Croup
Seal-like, barky cough
Croup
Croup is an infection that is caused by a virus. It can cause swelling of the upper airway, including the windpipe (trachea), voice box (larynx) and vocal cords. This swelling can lead to a hoarse voice, barky cough and sometimes difficulty breathing. It occurs most often in babies and children up to 3 years of age because their airways are smaller, but older children can also get it.
Croup most often happens in the fall and winter months, but it can happen in any season.
Signs & Symptoms
You might hear a high-pitched sound (sometimes as a harsh, vibrating sound) when your child breathes in – this is called stridor. Stridor can get worse when a child cries or coughs. If croup gets worse, your child may also have stridor while resting, and may have trouble breathing.
Croup symptoms usually start in the late evening and night and come on quite suddenly. It is not unusual for symptoms to improve during the day and then happen again the next night. Most children are better within two days, but some can have symptoms for up to a week.
What To Do
Most cases of croup are mild and can be treated at home.
Symptoms can get worse when your child is excited.
Take him/her outside for several minutes, or for a car ride with the window slightly rolled down. You could also try sitting by an open window, or freezer door, but make sure your child is dressed warmly. Another option is to use a cool-mist humidifier or run a cold shower and sit with your child in the bathroom with the door closed. The cool air helps with breathing.
Give your child plenty of clear fluids or popsicles when awake. This will help restore fluids and to loosen phlegm.
Plenty of rest will help fight the infection.
*Give your child acetaminophen (such as Tylenol® or Tempra®) or ibuprofen (such as Advil® or Motrin®) for fever or discomfort. Make sure you read the instructions on the bottle before giving any medicine to your child.
Call your doctor if:
- your child's symptoms last for more than 10 days;
- your child has a fever for more than 2 to 3 days; or
- you have any questions or concerns.
Go to the emergency department if your child:
- does not improve after 15 minutes of breathing cool air;
- has difficulty breathing (when not coughing);
- starts drooling or having trouble swallowing;
- makes a high-pitched noise when breathing in, even when he/she is calm and cold air does not help; or
- begins acting very sick.
Call 911 immediately if your child:
- has bluish lips or fingernails;
- appears very tired;
- faints or passes out (is unconscious); or
- stops breathing.
Treatment & Management
What can a doctor do for croup?
A doctor can prescribe dexamethasone - this is a steroid medicine that helps decrease the swelling in the throat, making it easier to breathe and the cough less harsh. It is given as a syrup into the mouth.
Some children need to stay in hospital for a couple of days to continue getting epinephrine and dexamethasone until the symptoms improve.
When can my child go back to school or daycare?
Children with croup can go back to school or daycare once they no longer have a fever and feel well enough to do everyday activities. Your child can return to school or daycare even if he/she still has a cough.
Dexamethasone takes a few hours to work so in more severe cases of croup, a medicine called epinephrine might be given first.
Epinephrine is given through a mask and should help your child breathe easier right away. The effects of epinephrine doesn't last very long so your child will need to stay at the hospital for observation.
Find Out More
Children get croup by coming into contact with another person who has the virus. The virus is spread through coughing, sneezing or contact with mucous on tissues, toys or hands. Adults and older children can become infected with the same virus but because their airways are bigger, the illness seems more like a cold.
Croup is also often mistaken for asthma, especially in young children. However, croup affects the throat and windpipe instead of the lungs. With croup you often hear a sharp, barky cough and a high pitched sound when the child breathes in (called stridor). Children with asthma have a wheezing sound when they breathe out. This is one way that doctors can tell the difference between croup and asthma.
How can croup be prevented?
Children can get croup more than once because there are many viruses that cause it. There is no vaccine or medicine to prevent croup, but you can lower the chance of your child getting it by encouraging regular handwashing - for example, after the bathroom and before eating. Handwashing, when done correctly, is the most effective way to prevent the spread of infection.
Find out about Michael and his parents’ experience with croup through an interactive story book: