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What is croup?
Croup is a swelling of the voice box (larynx) and windpipe (trachea), usually caused by a virus. Telltale signs of croup are a cough that sounds like a barking seal, a hoarse voice, and a high-pitched squawking sound when your child breathes in.
Croup is most common in children between the ages of 3 months and 5 years, although a child can get croup at any age. The illness shows up most frequently in the colder months – between October and March.
Most cases of croup today are not serious, but a severe case can require hospitalization.
What causes croup?
Croup is typically caused by the parainfluenza virus.
Other causes that can trigger croup include:
- Different types of viruses, such as respiratory syncytial virus (RSV), adenovirus, influenza, and measles.
- Inhaled irritants.
Common symptoms of croup are:
- A hoarse cough. Because croup swells the throat and voice box, it alters the sound of your child's cough. If your child has a very hoarse, deep cough that sounds like a barking seal, it's probably croup. In fact, this cough is so distinctive that your doctor can probably tell you whether it's croup just by listening to your child over the phone.
- Noisy breathing. Your child may have labored breathing or stridor, a high-pitched squawking or crowing noise when he inhales.
- Worse symptoms at night. Croup often appears after several days of cold symptoms and usually gets worse at night.,
- Hoarse voice
- Swollen lymph nodes
How long does it take for croup to go away?
Croup symptoms usually last 3 to 5 days, and are gone within a week. Symptoms are often worst the first two or three nights.
Is croup dangerous?
Not as dangerous as it once was. Today, the vaccines for measles, Haemophilus influenzae (Hib), and diphtheria protect children against some of the more dangerous forms of croup. Most cases these days are mild and go away without any problems.
If your child has a severe case of croup, however, it can lead to serious breathing difficulties.
When should I call the doctor?
Many children with croup have only mild symptoms and don't need to see a doctor, although it's always a good idea to call if you have concerns. However, occasionally croup can cause serious, potentially life-threatening swelling in the throat.
- Turns blue or very pale
- Is struggling to breath.
- Can't speak or cry because she can't breathe.
- Is very upset.
- Seems very sleepy or unresponsive.
- Makes a whistling sound that gets louder with each breath
- Has extreme difficulty swallowing saliva
Read more about when to call 911.
Call your child's provider if:
- Your child has stridor when resting
- Your child's cough or other croup symptoms continue more than a few days
- Your baby is younger than 3 months and has a fever
- Your child is older than 3 months and has a fever over 100.4ºF for more than 3 days
- The skin and muscles between or below your child's ribs look like they're caving in
How do you treat croup?
Home remedies for croup
If this is your child's first bout of croup and the doctor determines that he has a mild case, you should be able to treat her at home. Here are some tips for keeping your child comfortable:
- Comfort your child. Give her a hug or a back rub. Reassure her everything will be OK, sing a favorite bedtime song, and/or offer a favorite toy.
- Keep your child hydrated. Make sure your child is getting plenty of fluids.
- Elevate her head. If your child is more than a year old, you can try elevating her head a bit while she sleeps, to help ease her cough. (Don't use pillows with babies, as this increases the risk of SIDS.) You may also want to sleep in the same room with your child while she has croup, so you'll notice whether she develops any trouble breathing.
- Take your child into a steamy bathroom. Moist air may help reduce swelling of the airways, although there aren't scientific studies to prove it. Turn on the hot water in the shower or bathtub and close the bathroom door. Sitting straight up or standing will help her breathe more easily. If your child is too young to sit up straight or stand, try holding her upright. You may have to repeat the routine each time your child wakes up coughing during the night.
- Go out into the cold night air for 15 to 20 minutes. Again, this isn't scientifically proven, but some parents find this helps their child breathe better. You can also just open the window for a few minutes. Wrap your child in a blanket to keep her warm.
- Put a humidifier in your child's bedroom. Use a cool-mist humidifier, not a hot, steam-based one as this could put your child at risk for burns. (Clean the humidifier daily with a bleach-and-water solution to ward off the growth of mold and bacteria.)
Medications for croup
Children with a fever or more severe croup symptoms may require medications, including:
- Over-the-counter painkillers: If your child has a fever and is uncomfortable, you might want to give him acetaminophen or, if he's 6 months or older, ibuprofen. (Never give a child aspirin, which can trigger a rare but potentially fatal disease called Reye's syndrome in children with a virus.) If your child is younger than 3 months old, talk with his doctor before giving him any medication, even over-the-counter remedies.
- Oral steroids. These are sometimes prescribed by a doctor to reduce the swelling and help your child breathe more easily. Oral steroids were previously used mostly for children with moderate or severe croup, but recent research suggests they may be worthwhile even in milder cases.
- Epinephrine, oxygen and intravenous fluids. If your child has a severe case of croup that requires hospitalization, he may be given oxygen, an inhaled medication, or steroids to help reduce the swelling of his airways. He may also be given intravenous fluids to combat dehydration.
Do not give your child cough medicine. It won't have any effect on the swelling in his throat, and it can make it harder for him to cough up mucus.
Antibiotics won't help, either, since a virus is probably the culprit, not bacteria.
Can my child get croup again?
Yes. In fact, some children seem to be more prone to getting croup than others until their airways grow bigger. If your child gets croup a second time, try the at-home therapy right away. And don't hesitate to call your doctor, even if the previous episode was mild. Each bout of croup is different – some more serious or needing more aggressive treatment than others.
Is croup contagious?
Unless your child's croup is the result of allergies or irritants, the virus that's causing it is contagious, so keep your child home until she's free of symptoms.
How can I prevent my child from getting croup?
You can reduce your child's chances of getting croup by:
- Frequent hand washing with soap and water.
- Keeping your child away from anyone who has a respiratory infection.
- Making sure your child gets vaccinated every year against the flu if she is older than 6 months.