Croup is a viral infection that causes swelling in the throat and vocal cords (larynx). Croup commonly affects children under five because their airways are smaller and more prone to swelling. One of the tell-tale signs of croup is a loud, "barky" cough that is worse at night.
Causes of croup
Children can get croup from many different viruses. The most common are parainfluenza, influenza (flu), adenovirus, respiratory syncytial virus (RSV), and measles. Croup is most common in the winter and early spring. This is when the viruses that cause croup peak.
Symptoms of croup
At first, your child may have typical cold symptoms like a runny or stuffy nose and fever. As his throat and voice box become more swollen, your child may have a raspy voice and then develop a harsh, barky cough. This cough is often worse at night or when your child is crying.
These signs and symptoms are common with croup:
- a loud cough that sounds like a barking seal
- a wheezing or grunting noise while breathing
- hoarse, raspy voice
- cold symptoms — runny or stuffy nose, fever, feeling tired
Your healthcare provider can usually diagnose croup by paying attention to your child's cough and breathing. They will also check for fever, cold symptoms or a recent viral infection. If your child's croup is serious and not getting better with treatment, the doctor may order an X-ray to rule out any other causes for the breathing problems.
Treatment for croup
Croup usually lasts five to six days and is worse at night. The symptoms usually peak on the second or third night. Most children with croup don't need medical attention and get better with home treatments.
Treatment at home
Most cases of croup are mild and don't need medical treatment. If your child has a mild case of croup, there are many things you can do at home to help him feel better:
- Stay calm. Croup can be scary for children —speaking quietly will soothe your child and make breathing easier. Try reading stories, listening to music or playing a quiet game.
- Sit your child upright to make it easier for him to breathe.
- Give your child moist air to breathe. Turn on the hot water in the shower and close the door. When the bathroom is steamy, shut off the water, close the door and then sit with your child in the steamy air for 10-15 minutes. Be sure to keep your child away from hot water to avoid burns.
- Take your child outside at night for a few minutes to breathe the cool night air. Be sure to dress your child in warm clothing if it's cold outside.
- If it's cool outside, bundle your child up warmly and buckle him into his car seat. Keeping your car heater turned off, drive around for 10 or 20 minutes. Sitting upright in cool air will help your child breathe easier.
- Give your child lots of clear fluids to drink — diluted juice, water, and popsicles are good choices.
- If your child has a fever and is uncomfortable, treat the fever with acetaminophen (for example, Children's Tylenol).
- Sleep in the same room as your child or within hearing distance to monitor his breathing. If symptoms are not getting better with home care (steam, night air, sitting upright), see your doctor.
Don't give your child cough syrups – children under 14 years should not take over-the-counter cough medicines (cough suppressants or expectorants)..
In more serious cases, the doctor may prescribe corticosteroids to reduce the swelling in your child's airways and make breathing easier. Antibiotics are not used to treat croup since a virus causes it.
Sometimes oxygen with mist (humidified) or cool mist is given to children coming to the hospital with croup. This treatment helps to open the airways and reduce swelling and irritation.
When to seek emergency treatment
Seek emergency medical help right away if your child has any of the following signs or symptoms:
- drooling or trouble swallowing
- blue lips/fingers
- high fever — above 39°C (102°F)
- difficulty breathing, the skin between the ribs pulls in with each breath
- a high-pitched, squeaking sound when your child takes a breath (stridor)
Croup is easily spread among children. The best way to prevent croup is to fight the spread of germs; wash your child's hands often with soap and water and avoid people who have respiratory tract infections like colds and flu.