Kids with croup have a virus that makes their airways swell. They have a telltale "barking"
cough (often compared to the sound of a seal's bark) and a raspy voice,
and make a high-pitched, squeaky noise when they breathe.
Most kids with croup get better in a week or so.
What Are the Symptoms of Croup?
At first, a child may have cold symptoms, like a stuffy or runny nose and a fever. As the upper airways —
the voice box (larynx) and windpipe (trachea)— become irritated and swollen,
a child may become hoarse and have the barking cough.
If the airways continue to swell, breathing gets harder. Kids often make a high-pitched
or squeaking noise while breathing in — this is called stridor.
They also might breathe very fast or have retractions (when the skin
between the ribs pulls in during breathing). In the most serious cases, a child may
appear pale or have a bluish color around the mouth due to a lack of oxygen.
Symptoms of croup are often worse at night and when a child is upset or crying.
What Causes Croup?
The same viruses that cause the common
cold also cause croup. Most often seen in the fall, croup can affect kids
up to age 5.
There are two types of croup, viral croup and spasmodic croup, both
of which cause the barking cough. Most cases of croup are viral.
How Is Croup Diagnosed?
Health care providers listen for the telltale cough and stridor. They'll also ask
if a child has had any recent illnesses that caused a fever, runny nose, and congestion;
and if the child has a history of croup or upper airway problems.
The doctor might order a neck X-ray if
the croup is severe and slow to get better after treatment. In cases of croup, an X-ray usually will show the top of the airway narrowing
to a point, which doctors call a "steeple sign."
How Is Croup Treated?
Most cases of croup are mild and can be treated
at home. Try to keep your child calm, as crying can make croup worse.
For a fever, medicine (acetaminophen or, only for kids older than 6 months, ibuprofen) may make your child
more comfortable. Ask your health care provider how much to give and follow the directions
Breathing in moist air can help kids feel better. To help your child breathe in
Use a cool-mist humidifier or run a hot shower to create a steam-filled
bathroom where you can sit with your child for 10 minutes. Breathing in the
mist will sometimes stop the severe coughing.
In cooler weather, taking your child outside for a few minutes to breathe in the
cool air may ease symptoms. You also can try taking your child for a drive with the
car windows slightly lowered.
Your child should drink plenty of fluids to prevent dehydration.
If needed, give small amounts of liquid more often using a spoon or medicine dropper.
Kids with croup also should get lots of rest.
Some kids need a breathing treatment that can be given in the hospital or a steroid
medicine to reduce swelling in the airway. Rarely, kids with croup might need to stay
in a hospital until they're breathing better.
When Should I Call My Health Care Provider?
Most kids recover from croup with no lasting problems. But some kids — especially
those who were born prematurely,
or have asthma or other
lung diseases — can be at risk for complications from croup.
Call your doctor or get immediate medical care if your child:
has trouble breathing, including very fast or labored breathing
is too out of breath to talk or walk
has pulling in of the neck and chest muscles when breathing
has stridor that is getting worse
is pale or bluish around the mouth
is drooling or has trouble swallowing
is very tired or sleepy or hard to awaken
is dehydrated (signs include a dry or sticky mouth, few or no tears when
crying, sunken eyes, thirst, peeing less)