Respiratory Problems, Age 11 and Younger
Respiratory Problems, Age 11 and YoungerSkip to the navigationTopic OverviewMost babies and older children have several mild infections of the
respiratory system each year. Upper respiratory systemThe upper respiratory
system includes the nose, mouth, sinuses, and throat. A child with an upper
respiratory infection may feel uncomfortable and sound very congested. Other
symptoms of an upper respiratory infection include: - A runny or stuffy nose. This may lead to blockage of the nasal
passages, causing the child to breathe through his or her mouth.
- Irritability, restlessness, poor appetite, and decreased activity
level.
- Coughing, especially when lying down.
- Fever that occurs suddenly and may reach
105°F (41°C).
Lower respiratory systemThe lower respiratory
system includes the bronchial tubes and lungs. Respiratory problems are less
common in the lower respiratory system than in the upper respiratory
system. Symptoms of a lower respiratory (bronchial tubes and
lungs) problem usually are more severe than symptoms of an upper respiratory
(mouth, nose, sinuses, and throat) problem. A child with a lower respiratory
problem is more likely to require a visit to a doctor than a child with an
upper respiratory problem. Symptoms of lower respiratory system
infections include: - Shallow coughing, which continues throughout the day and
night.
- Fever, which may be high with some lower respiratory system
infections, such as pneumonia.
- Irritability, restlessness, poor appetite, and decreased activity
level.
- Difficulty breathing. You may notice:
- Rapid breathing.
- Grunting, which is heard during the breathing out (exhaling)
phase of breathing. Most babies grunt occasionally when they sleep. But
grunting that occurs with rapid, shallow breathing may mean lower
respiratory system infection.
- Wheezing (which is a different sound than
croup).
- Flaring the nostrils and using the neck, chest, and abdominal
muscles to breathe, causing a "sucking in" between or under the ribs (retractions).
Respiratory problems may have many causes. Viral infectionsViral infections cause most upper
respiratory infections. Sore throats, colds, croup, and
influenza (flu) are common viral illnesses in babies
and older children. These infections are usually mild and go away in 4 to 10
days, but they can sometimes be severe. For more information, see the topics
Croup and
Influenza (Seasonal Flu). Home treatment can help
relieve the child's symptoms. The infection usually improves on its own within
a week and is gone within 14 days. Antibiotics are not used to
treat viral illnesses and do not alter the course of viral infections.
Unnecessary use of an antibiotic exposes your child to the risks of an
allergic reaction and antibiotic side effects, such as
nausea, vomiting, diarrhea, rashes, and yeast infections. Antibiotics also may
kill beneficial bacteria and encourage the development of dangerous
antibiotic-resistant bacteria. Viral
lower respiratory system infections may be mild, similar to upper respiratory
system infections. An example of a possibly serious viral infection is
bronchiolitis. Up to 10% of babies and children with
viral infections of the lower respiratory system, such as those caused by
respiratory syncytial virus (RSV), may develop severe
blockage of the air passages and require hospitalization for treatment. For
more information, see the topics
Acute Bronchitis, Pneumonia, and Respiratory Syncytial Virus (RSV) Infection. Bacterial infectionsThe most common sites for
bacterial infections in the upper respiratory system are the sinuses and
throat. A
sinus infection is an example of an upper respiratory
bacterial infection. Bacterial
pneumonia may follow a viral illness as a secondary infection or appear as the
first sign of a lower respiratory infection. In babies and small children, the
first sign of infection often is rapid breathing, irritability, decreased
activity, and poor feeding. Antibiotics are effective against bacterial
infections. Tuberculosis is a less common bacterial
infection of the lower respiratory system. AllergiesAllergies are a common cause of
respiratory problems. Allergy symptoms in children include: - Clear, runny drainage from the nose or a stuffy nose. Children
often rub their noses by pushing the tip upward with the palm of the hand
("allergic salute").
- Sneezing and watery eyes. Often there are dark circles under the
eyes ("allergic shiners").
- Irritability and loss of appetite.
AsthmaBabies and small children usually do not have
asthma. But the number of new cases of asthma
increases with age. - In babies and small children, a hacking cough may be the only
symptom of mild asthma.
- If asthma worsens, symptoms may include wheezing and shortness of
breath after exercise or at nighttime.
- In severe asthma, difficulty breathing (using the neck, chest,
and abdominal muscles to breathe) and a high-pitched sound when breathing
(wheezing) are the most common symptoms.
- Allergies and asthma often occur together. For more information,
see the topic
Asthma in Children.
Other causesBesides asthma, allergies, and
infection, other possible causes of respiratory problems in children
include: - Exposure to cigarette smoke. Tobacco smoke impairs lung growth
and development. Children who are exposed to tobacco smoke, even before birth
(prenatal), are more likely to have asthma and other respiratory
problems.
- Blockage of the airway by an
inhaled object, such as food, a piece of a balloon, or
a small toy. For more information, see the topic
Swallowed or Inhaled Objects.
- Problems that have been present from birth (genetic causes), such
as
cystic fibrosis.
Babies and children younger than age 3 may have more
symptoms with respiratory problems than older children, and they may become
more ill. For this reason, younger children need to be watched more closely.
The type and severity of the symptoms helps determine whether your child needs
to see a doctor. Check your child's symptoms to decide if
and when your child should see a doctor. Check Your SymptomsDoes your child have a respiratory problem? Respiratory problems can affect the nose, mouth, sinuses, and throat (upper respiratory system) or the bronchial tubes and lungs (lower respiratory system). How old are you? Less than 3 months Less than 3 months 3 to 11 months 3 to 11 months 12 months to less than 3 years 12 months to less than 3 years 3 to 11 years 3 to 11 years 12 years or older 12 years or older Has your child swallowed or inhaled an object? Yes Swallowed or inhaled object No Swallowed or inhaled object Has your child had surgery in the past 2 weeks? Surgery can cause problems that make your child cough. Yes Surgery within past 2 weeks No Surgery within past 2 weeks Does your baby seem sick? A sick baby probably will not be acting normally. For example, the baby may be much fussier than usual or not want to eat. How sick do you think your baby is? Extremely sick Baby is very sick (limp and not responsive) Sick Baby is sick (sleepier than usual, not eating or drinking like usual) Would you describe the breathing problem as severe, moderate, or mild? Severe Severe difficulty breathing Moderate Moderate difficulty breathing Mild Mild difficulty breathing Is your child having trouble breathing (more than a stuffy nose)? Yes Difficulty breathing more than stuffy nose No Difficulty breathing more than stuffy nose Yes Drooling and unable to swallow No Drooling and unable to swallow Would you describe the breathing problem as severe, moderate, or mild? Severe Severe difficulty breathing Moderate Moderate difficulty breathing Mild Mild difficulty breathing Does your child have a chronic health problem that affects his or her breathing, such as asthma? A breathing problem may be more of a concern if your child normally does not have breathing problems. Yes Has chronic breathing problems No Has chronic breathing problems Is the problem your child is having right now different than what you are used to? Yes Breathing problem is different than usual symptoms No Breathing problem is different than usual symptoms Is your child's ability to breathe: Getting worse? Breathing problems are getting worse Staying about the same (not better or worse)? Breathing problems are unchanged Getting better? Breathing problems are getting better Is your child's ability to breathe: Quickly getting worse (within minutes or hours)? Breathing problems are quickly worsening Slowly getting worse (over days)? Breathing problems are slowly worsening Staying about the same (not better or worse)? Breathing problems are unchanged Getting better? Breathing problems are getting better Does your child make a harsh, high-pitched sound when he or she breathes in? This often occurs with a loud cough that sounds like a barking seal. Yes Harsh, high-pitched sound when breathing No Harsh, high-pitched sound when breathing Does your child have symptoms of a serious illness? Yes Symptoms of serious illness No Symptoms of serious illness Do you think your baby has a fever? Did you take a rectal temperature? Taking a rectal temperature is the only way to be sure that a baby this age does not have a fever. If you don't know the rectal temperature, it's safest to assume the baby has a fever and needs to be seen by a doctor. Any problem that causes a fever at this age could be serious. Yes Rectal temperature taken No Rectal temperature taken Is it 100.4°F (38°C) or higher? Yes Temperature at least 100.4°F (38°C) No Temperature at least 100.4°F (38°C) Do you think your child has a fever? Did you take your child's temperature? How high is the fever? The answer may depend on how you took the temperature. High: 104°F (40°C) or higher, oral High fever: 104°F (40°C) or higher, oral Moderate: 100.4°F (38°C) to 103.9°F (39.9°C), oral Moderate fever: 100.4°F (38°C) to 103.9°F (39.9°C), oral Mild: 100.3°F (37.9°C) or lower, oral Mild fever: 100.3°F (37.9°C) or lower, oral How high do you think the fever is? Moderate Feels fever is moderate Mild or low Feels fever is mild How long has your child had a fever? Less than 2 days (48 hours) Fever for less than 2 days From 2 days to less than 1 week Fever for more than 2 days and less than 1 week 1 week or longer Fever for 1 week or more Does your child have a health problem or take medicine that weakens his or her immune system? Yes Disease or medicine that causes immune system problems No Disease or medicine that causes immune system problems Does your child have shaking chills or very heavy sweating? Shaking chills are a severe, intense form of shivering. Heavy sweating means that sweat is pouring off the child or soaking through his or her clothes. Yes Shaking chills or heavy sweating No Shaking chills or heavy sweating Does your child have a cough? When your child is coughing, does his or her face turn blue or purple? Yes Color changes to blue or purple when coughing No Color changes to blue or purple when coughing Has the coughing been so bad that it has made your baby vomit? Yes Vomiting after coughing spasm No Vomiting after coughing spasm Is your baby coughing up blood? Is your baby eating less than usual? Yes Change in eating habits No Change in eating habits Has your baby had a cough for more than 1 full day (24 hours)? Yes Cough for more than 24 hours No Cough for 24 hours or less Is your child coughing up mucus, phlegm (say "flem"), or blood from the lungs? This is called a productive cough. Mucus or blood draining down the throat from the nose because of a cold, a nosebleed, or allergies is not the same thing. Yes Coughing up sputum or blood No Coughing up sputum or blood Is your child coughing up blood? How much blood is there? Thin streaks of blood Streaks More than just streaks More than streaks Has this been going on for more than 2 days? Yes Coughing up mucus for more than 2 days No Coughing up mucus for more than 2 days Has the coughing been so bad that it has made your child vomit? Yes Vomiting after coughing spasm No Vomiting after coughing spasm Has your child had a cough for more than 2 weeks? Yes Cough for more than 2 weeks No Cough for more than 2 weeks Did the symptoms start after your child took a new medicine? Do not give your child any more of the medicine until you have talked to the child's doctor. Yes Medicine may be causing problems No Medicine may be causing problems Does your child have a runny nose? Does your baby have trouble eating or sleeping because of a runny, stuffy nose? Yes Trouble eating or sleeping because of nasal congestion No Trouble eating or sleeping because of nasal congestion Is there thick, yellow drainage coming from your child's nose? Yes Thick, yellow nasal drainage No Thick, yellow nasal drainage Has your child had the nasal drainage for more than 2 days? Yes Nasal drainage for more than 2 days No Nasal drainage for more than 2 days Is your child acting sicker than you would expect if he or she had a minor illness, like a cold? Yes Seems sicker than expected No Seems sicker than expected Does your child have a runny nose, watery eyes, and a lot of sneezing without other cold symptoms? Have your child's symptoms lasted longer than 2 weeks? Yes Symptoms for more than 2 weeks No Symptoms for more than 2 weeks Many things can affect how your body responds to a symptom and what kind
of care you may need. These include: - Your age. Babies and older
adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
sooner.
- Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
worse.
- Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.
Try Home TreatmentYou have answered all the questions. Based on your answers, you may be
able to take care of this problem at home. - Try home treatment to relieve the
symptoms.
- Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.
Symptoms of serious illness in a baby
may include the following: - The baby is limp and floppy like a rag doll.
- The baby doesn't respond at all to being held, touched, or talked
to.
- The baby is hard to wake up.
Symptoms of serious illness may
include: - A severe headache.
- A stiff
neck.
- Mental changes, such as feeling confused or much less
alert.
- Extreme fatigue (to the point where it's hard for you to
function).
- Shaking chills.
If you're not sure if a child's fever is high, moderate, or
mild, think about these issues: With a high fever: - The child feels very hot.
- It is likely
one of the highest fevers the child has ever had.
With a moderate fever: - The child feels warm or hot.
- You are
sure the child has a fever.
With a mild fever: - The child may feel a little warm.
- You
think the child might have a fever, but you're not sure.
Symptoms of difficulty breathing can range from mild to severe. For example: - You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
- It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).
Symptoms of difficulty breathing in a baby or young child can range from mild to severe. For example: - The child may be breathing a little faster than usual (mild difficulty breathing), or the child may be having so much trouble that the nostrils are flaring and the belly is moving in and out with every breath (severe difficulty breathing).
- The child may seem a little out of breath but is still able to eat or talk (mild difficulty breathing), or the child may be breathing so hard that he or she cannot eat or talk (severe difficulty breathing).
Severe trouble breathing means: - The child cannot eat or talk because he or she is
breathing so hard.
- The child's nostrils are flaring and the belly
is moving in and out with every breath.
- The child seems to be
tiring out.
- The child seems very sleepy or confused.
Moderate trouble breathing means: - The child is breathing a lot faster than
usual.
- The child has to take breaks from eating or talking to
breathe.
- The nostrils flare or the belly moves in and out at times
when the child breathes.
Mild trouble breathing means: - The child is breathing a little faster than usual.
- The child seems a little out of breath but can still eat or talk.
A baby that is extremely sick: - May be limp and floppy like a rag
doll.
- May not respond at all to being held, touched, or talked
to.
- May be hard to wake up.
A baby that is sick (but not extremely
sick): - May be sleepier than usual.
- May not eat
or drink as much as usual.
Temperature varies a little depending on how you measure it.
For children up to 11 years old, here are the ranges for high, moderate, and
mild according to how you took the temperature. Oral (by mouth), ear, or rectal temperature - High:
104°F (40°C) and
higher
- Moderate:
100.4°F (38°C) to
103.9°F (39.9°C)
- Mild:
100.3°F (37.9°C) and
lower
A forehead (temporal) scanner is usually 0.5°F (0.3°C) to 1°F (0.6°C) lower than an oral temperature. Armpit (axillary) temperature - High: 103°F (39.5°C) and higher
- Moderate:
99.4°F (37.4°C) to
102.9°F (39.4°C)
- Mild: 99.3°F (37.3°C) and lower
Note: For children under 5 years old, rectal temperatures are
the most accurate. You can use a small rubber bulb (called an aspirating bulb)
to remove mucus from your baby's nose or mouth when a
cold or allergies make it hard for the baby to eat, sleep, or breathe. To use the bulb: - Put a few saline nose drops in each side of the
baby's nose before you start.
- Position the baby with his or her
head tilted slightly back.
- Squeeze the round base of the
bulb.
- Gently insert the tip of the bulb tightly inside the baby's
nose.
- Release the bulb to remove (suction) mucus from the
nose.
Don't do this more than 5 or 6 times a day. Doing it too often
can make the congestion worse and can also cause the lining of the nose to
swell or bleed. Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in children are: - Diseases such as diabetes, cystic fibrosis, sickle
cell disease, and congenital heart disease.
- Steroid medicines,
which are used to treat a variety of conditions.
- Medicines taken
after organ transplant.
- Chemotherapy and radiation therapy for
cancer.
- Not having a spleen.
Sudden drooling and trouble swallowing can be signs of a
serious problem called epiglottitis. This problem can
happen at any age. The epiglottis is a flap of tissue at the back
of the throat that you can't see when you look in the mouth. When you swallow, it closes to keep food and fluids out of the
tube (trachea) that leads to the lungs. If the epiglottis becomes inflamed or
infected, it can swell and quickly block the airway. This makes it very hard to
breathe. The symptoms start suddenly. A person with epiglottitis
is likely to seem very sick, have a fever, drool, and have trouble breathing,
swallowing, and making sounds. In the case of a child, you may notice the child
trying to sit up and lean forward with his or her jaw forward, because it's
easier to breathe in this position. Seek Care NowBased on your answers, you may need care right away. The problem is likely to get worse without medical care. - Call your doctor now to discuss the symptoms and
arrange for care.
- If you cannot reach your doctor or you don't have
one, seek care in the next hour.
- You do not need to call an
ambulance unless:
- You cannot travel safely either by driving
yourself or by having someone else drive you.
- You are in an area
where heavy traffic or other problems may slow you down.
Call 911 NowBased on your answers, you need
emergency care. Call911or other emergency services now. Seek Care TodayBased on your answers, you may need care soon. The
problem probably will not get better without medical care. - Call your doctor today to discuss the symptoms
and arrange for care.
- If you cannot reach your doctor or you don't
have one, seek care today.
- If it is evening, watch the symptoms and
seek care in the morning.
- If the symptoms get worse, seek care
sooner.
Make an Appointment Based on your answers, the problem may not improve without medical
care. - Make an appointment to see your doctor in the
next 1 to 2 weeks.
- If appropriate, try home treatment while you
are waiting for the appointment.
- If symptoms get worse or you have
any concerns, call your doctor. You may need care sooner.
Respiratory Problems, Age 12 and Older Postoperative Problems Swallowed or Inhaled Objects Home TreatmentMost children have 7 to 10 mild upper
respiratory infections each year. Your child may feel uncomfortable and have a
stuffy nose. The infection is usually better within a week and is usually gone
within 14 days. Home treatment is appropriate for mild symptoms
and can help your child feel better. - Keep the room temperature comfortable for you and your child. A
hot, dry environment will increase nasal congestion.
- Raise the head of your baby's bed about
1 in. (2.5 cm) to
2 in. (5 cm) by placing blocks
under the crib. Do not raise just the mattress because it may leave a gap for
your baby to roll into. Do not raise the head of the bed
if your baby is younger than 6 months.
- Prevent
dehydration.
- Let your baby breastfeed more often or give your baby extra
bottles. Liquids may help thin the
mucus and also reduce fever (if present).
- Do not awaken your child during naps or at night to take
fluids.
- Do not force your child to take fluids, which may cause your
child to vomit.
- Give your child extra cuddling and distraction.
- Let your child get extra rest to fight the infection.
- Do not give your child leftover antibiotics or antibiotics or other
medicines prescribed for someone else.
- Put a
vaporizer or humidifier in your child's room if he or
she is breathing through the mouth.
- Lukewarm mist may help your child feel more comfortable by
soothing the swollen air passages. It may also help with your child's
hoarseness. But do not let your child's room get uncomfortably cold or very
damp.
- Use a shallow pan of water to provide moisture in the air
through evaporation if you don't have a humidifier. Place the pan where no one
will trip on it or fall into it.
- If your child has a stuffy nose:
- Use
saline nose drops to help with nasal
congestion.
- Use a
rubber bulb to suction the nose sparingly. It will help reduce nasal
drainage if your baby is having difficulty breastfeeding or bottle-feeding or
seems to be short of breath. Babies often do not like having their noses
suctioned with a rubber bulb.
- Do not give your child oral
antihistamines or
decongestants unless directed to do so by your child's
doctor. Antihistamines and decongestants can cause your child to behave
differently, making it harder to tell how sick he or she really is. Studies
show that over-the-counter cough medicines do not work very well. And some of
these medicines can cause problems if you use too much of them. It is important
to use medicines correctly and to keep them out of the reach of children to
prevent accidental use.
- If your child has a cough:
- Honey or lemon juice in hot water or tea may
help a dry cough. Do not give honey to a child younger than 1 year old. It may
have bacteria that are harmful to babies.
- Be careful with cough and cold medicines. Don't give them to children younger than 6, because they don't work for children that age and can even be harmful. For children 6 and older, always follow all the instructions carefully. Make sure you know how much medicine to give and how long to use it. And use the dosing device if one is included. For more information, see Quick Tips: Giving Over-the-Counter Medicines to Children.
- If your child has a barking cough during the night, you can
help him or her breathe better using a humidifier or running a hot shower in the bathroom to make the air moist.
Medicine you can buy without a prescription Try a nonprescription
medicine to help treat your child's fever or pain: |
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Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine. | Safety tips Be sure to follow these
safety tips when you use a nonprescription medicine: |
---|
- Carefully read and follow all labels on the medicine bottle
and box.
- Give, but do not exceed, the maximum recommended
doses.
- Do not give your child a medicine if he or she has had an
allergic reaction to it in the past.
- Do not give aspirin to anyone younger than age 20 unless directed to do so by your child's doctor.
- Do not give naproxen (such as Aleve) to children
younger than age 12 unless your child's doctor tells you to.
| Symptoms to watch for during home treatmentCall your child's doctor if any of the following occur during home
treatment: - Difficulty breathing develops.
- Increased drooling develops.
- Cough gets worse or a persistent cough develops.
- Symptoms become more severe or frequent.
PreventionIt is common for children to develop
respiratory problems (such as viral infections) because they are often exposed
to other people who have infections and have not built up immunity. There is no
sure way to prevent many respiratory illnesses in babies and children. Very
young babies are at greater risk for developing complications from respiratory
illnesses, so it is important to do what you can to protect them from exposure.
The following may help reduce your child's risk for respiratory
problems: - If you have a respiratory infection, such as a cold or the
flu, or if you are caring for someone with a
respiratory infection,
wash your hands before caring for your child. Hand-washing eliminates the
germs on your hands and the spread of germs to your child when you touch your
child or touch an object he or she might touch.
- If your child goes to a day care center, ask the staff to wash
their hands often to prevent the spread of infection.
- Make sure that your child gets all of his or her vaccinations,
especially for diphtheria, tetanus, and pertussis (DTaP) and for
Haemophilus influenzae type b (Hib). For more
information, see the topic
Immunizations.
- Breastfeed your baby for at least the first 6 months after birth,
if possible. Breastfed children develop fewer respiratory problems than those
who are not breastfed.
- If one of your children is sick, separate him or her from other
children in the home, if possible. Put the child in a room alone to
sleep.
- Do not smoke or use other tobacco products. If you smoke, quit. If
you cannot quit, do not smoke in the house or car. Secondhand smoke irritates
the mucous membranes in your child's nose, sinuses, and lungs and increases his
or her risk for respiratory infections. For more information, see the topic Quitting Smoking.
- Avoid giving young children food or objects that may be improperly
swallowed and inhaled, such as nuts, popcorn, small candies, or small toys. An
inhaled object can lead to a respiratory infection. For more information, see
the topic
Swallowed or Inhaled Objects.
- For information on preventing allergies or asthma, see the topic
Allergic Rhinitis or
Asthma in Children.
Preparing For Your AppointmentTo prepare for your appointment, see the topic Making the Most of Your Appointment. You can help your child's
doctor diagnose and treat your child's condition by being prepared to answer
the following questions: - Did the symptoms start as a cold but now appear to be worse than
you would expect from a cold?
- What home treatment have you tried? Did it help?
- What nonprescription medicines have you used? Did they help?
- What prescription and nonprescription medicines does your child
take?
- Does your child seem to have any symptoms that indicate an
infection in one area, such as pain in one ear?
- Has your child had any other recent illnesses?
- Has your child had his or her routine immunizations?
- Does another member of your family have similar symptoms?
- Has your child been eating, sleeping, and playing normally?
- Have you, your child, or another member of your family recently
traveled, either inside or outside of the country?
- Does your child have any
health risks?
CreditsByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine John Pope, MD - Pediatrics Kathleen Romito, MD - Family Medicine Specialist Medical ReviewerAdam Husney, MD - Family Medicine Current as ofMarch 20, 2017 Current as of:
March 20, 2017 Last modified on: 8 September 2017
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