Croup

What is croup? 

Once a parent hears that harsh, barking cough, they never forget the sound of croup. A condition that causes inflammation of the larynx (voice box) and trachea (windpipe), croup is most often caused by the parainfluenza virus, and best known for its barking cough. Croup is most common in children between the ages of 6 months and 3 years. The cough (which typically worsens at night) can begin without warning or develop gradually along with cold symptoms. Croup is seldom serious and can usually be managed at home. However, being awakened at night by the sound of a “seal barking” can be frightening for parents. In rare cases, the upper airway gets so swollen children have difficulty breathing and make a high-pitched, squeaking noise when they inhale (this is called stridor).

What are the symptoms of croup? 

While the barking cough is croup’s signature symptom, it can also cause labored or noisy breathing (stridor), fever, and hoarseness. These symptoms last 2–5 days or up to several weeks. Common cold symptoms can precede croup and may linger for 7–10 days. 

How do children get croup? 

Like most viruses, children can get croup by touching an object that has the croup virus on it and then touching their eyes, nose, or mouth. But they are more likely to get it through contact with contaminated droplets produced when an infected person sneezes or coughs.

How is croup treated? 

Occasionally, the upper airway is so swollen a child can’t breathe and ends up in the doctor’s office or emergency room. Fortunately, most cases of croup are mild and the symptoms can be treated at home. Breathing in moist air reduces the swelling in the upper airway and makes most kids feel better. Turn on the hot water in the shower and sit with your child in the steam filled bathroom. Keep the door tightly closed so the steam doesn’t escape. Taking your child outside for a few minutes so she can breathe the cool, moist air also works well. Crying can make the symptoms worse, so it’s important that you and your child remain calm. 

A cool-air humidifier (warm-air humidifiers give germs a place to grow) in your child’s room can also be helpful. Your child’s health care provider may recommend acetaminophen or ibuprofen (over-the-counter medications) to ease fever. However, the American Academy of Pediatrics and the Centers for Disease Control and Prevention (CDC) recommend that other cold and cough medicines not be given to infants and young children. These drugs have not been proven effective and can be harmful. In addition, do not give aspirin to children under the age of 12 (or to teens under the age of 19) with a viral illness. Research has established a link between the use of aspirin and Reye’s syndrome, a rare but serious illness. 

If your child has difficulty breathing the doctor may prescribe a steroid to help reduce swelling in the upper airway.

How can croup be prevented? 

There is no vaccine for croup. However, the following practices—which are the same as those recommended for warding off the common cold—can reduce your child’s risk of getting croup: 

  • Wash hands frequently. Teach children the importance of hand washing. Review the CDC’s tips for proper hand washing. 
  • Clean kitchen and bathroom countertops, especially when a family member has croup.
  • Wash your children’s toys.
  • Use tissue when sneezing or coughing. If tissue isn’t available, use an elbow or shoulder (rather than a hand).
  • Don’t share drinking glasses or utensils.
  • Avoid contact with anyone who has croup.
  • Choose a child care facility with good hygiene practices and clear policies about keeping sick children at home. 

When should I call a doctor? 

Parents should seek medical attention right away if their child has any of the following symptoms

  • Makes noisy, high-pitched breathing sounds when inhaling (stridor). 
  • Begins drooling or has difficulty swallowing. 
  • Seems extremely irritable or extremely tired. 
  • Refuses to eat or drink. 
  • Struggles to breathe. 
  • Develops blue or grayish skin around the nose, mouth, or fingernails. 
  • Has a fever of 102.2°F or higher (100.4°F or higher for babies less than 3 months old).

Last updated July 15, 2017

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