on the postpartum units.

MyRoom Connect, the first of its kind at the Mount Sinai Health System, is an interactive system designed to enhance the patient experience, improve communication, and optimize care.

The system is seamlessly integrated with the patient’s in-room television and is operated by using the in-room pillow speaker/remote control. The program will be introduced on the recently renovated and expanded inpatient Rehabilitation Unit at Mount Sinai Morningside in early 2024.

With MyRoom Connect, patients can use the pillow speaker remote to: 

  • Order meals:Patients can choose their preferred options while ensuring dietary needs are met.
  • View education resources: Patients can view videos recommended by the care team on a diverse range of topics. New parents are asked to watch videos on preventing shaken baby syndrome, car seat safety, safe sleep for newborns, and feeding recommendations.
  • Access on-demand entertainment:Patients can select from a library of 40 on-demand movies including blockbusters like My Big Fat Greek Wedding, Top Gun: Maverick, and Black Panther: Wakanda Forever.
  • Connect with family and friends:Patients can stay connected with loved ones through in-room video visits, which can offer comfort and emotional support when patients need it most.
  • Review language translation options:Patients can choose from multiple language translation options.
  • Use live interpretative services:Patients can access live interpretative services to bridge any language barriers and ensure clear communication with the care team.
  • Learn about the local area:Patients can learn more about the hospital and the surrounding area including parking options and nearby lodging.
  • Listen to audiobooks:Patients can access a variety of content, including relaxation options, like white noise and 360 degrees of relaxation, and audiobooks.

“We believe that MyRoom Connect will not only elevate the patient experience but also streamline the care delivery process,” said Robbie Freeman, MSN, RN, NE-BC, Vice President, Digital Experience, and Chief Nursing Informatics Officer, Mount Sinai Health System. “It empowers patients to actively engage in their health care journey while enabling our staff to deliver high-quality, coordinated, and compassionate services.”

“At Mount Sinai West, we are here to support your needs, choices, and preferences with skilled, compassionate care, and to ensure that you receive comprehensive services personalized to your goals,” said Holly Loudon, MD, MPH, Chair, Obstetrics, Gynecology, and Reproductive Medicine at Mount Sinai West.

Learn more about Pregnancy and Childbirth at Mount Sinai West
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What Are “Forever Chemicals,” and Can I Avoid Them?

Updated on Dec 15, 2023 | Cancer, Your Health

You may have been hearing a lot lately about “forever chemicals,” or PFAS (per- and polyfluoroalkyl substances), so called for their ability to stay in the body and environment for years and resist breakdown.

In this Q&A, Shelley H. Liu, PhD, Associate Professor of Population Health Science and Policy at Mount Sinai, explains what these chemicals are, why they are linked to cancer, and how to reduce your exposure. An expert on PFAS, Dr. Liu researches the wide-ranging health impacts of these chemicals, including identifying disparities in exposure burden across populations.

Shelley H. Liu, PhD

What are forever chemicals?

PFAS are a big class of man-made chemicals that have been around for decades. They are very useful to industry due to their stain- and water-resistant properties. They are used in all kinds of products from consumer products (like nonstick pans, carpeting, and textiles), to food packaging and firefighting foam. Because these chemicals are so widely used, they can be detected in the blood of more than 98 percent of Americans, including people who have not been exposed through their jobs. Because we may be continually exposed at low amounts to PFAS through everyday living, our accumulated exposure over time (such as over decades) to PFAS and other synthetic chemicals is a growing concern for our health and wellbeing.

What is the link between forever chemicals and cancer?

There is a lot of great ongoing research around PFAS and cancer. While emerging findings show concern, there is still a lot we don’t know. For example, there has been some early work showing potential links between PFAS and different types of cancer in what scientists call a “dose-response relationship,” meaning that higher concentrations of PFAS chemicals in the blood are associated with a higher risk of liver cancer or kidney cancer. This means that even if you can’t absolutely remove your exposure to PFAS, doing your best to reduce exposure over time could still be quite helpful. There is also very new research that suggests PFAS might be linked to hormonally-driven cancers, such as breast cancer, depending on whether you’re female or male and also your race and ethnicity. These are early studies right now, and we don’t quite know yet what those links are.

Seven ways to reduce your exposure to forever chemicals:

  • Drink filtered water
  • Reduce consumption of freshwater fish, and consider diversifying the fish you eat
  • Discard nonstick cookware that is worn, and replace nonstick cookware with stainless steel
  • Reduce use of paper and paperboard takeout containers
  • Reduce use of fabrics, textiles and other products labelled as water- or stain-resistant
  • Replace old carpets with new ones to keep babies safe
  • Test private well water for PFAS, and install a purification system if necessary

What products are forever chemicals commonly found in?

We don’t know every product that PFAS are in, but we do know some of the major ones. These include products with nonstick and water-resistant properties, such as nonstick pans and nonstick coatings in food packaging, as they are used as grease-proofing agents in fast food wrappers and take-out paperboard containers, as well as stain-resistant fabrics on your couches and carpets. Diet can also be another exposure source. For example, fish, such as freshwater fish, can sometimes be contaminated with PFAS, and there are many communities in the United States, including in New York, that have contaminated public drinking water. This spring, the U.S. Environmental Protection Agency proposed the first-ever enforceable federal-level regulation of PFAS in public drinking water, although this has not finalized yet. Private wells can also be contaminated with PFAS, and are not part of federal-level regulations. Unfortunately, PFAS are a pervasive problem because they are very stable molecules and resist degradation. Some PFAS can be eliminated fairly quickly from the human body, but others can remain for years (for example, three to five years), and they can accumulate in your organs, such as the liver. In the environment, PFAS can also be transported great distances by weather patterns and groundwater, and eventually make their way into public drinking water and food sources.

Who is most at risk?

Scientists are still researching which groups are at higher risk of exposure to PFAS and/or more vulnerable in terms of health impacts. We know that some people are highly exposed to PFAS through their occupation—for example, firefighters have high exposure to PFAS chemicals because PFAS are a major component of firefighting foam. When we think about non-occupational types of exposures, our research has shown that Asian Americans have a higher exposure burden to PFAS than other race/ethnicities, and we are researching why. It may be a combination of diet, consumer product use and immigration history, as PFAS are used and regulated and disposed of differently in other countries. The other way to think about who is at higher risk is to look at groups who already have poorer health or chronic conditions, and understand whether higher PFAS exposure may worsen their disease progression compared to people with a similar disease stage but with lower PFAS exposure. Perhaps their threshold of tolerance to cumulative PFAS exposure could be diminished. These are all ongoing and important research questions.

What are a few specific ways to reduce my exposure to PFAS?

A few ways to reduce your exposure include lowering your PFAS exposure through diet, using stainless steel cookware instead of nonstick when possible, replacing old nonstick cookware that contain coatings that may have worn off over time, and reducing use of paper and paperboard takeout containers. For babies and young children, carpeting may also be an exposure source. Some newer carpets are not treated with PFAS, so consider replacing old carpets with new ones. If your drinking water comes from private wells, it could be helpful to get your water tested for PFAS, and if you discover high PFAS contamination, consider using water filters, installing a reverse osmosis filtration system, which purifies water, or drinking bottled purified water (which is made with reverse osmosis filtration). In general, using water filters is helpful for PFAS and other contaminants, even if you have a public water supply. While it’s hard to eliminate PFAS exposure completely, it can be quite helpful in the long term if you can reduce your exposure. It would be helpful for our governments to regulate PFAS, and while there is some progress on this front, much more work needs to be done.

Is there a way to rid my body of PFAS?

Unfortunately, there are not many ways for your body to expel PFAS. They are extremely stable molecules, which is why they can remain in your body for years. As such, PFAS levels are often higher in older adults because they accumulate over one’s lifetime. However, menstruation, breastfeeding, and childbirth have been shown to be ways that PFAS are expelled from the body, though research shows that mothers can pass them to their babies. That said, there is no way to totally avoid exposure. You can even find PFAS in the Arctic because they get transported everywhere and persist in the environment. Further, PFAS are not the only concern. Over the last few decades, society has exponentially increased the production of all kinds of synthetic chemicals, some of which can eventually make their way into the human body, and we don’t yet know what that means for human health going forward.

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Hand, Foot, and Mouth Disease in Kids: Tips for Prevention

Updated on Dec 8, 2023 | Your Health

Many parents may be unfamiliar with hand, foot, and mouth disease, but it’s actually very common among young children. The good news is that it’s typically mild, and it can be easy to treat and prevent. However, hand, foot, and mouth disease may cause parents and caregivers to worry and perhaps even cringe a bit. But why exactly?

It’s a highly contagious viral disease that predominantly affects children age five and under, but it can also affect older children and adults. The most common symptom is a rash in the mouth, and on the hands and feet. Other common symptoms include fever, painful sores and ulcers, muscle aches, dehydration due to painful swallowing, general fussiness from discomfort, and in some cases diarrhea and gastrointestinal problems. It’s known to spread rapidly, especially in daycare centers and schools, and it causes great pain and discomfort for kids.

Carolina Pombar, MD

In this Q&A, Carolina Pombar, MD, a pediatrician and Assistant Professor, Icahn School of Medicine at Mount Sinai, explains what causes hand, foot, and mouth disease, how long it’s contagious, and tips for prevention.

What causes hand, foot, and mouth disease?

It’s caused by a group of viruses referred to as enteroviruses. The most common cause is the Coxsackie A6 virus, but other strains of Coxsackie virus, as well as other enteroviruses, can cause the illness. When there is an outbreak of hand, foot, and mouth disease, there may be more than one type of virus circulating. Since there are different strains of the virus, a child can get the virus more than once. Adults may not be immune to the virus, so as a result, children can transmit it to their parents and caregivers.

How does it spread?

The virus is spread easily through:

  • Person-to-person contact with droplets when an infected person talks, coughs, or sneezes. These droplets can land on objects or be rubbed into eyes, nose or mouth. These droplets do not stay in the air (like COVID-19) and do not travel more than three feet.
  • Touching skin lesions (kissing, hugging) or coming into contact with objects and surfaces that have been contaminated.
  • Coming in contact with an infected person’s poop, such as changing diapers, and then touching the eyes, nose, or mouth.
  • Touching objects and surfaces that have the virus on them, like doorknobs or toys, and then touching your eyes, nose, or mouth.

What are the signs and symptoms of hand, foot, and mouth disease?

The signs and symptoms include:

  • Fevers
  • Rashes appear like red pimples that can transform into blisters mainly on the palms/between fingers/feet and around the mouth. Other common places are knees and elbows and diaper area. Children who have eczema are more susceptible and can have a more widespread and aggressive rash. Rashes normally scab over and heal without scarring, although some discoloration where the spots where can last for some time.
  • Mouth sores, similar to cold sores that you can see, can develop inside the mouth and tongue but mainly at the back of the throat. This can worsen appetite due to discomfort, so dehydration is a concern in a child who cannot tolerate fluids orally.
  • Diarrhea can occur before, during, or after the skin rash appears.
  • Nail shedding and loss of nails can occur weeks to a few months after onset. While alarming, this is not painful or dangerous, and the nails regrow on their own.

How do you treat hand, foot, and mouth disease?

There is no specific treatment for the virus. It needs to run its course, and this normally takes 7 to 10 days. Here are some suggestions about how to treat the symptoms in kids:

  • For fevers and discomfort, over-the-counter medicines like acetaminophen and ibuprofen can be used. (Note: Aspirin should not be used in children.)
  • It’s important to drink plenty of fluids to prevent dehydration. Cold foods like ice cream, smoothies, and popsicles also help by numbing the area in the mouth. Soft foods like yogurt, pudding, and mashed potatoes can help, and these all can be a nice treat for kids who have trouble swallowing. Avoid hot drinks, sodas, and acidic juices or foods because they can make the pain worse.
  • Get plenty of rest.
  • If mouth sores are particularly bothersome, ask your doctor for treatments that may ease discomfort like lidocaine gel or magic mouthwash (usually not used in kids younger than 6 years of age).
  • For skin rashes, a physician may recommend moisturizers. Symptoms do get better within 7 to 10 days for most people. Children with blisters on their hands or feet should keep the areas clean and uncovered. Wash the skin with lukewarm soap and water, and pat dry to keep it clean. If a blister pops, dab on a bit of antibiotic ointment to help prevent infection, and cover it with a small bandage.
  • Try to stay as comfortable as possible, and prevent transmission by washing hands and using good hand hygiene.

 How do you prevent hand, foot and mouth disease?

There are some steps you can take to prevent this condition. These include:

  • Wash hands with soap and water often.Hand washing is especially important after using the toilet, after changing diapers or potty training, before and after eating, and before preparing food.
  • Keep hands away from the eyes, nose, and mouth.
  • Avoid close contact with anyone who has it.
  • Disinfect surfaces if an infected person came in contact with them.

When can my child return to school or daycare?

A child can return to school if:

  • There is no fever for 24 hours
  • There are no new skin lesions or open blisters (most lesions should be scabbing over).
  • They appear well enough and active.

When should I call my doctor?

You should call the doctor if:

  • Your child is not able to drink normally and you’re worried they might be getting dehydrated (very sluggish, urine less than three times a day, sunken eyes).
  • The fever lasts longer than three to four days.
  • Symptoms do not improve after 10 days.
  • Your child has a weakened immune system (body’s ability to fight germs and sickness).
Learn more about Pediatrics at Mount Sinai

Giving Thanks and Helping Kids Express Gratitude

Nov 21, 2023 | Featured, Your Health

With the holiday season upon us, it’s that time of year when we take a moment to reflect and give thanks for the wonderful blessings in our lives. We gather with family and friends to feast and celebrate, and we express our gratitude through acts of kindness and appreciation.

Children are excited for the big season ahead and the wonder of it all. But how do we encourage them to embrace and express gratitude—and not only now but all year round? It might be a bit of an abstract concept for some little ones.

There are many reasons why teaching kids gratitude is important, according to Aliza Pressman, PhD, co-Founding Director and Director of Clinical Programming for the Mount Sinai Parenting Center. She explains how practicing gratitude has been linked to many positive outcomes and ways to express gratitude.

“Gratitude is a value that your family can hold dear and practice together in various ways,” she says. “It can be a family tradition that is celebrated all year round. But it’s not just about teaching kids to say, ‘thank you.’ We all know that being grateful is about so much more than that. We need to ask kids ‘How did that make you feel?’ This way, they can start linking the emotion and the feeling of gratitude with the words.”

In addition, gratitude can have health benefits for kids—such as improved relationships, better physical health, reduced depression and anxiety, enhanced empathy, reduced aggression, better sleep, increased resilience, and improved performance at school or with chores at home.

Dr. Pressman suggests starting a “gratitude practice” in your own life, and modeling one for your children.

“Cultivating gratitude in our children balances the many challenges we all face, and helps to promote connected, grounded and involved citizens in our communities,” she says. “However, we sometimes fall into a trap of forcing a feeling of gratitude in our children and this is not something we can force.”

In fact, gratitude takes patience. “The benefits of a gratitude practice expand over time, unlike many of the quick fix or feel good solutions we usually turn to,” she says. “Effects of gratitude occur in the prefrontal cortex and make us more sensitive to emotional connectivity and relationships with others.”

 Here are five ways we can help children learn to express gratitude:

  • Model saying “thank you” and help your child to thank others in whatever way they feel comfortable. Write thank you notes, make cards, or send videos to show others you are grateful for them. Sharing a message to say thank you means so much.
  • Use the phrase “I really appreciate” when noticing acts for which you are grateful.
  • Play the rose/thorn/bud game at the dinner table. For the rose, name one sweet part of the day. For the thorn, name one challenge. For the bud, name one thing you are excited for or are looking forward to.
  • Volunteer in your community. Find an opportunity to help others and discuss how that act adds value to your own life and a sense of purpose.
  • Create a gratitude journal that you fill out on holidays or special occasions. This can be a gratitude tree for Thanksgiving or a birthday gratitude journal. Have each family member participate and read the entries from the year before.

Consistency is the key to helping make lasting change in your family, so keep it simple and easy for you to work into everyday life. Avoid labels like “spoiled” in your own home, and focus instead on feeling appreciative for what you have and what surrounds you.

“Let your children feel grateful for whatever comes naturally to them, and don’t judge. Remember that your goal is to inspire your children into building this muscle, not force them into it,” says Dr. Pressman. All of your hard work, thoughtfulness, and efforts now will have an great impact on your children for years to come. This is a wonderful way of sharing gratitude and giving thanks full circle.”

 

Learn more about the Mount Sinai Parenting Center
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My Child Is Having Difficulties Eating, Do We Need to See a Feeding Specialist?

Nov 15, 2023 | Your Health

When it comes to food, babies and young children can be picky eaters. It could be a forkful of broccoli that is met with resistance or a whole meal that they push away, yet parents often expect these reactions when introducing new foods.

But what do you do if mealtime is a constant source of agitation for your child? For example, they refuse to eat anything except for one particular item, such as french fries. Or you have noticed that they are taking forever to chew and swallow certain foods. These reactions may not be related to their personal preferences. They could be signs of a problem that needs to be addressed by a feeding specialist.

What is a feeding specialist?

A feeding specialist is a trained medical professional who works with you and your child to determine whether the food issues you have noticed are a phase that your child is expected to outgrow independently or if this is something that requires intervention.  Additionally, the specialist will help to pinpoint if feeding struggles are behavioral or if there is an underlying medical condition contributing to the challenges associated with eating or drinking.  A specialist’s examination will help get to the root of the problem and establish next steps for treatment when necessary.

Beth Kraus, MS, CCC-SLP, Speech Language Pathologist and Senior Clinical Specialist at the Department of Pediatric Otolaryngology at the New York Eye and Ear Infirmary of Mount Sinai.

“There are certain medical conditions that place kids at a higher risk for a feeding issue,” says Beth Kraus, MS, CCC-SLP, Speech Language Pathologist and Senior Clinical Specialist at the Department of Pediatric Otolaryngology at the New York Eye and Ear Infirmary of Mount Sinai.

“In some instances, a feeding problem is one of the first red flags, and we discover the underlying medical condition through thorough examination.”

When should I see a feeding specialist?

There are several signs that a child may be experiencing feeding issues that go beyond picky eating. These signs differ based on age and stage of development.

For babies who are still being breastfed or bottle fed, look for:

  • Arching of the back or general stiffness during feeding
  • Constant crying or fussing during or after feeding
  • Problems staying awake during feeding
  • Few or no wet diapers
  • Difficulty latching on the breast or bottle, spilling milk/formula from the mouth
  • Generally refusing the breast or bottle

“Stiffness, arching, or fussing during or after feeding generally are typically signs of discomfort and may indicate digestive concerns,” Ms. Kraus says. “However, lack of wet diapers or weight gain is a strong indicator that a child is not receiving enough calories to grow.”

For children who have transitioned to solid food, look for signs such as:

  • Refusing or turning their head away when offered food
  • Agitation at the sight of food
  • Choking or gagging when eating or drinking
  • Struggling or unwillingness to chew their food
  • Taking a long time to eat a meal
  • Avoiding all but one type of food
  • Frequent vomiting
  • Lack of weight gain
  • Changes in vocal quality during or after mealtime, such as a wet or phlegmy voice
  • Nasal stuffiness when eating
  • Pronounced drooling or significant food or liquid dripping out of the mouth
  • Frequent respiratory infections

What do I do if my child has signs of feeding issues?

In cases where there is a safety concern, such as coughing, choking, gagging, persistent vomiting, or ongoing weight loss, you should immediately contact your pediatrician for an initial assessment. This will help rule out acute illness as a possible cause before you are referred to a feeding specialist for work-up of a chronic feeding problem.

Prior to meeting with a feeding specialist, Ms. Kraus also recommends keeping a daily log of food intake and behaviors during snacks and meals to get a better sense of both the issues that your child is experiencing and their frequency. This will help to provide concrete details during your child’s evaluation.

“Often times, parents can identify that something isn’t quite right during mealtimes, but they have a hard time quantifying the frequency or identifying specifics of the problem when they are in the office with the specialist,” says Ms. Kraus. “Having some data collected beforehand will help the specialist complete a more comprehensive assessment right from the initial encounter.”

Learn more about Pediatric Otolaryngology at NYEE

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