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Pain or discomfort in the chest (front or back)
This includes the area from the lower neck to the bottom of the rib cage
Most persistent chest pain is from a hacking cough. Coughing can cause sore muscles in the chest wall, upper abdomen or diaphragm.
Occasionally, chest pain follows strenuous exercise (e.g., throwing a baseball), lifting (e.g., weights or heavy boxes), or work that involves the upper body (e.g., digging). This type of muscle soreness often increases with movement of the shoulders.
Heartburn: Heartburn is due to reflux of stomach contents. It usually causes a burning discomfort under the lower sternum (breastbone).
Most brief chest pain lasting minutes is from harmless muscle cramps or a pinched nerve.
Heart disease is hardly ever the cause of chest pain in children.
Has asthma symptoms, see ASTHMA ATTACK
Caused by a cough, see COUGH
Severe difficulty breathing (struggling for each breath, grunting to push air out, unable to speak or cry or lips are bluish)
Not moving or too weak to stand
Your child looks or acts very sick
Your child has heart disease
Difficulty breathing, but not severe
Taking a deep breath makes pain worse
Severe chest pain
Heart beating very rapidly or has fainted
Followed a direct blow to the chest
Unexplained chest pain present (EXCEPTION: pain due to coughing, sore muscles, heartburn or other obvious cause)
You think your child needs to be seen urgently
You think your child needs to be seen, but not urgently
Fever is present
You have other questions or concerns
Chest pains only occur with vigorous exercise (eg, running)
Sore muscles lasts over 7 days
Heartburn persists over 2 days on treatment
Chest pains are a recurrent chronic problem
Normal chest pain from sore muscles or heartburn and you don't think your child needs to be seen
Chest pains in children lasting for a few minutes are usually harmless muscle cramps. They need no treatment.
Chest pains (sore muscles) from vigorous exercise or work using the upper body usually start soon after the activity and need the following treatment.
Pain Medicine: Give acetaminophen (e.g., Tylenol) or ibuprofen. Continue this until 24 hours have passed without pain.
Local Heat: Apply local heat for 20 minutes 4 times a day. Use a heating pad, warm washcloth or hot shower to the area.
Stretching Exercises: Gentle stretching exercises of the shoulders and chest wall in sets of 10 twice daily may prevent recurrence of muscle cramps. Stretching exercises can be continued even during active chest pain. Avoid any that increase the pain.
Expected Course: For sore muscles, the pain usually peaks on day 2 and lasts 6 or 7 days.
Call Your Doctor If:
Pain becomes severe
Pain lasts over 7 days on treatment
Your child becomes worse
Heartburn is common
It's due to stomach acid refluxed up into the esophagus
Causes a burning discomfort behind the lower sternum, a sour (acid) taste in the mouth and belching
Heartburn is usually easily relieved by 1 to 2 tablespoons (15 - 30 ml) of liquid antacid by mouth.
If you don't have an antacid, wash out the esophagus with 2 to 3 ounces (60 - 90 ml) of milk.
For persistent heartburn, give antacid 1 hour before meals and at bedtime for a few days.
Avoid overeating which overfills the stomach
Avoid foods that increase reflux (chocolate, fatty foods, spicy foods, carbonated soda, caffeine)
Avoid bending over during the 3 hours after meals
Avoid tight clothing or belts around the waist
Heartburn doesn't resolve after 2 days of treatment
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