Croup

Croup is a common respiratory illness that most often affects young children. (Read about "Respiratory System") It is normally mild, but in some cases can be severe.

What is croup

Croup is the swelling of the voice box (larynx) and windpipe (trachea). The swelling narrows the airway, making breathing noisy and difficult. Croup can also cause fever, hoarseness, a hacking cough and sometimes a coarse or crowing noise, called stridor, during breathing. The cough is often described as sounding like a dog barking. While croup can normally be treated at home, some rare cases can be severe, requiring immediate medical attention and possibly hospitalization.

Croup commonly occurs in children between six months and three years of age. After age 3, it is not as common because the windpipe is larger, so swelling is less likely to interfere with breathing, according to the American Academy of Pediatrics (AAP). Although it can occur at any time of year, croup is most common during flu season, between October and March. (Read about "Influenza")

There are two different types of croup, spasmodic and viral.

• Spasmodic croup - Spasmodic croup can sometimes be more frightening because it comes on suddenly in the middle of the night. A child may go to sleep with a mild cold and awaken a few hours later gasping for breath. The child will also be hoarse and have a distinctive cough that sounds like a seal barking, according to AAP. This type of croup is usually caused by a mild respiratory infection or allergy (Read about "Allergies") and does not normally include a fever.
• Viral croup - Viral croup is caused by a viral infection in the voice box and windpipe. (Read about "Microorganisms") It normally begins with a cold that slowly develops into the barking, croupy cough and is accompanied by a low fever. This type often also includes a coarse, crowing sound called stridor, during breathing. Stridor is common with mild croup, especially when a child is crying. But AAP says if a child has stridor while resting, it can be a sign of severe croup.

Treatment

Most mild cases of croup can be treated at home. The child should get plenty of rest and liquids. Acetaminophen can be given to relieve discomfort and reduce fever, but cough medicines are not recommended, according to the American Academy of Family Physicians (AAFP).

For an attack of croup, try to get your child to breathe moist air. AAFP says you can have your child breathe through a warm, wet washcloth. Or take your child into the bathroom and run hot water in the shower to fill the room with steam. Sit with your child for about 15 minutes. The warm, moist air should help breathing. If the steam does not work, it may help to take your child outdoors for a few minutes. For the next few nights, you may want to use a vaporizer or humidifier in your child's room to help prevent another attack. If these treatments don't help, you can call your pediatrician for other options. Moderate and severe croup are sometimes treated with corticosteroids, but as with all drugs there can be side effects.

Listen closely to your child's breathing. There are signs that could indicate a severe case of croup that will require medical attention. Here's what to watch for according to AAP:

• your child is struggling for breath
• your child has difficulty eating and drinking without having to stop and catch their breath
• your child makes a whistling sound that gets louder with each breath
• your child cannot speak for lack of breath
• your child has stridor (a coarse or crowing noise) while resting
• your child is drooling and has trouble swallowing
• your child is very pale or has a bluish mouth, lips or fingernails

Again, most cases of croup are mild, but if you have any concerns or questions, you can call your pediatrician.

Related Information:

    Baby and Young Child Care

    Newborn Concerns