Croup: Symptoms and Treatment

What is croup?

Croup is a common childhood infection marked by labored breathing and hoarse coughing. It's most likely to show up in toddlers, but it can occur at any age. Croup usually begins as a respiratory infection, and a child may have a runny nose for several days before beginning to cough. If your child has croup, her airways will probably become sore and swollen, making it hard for her to get air in and out. Luckily, most children recover from croup in just a few days without much difficulty.

What causes croup?

Most often, the culprit is a virus.

There's no special test to diagnose croup, but it's typically easy to recognize by the seal-like barking sound of the cough. Your child may also breathe noisily, especially at night, and make a squeaky sound called "stridor" during inhalation. It's most noticeable during a coughing spell as a child gasps for breath between coughs. If this squeaky sound is continual or occurs when your child is at rest, her airways are significantly swollen and she needs urgent medical attention.

Other symptoms of croup include hoarseness and fever, sometimes as high as 104 degrees.

Could these symptoms be from something else?

In some cases, your child's breathing problems might be due to another kind of infection. Or she may have inhaled a small object, like a peanut, which can cause noisy breathing; if so, she won't have a fever. If you're not sure what's responsible for your child's symptoms, consult your pediatrician.

How can I treat croup?

Keep tabs on your child's breathing, especially during the first three days she's sick. This probably means having her sleep in your room. That barking cough may alarm you, but it's important to stay calm and soothe your child. If she cries or becomes anxious, her breathing will only get worse. Some experts suggest having children with croup breathe moist air -- from a cool-mist humidifier, a hot shower, or a bowl filled with just-boiled water. You might also open a window to let in moist air, take a car ride with the windows open, or sit with her in a steamy bathroom. If she's in bed and struggling to breathe, prop her up.

When should I call a doctor?

Croup usually goes away in less than a week, but occasionally a child's airways swell so much that she can hardly breathe. If this happens, your child may need to go to the hospital.

Call 911 or go to an emergency or urgent care facility if your child:

• Begins coughing suddenly after playing with small toys. This may mean she's gotten something stuck in her throat.
• Is taking only rapid, shallow breaths, looks bluish or very pale, or sucks in the muscles around her ribs in the struggle to breathe.
• Can't speak for lack of breath and labors to breathe.
• Makes loud, shrill noises while inhaling ("stridor").
• Has difficulty breathing while lying down.
• Drools more than usual. This can indicate a dangerous swelling at the back of the throat.

The hospital doctors may put a mask on your child that supplies oxygen and cool mist to help her breathe. To open her airways, she might be treated with a steroid as well. This remedy, which is both safe and effective, can be given by injection or by mouth, or it can be inhaled in a mist.

How can I prevent croup?

Teach your child to wash her hands frequently so that she'll be less likely to pick up viruses.

The bottom line

Your child should still be happy and playful despite some discomfort with breathing. If she's distressed and she doesn't respond promptly to simple home treatment, take her to see your pediatrician. If she begins to breathe quickly and noisily, or if her temperature is 102 degrees or higher, get an immediate appointment.

Most children who have croup have a mild disease that's easily treatable by a pediatrician, who'll prescribe medicines that can be taken at home.

Further Resources

Pantell, Robert H. M.D., James F. Fries M.D., and Donald M. Vickery M.D. Taking Care of Your Child: A Parent's Illustrated Guide to Complete Medical Care, Eighth Edition. Da Capo Lifelong Books.

References

Pantell, Robert H. M.D., James F. Fries M.D., and Donald M. Vickery M.D. Taking Care of Your Child: A Parent's Illustrated Guide to Complete Medical Care, Eighth Edition. Da Capo Lifelong Books.

American Academy of Pediatrics. Croup Treatment.