IMG_1211_blurredSince my arrival to Central Florida last June, I have seen many preschool and school aged children with recurrent "croup". These are children who are usually otherwise completely healthy, but has "episodes" or attacks where they have trouble breathing, have harsh "barky" cough, and are frequent flyers to the Emergency Room especially in the middle of the night.  I have several in recent months who have not only logged over 8-10 visits to the Emergency Department in a 6 month period, but have even been hospitalized for this condition.  These children are usually given the diagnosis of "croup", given steroids in the ED, then discharged home with their own bottle of steroid that mom keeps in the fridge.

As I experienced my career epiphany over the last several years about how our children’s diet and dietary habits may lead to ENT symptoms, I have noticed something remarkable that many children with recurrent croup have in common: love of beverages high in sugar content! No joke, I have just performed airway endoscopy recently on a few patients who thankfully their airway anatomy is completely normal, yet their episodes are most likely “laryngospasm” or “Charley horse” of their larynx or voice box.  The voice box will protect us from having food, beverages, stomach content, and any other foreign objects and anything that is not air from entering. How our bodies protect us is that anytime the mucosa or mucous membrane lining of the voice box senses any sensation that something is about to enter, cough will occur to make sure that our windpipe and lungs are kept free of anything other than air.

After interviewing countless families about what their “croupy” child eats and drinks day to day, here is what almost all these children have in common…..

1. Love of Chocolate Milk! This is the ultimate in Milk and Cookie Disease as there is at least 25 grams of sugar per 8 oz serving of chocolate milk, low fat or not. most of these patients will drink it at least once per day, often 2-3 times (with school lunches every day) and then at home, and especially in the evenings and before bed!!! The milk and dairy becomes more acidic as it sits in the stomach, and curdles, and the high sugar content breaks down into acid, and this will make anyone “upchuck” a little into the throat which I believe triggers the laryngospasm

2. Love JUICE!!! I mean to the point that several mothers tell me, “he will not drink water”. I have parents who tell me that if they dilute the apple juice too much their child simply will not drink it, that the children know when it’s diluted and will not accept that.  This is horrific for our nation, as endless number of children are ADDICTED to juice and sweetened beverages!  Okay, here are what croupy kids have in common

Apple Juice – basically, they can open the fridge and/or are given apple juice several times through out the day……but that’s not all…..they will drink orange juice,      grape juice, cranberry juice, just about any juice you can think of, instead of water.  One 8 oz glass of Motts 100% apple juice has 27.8 grams of sugar! Yes,  the label stating that its 100% juice, or any other brand label that states ” no sugar added”, generally gives parents false security that somehow it’s safe and good for kids. bsolutely not!

3. All other pouch/sweetened beverages, like Capri Sun – 25% less sugar, Pacific Cooler , for example – 16 grams of sugar in each pouch! most kids drink more than one pouch per day, often parents will pack one for lunch and then who knows how many after school and whenever.

4. Gatorade – 34 grams of sugar in a 20 oz bottle

5. SODA – for example, Coke 12 oz can has 39 grams of sugar, 20 oz bottle has 65 grams of sugar, all other sodas also high in sugar, rootbear = 39 grams of sugar, Sprite may be less but still sugary

6. Strawberry milk or YOO HOO – 30 gram of sugar

You get the point, the same kids who love sugary drinks, do not drink  much water, tend to not eat much fresh fruits and vegetables, and also love tubes of G0gurts (10 grams of sugar per tube).

Simple math: one of my 10 year old patient’s mother reported that in a single day, the child drinks :

4-5 glasses of juice                                                                  28 grams x 5 = 140 grams

2-3 glasses of chocolate /strawberry milk                    25 grams x 3 = 75 grams

3-5 Capri Suns                                                                            16 grams x 4 = 64 grams

so far that’s 279 grams of sugar, just on liquids alone, not including the rest of the diet which likely includes candy, yogurt, fruit snacks, let’s hope not LUNCHABLES (46+ grams of sugar),

Please share this with all families/parents that you know so that we can stop this horrific epidemic in America. My goal is not NEVER, but that our children must drink water again, and lots of it, and we have to stop enabling and supporting industry crafted addiction by buying them for our children.  As I told a mother of a 3 year old this week who drinks no water, “If we don’t teach him to drink water now, he will probably have no reason to drink it every for the rest of his life”. Children will unlikely grow up and just suddenly wean themselves off of sugar and processed foods and beverages, it is up to us to help them live A Healthier Wei!

If you haven’t read it, enjoy my blog on “SUGAR” and one on Top Foods/Beverages to Avoid for Children.

As for these children with recurrent croup, I have been very fortunate that most parents are willing to listen and try something other than medications to help stop these scary episodes. Most children stop having these episodes of “spasmodic croup” or recurrent croup, or whatever kind of croup, once parents eliminate majority of sugar, juices, and eliminate later afternoon/evening/bedtime milk along with eliminating MCD at night. Decrease in reflux results in decreased over-triggering of the larynx to protect itself and the hyper-reactiveness to constant and excessive coughing!


Dr. Julie Wei is a pediatric ear, nose, and throat specialist and the author of A Healthier Wei. As a mother herself, Dr. Wei is a passionate advocate for improving children's health through better diet and dietary habits. She has been committed to helping parents learn how to eliminate their child's ear, nose, and throat problems simply by reducing excessive sugar and dairy intake, as well as minimizing habitual late night snacking. She hopes to raise awareness for the need for accountability by both medical professionals and parents to ensure that children are not prescribed or take unnecessary medications long term.

When she is not in the clinic, operating room, or conducting research, you will find her in the kitchen preparing food with love along with her daughter Claire. If you sit next to her on the plane, she will likely share with you information about how to minimize choking hazards in young children, and many other tips for improving your child's health.