Croup is an infection of the upper airway that makes it harder for babies and toddlers to breathe, along with causing a cough. Children between 3 months and 5 years old are most at risk.
Croup can be caused by different viruses including parainfluenza (the common cold), respiratory syncytial virus, influenza (the flu), adenovirus, enterovirus, and measles, and even rarely by allergies or bacterial infections. Generally, more boys than girls are affected by croup, and it is more common in the fall and winter.
Croup spreads easily. It usually starts with cold symptoms but moves into the lungs. Swelling around the windpipe (trachea) and voice box (larynx) in a child's smaller airways make it harder for them to breathe.
Symptoms of croup include:
- Cold symptoms such as sneezing and runny nose
- Harsh, barking cough, like a seal or dog
- Difficulty breathing, which may include stridor, a high-pitched wheezing while breathing from restricted airways
- Swollen lymph nodes
- Redness around the eyes
Croup symptoms are usually at their worst during the night and last several days. Croup is usually not serious, but parents should trust their gut and call their doctor if they are concerned. If your child has trouble breathing, has a fever over 103.5 F, doesn't want to drink, has stridor while resting, or has symptoms that don't improve after several days, contact your doctor.
Remedies and Treatments for Croup
The following remedies can be tried to keep your child comfortable until croup has passed, which typically takes three to five days:
- Keep your child as soothed and calm as possible. Read stories and cuddle. Try to avoid crying or running around, which will make breathing harder.
- Give extra liquids. Infants should drink breast milk or formula, while older children may have water, juices, soups, or ice pops.
- Avoid cough medicine, as it won't help
- Hold your child upright, which might make it easier to breathe.
- Use cool, humidified air or steam. Although there is no medical evidence that this improves symptoms, many parents find it helpful. Use a cool-mist humidifier, sit in the bathroom with the shower running hot to create steam, or take your child out into the cold night air for a few minutes while wrapped up to stay warm.
- Encourage rest and sleep.
Croup is highly contagious. It is carried through the air in droplets from coughing and sneezing that may land on toys and other surfaces. This makes it hard to prevent, but you can help stop it from spreading by doing the following:
- Wash hands frequently. Keep your hands clean while caring for your infant, and teach toddlers to wash their own hands.
- Keep your child away from others who are obviously sick. If they attend day care or play groups with other children, keep them home if you can when there are illnesses going around.
- Teach older children proper sneezing and coughing etiquette, such as using the crook of the arm instead of a hand to block droplets.
- While there is no vaccine for croup or the viruses that cause most cases, keeping other vaccinations up to date will help your child avoid the most serious respiratory infections.
When to See a Doctor
In most cases, croup is treatable at home. If symptoms are severe, persist, or worsen, you should contact your child's doctor for advice. It might be helpful to jot down questions, symptoms (along with changes in them), the medicine you've given, and durations of fevers so that you can give the doctor all the information needed to make a plan for treatment.
The following treatments may be given by a doctor:
- Steroid injections (glucocorticoids) that will reduce the swelling in your child's airways and bring relief in a matter of hours.
- Breathing treatments, such as nebulizers or inhalers.
- Nebulized epinephrine in severe cases to reduce swelling in the airways and ease breathing.
- Steroids delivered by mouth. Dexamethasone delivers quick results, but prednisone may also be given.
- Tests for other illnesses and infections.
- Monitoring blood oxygen levels. Oxygen may be given in severe cases.