Croup

Croup is a respiratory infection that narrows the airways in the upper part of your throat. This makes breathing more difficult. A key symptom of croup is a distinctive barking cough.

This cough, and other croup symptoms, happen because the voice box (larynx), windpipe (trachea), and bronchial tubes (the airways in the lungs) become swollen and irritated. When you cough, air has to push through these constricted areas. This causes the swollen vocal cords to vibrate, creating a sound similar to a dog barking. You might also hear a high-pitched, whistling sound, called stridor, when you breathe in.

Croup usually starts like a common cold. When the airways get inflamed and irritated, a child might experience some uncomfortable symptoms. These include:

• A loud, "barking" cough: This cough can get worse when the child cries, coughs, or feels anxious or distressed. This can create a feedback loop where the coughing and discomfort worsen each other.
• A fever: A temperature increase is a common sign of illness.
• A hoarse voice: This means the voice sounds raspy or scratchy.
• Trouble breathing: The child might breathe faster, have a whistling or wheezing sound (stridor) when breathing, or seem to struggle to take deep breaths.

These croup symptoms often become more noticeable at night and typically last for about 3 to 5 days.

If your child is sick, it's important to monitor their symptoms. Contact your child's doctor if the symptoms are serious, get worse, last longer than three to five days, or aren't improving with home care.

Get immediate medical help if your child:

• Is wheezing: This means they're making a whistling or squeaking sound when breathing, both when they're breathing in and out. It's especially concerning if they're wheezing even when they're not crying or upset.
• Has trouble swallowing or is drooling: This could indicate a problem with their throat or airways.
• Is unusually anxious, restless, or very tired: Changes in mood or energy levels can be signs of a more serious condition.
• Is breathing faster than normal: This means their breathing is quicker than usual.
• Has trouble breathing: If your child is struggling to breathe, this is a serious emergency.
• Shows bluish or grayish coloring: This bluish or grayish tint, called cyanosis, around the mouth, fingernails, or nose, means the body isn't getting enough oxygen. This is a critical sign and requires immediate medical attention.

If you notice any of these symptoms, don't hesitate to call your doctor or go to the emergency room right away. Early intervention is crucial in these situations.

Croup is a common childhood illness usually caused by a virus, most often one called parainfluenza.

Children can catch this virus when they breathe in tiny droplets of moisture carrying the virus. These droplets are released when someone coughs or sneezes. The virus can also live on surfaces like toys or doorknobs. If a child touches a contaminated surface and then touches their eyes, nose, or mouth, they might get sick.

Croup is a common childhood illness, most often affecting babies and toddlers. Children between six months and three years old are at the greatest risk. This is because their airways are still developing and quite small. Smaller airways make it easier for inflammation and other issues to cause noticeable symptoms. Croup is less common in children over six years old.

Croup is usually a mild illness. Most children who get croup will recover easily. However, in some cases, the airways in the throat and windpipe become swollen. This swelling can make it hard for a child to breathe comfortably. Sometimes, a bacterial infection joins with the viral infection that causes croup. This combination can make breathing very difficult and needs immediate medical attention.

Very few children with croup need to be admitted to the hospital. The vast majority of cases are treated successfully at home.

Protecting your child from croup and other respiratory illnesses involves similar steps to preventing colds and the flu. The most important thing is regular handwashing. Wash your child's hands with soap and water for at least 20 seconds, often. This simple act helps stop germs from spreading.

Keeping your child away from people who are sick is also key. If someone in your family or your child's circle of friends is unwell, try to limit contact.

Teach your child to cover their mouth and nose with their elbow when coughing or sneezing. This simple habit helps stop the spread of germs.

Regularly clean surfaces that are touched often, like doorknobs, toys, and phones. These are common germ hotspots.

For even better protection against more serious infections that can sometimes lead to croup, make sure your child's vaccinations are up to date. Vaccines for diseases like diphtheria and Haemophilus influenzae type b (Hib) help safeguard against some very serious upper respiratory infections. Sadly, there isn't yet a vaccine to protect against parainfluenza viruses, which can cause croup.

Doctors usually diagnose croup by looking at a child's symptoms and doing a physical exam. This involves several steps:

1. Checking breathing: The doctor will carefully watch how your child breathes, noting any unusual patterns or difficulty. This includes looking for things like rapid breathing, wheezing, or noisy inhalations.

2. Listening to the chest: A stethoscope is used to listen to the sounds coming from your child's chest. This helps the doctor check for any unusual noises, like wheezing, that could suggest croup or other conditions.

3. Examining the throat: The doctor will look at your child's throat to see if there are any signs of swelling or inflammation, which can be common in croup.

Sometimes, to be sure it's croup and not another illness, the doctor might order X-rays or other tests. These tests help rule out other possible causes of the symptoms.

Croup is a common childhood illness that often gets better at home. However, it can be frightening for parents, especially when a trip to the doctor's office, emergency room, or hospital is necessary. Treatment depends on how bad the symptoms are.

It's crucial to comfort your child during a croup episode. Crying and stress can make the airway swell, making breathing harder. Hold your child, sing, read, offer a favorite blanket or toy, and speak calmly. These actions can help soothe your child.

Also, make sure your child drinks plenty of liquids to stay hydrated. This is very important.

If your child's croup is severe, a doctor might recommend these treatments:

• Corticosteroids: These medicines, like dexamethasone, reduce swelling in the airways. You'll likely see improvement within a few hours. Your child might take pills for several days, or get a single shot of dexamethasone, which lasts longer.

• Epinephrine: For more serious cases, epinephrine can quickly reduce airway swelling. It's often delivered through a nebulizer (a machine that turns liquid medicine into a mist). While it works fast, its effects don't last long. Your child will likely need to be watched closely in the emergency room for a few hours to see if a second dose is needed before going home. This is important to make sure the swelling doesn't come back.

If the croup is severe enough, your child may need to stay in the hospital to be closely monitored and get more treatment.

Croup usually clears up within 3 to 5 days. In the meantime, there are ways to help your child feel more comfortable.

Managing Fever and Pain:

If your child has a fever or is in pain, over-the-counter medicines like acetaminophen (like Tylenol) or ibuprofen (like Advil or Motrin) are good options. These are safer choices than aspirin. Always follow the directions carefully on the package for the right dose, and talk to your doctor if you're unsure.

Important Note about Aspirin:

Be very careful giving aspirin to children or teenagers. While aspirin is okay for kids over 3, it's never a good idea to give it to children or teens who have chickenpox or other flu-like illnesses. This is because aspirin has been linked to Reye's syndrome, a rare but serious illness.

Managing Cough and Breathing:

Your child's cough might be worse at night. It's a good idea to stay close to your child during the night, so you can respond quickly if their breathing gets worse.

Here are some things you can try to help your child:

• Keep them calm: Comfort and distraction are key. Cuddle them, read a book, or play a quiet game. Crying can make breathing more difficult.
• Create a comfortable environment: Some parents find humid or cool air helps with breathing. You can use a humidifier to add moisture to the air, or sit in a bathroom with the shower running (to create steam). If the weather is cool outside, opening a window can also help.
• Keep them upright: Holding your child on your lap or in a comfortable chair can make breathing easier.
• Offer fluids: Breast milk, formula, or soothing drinks like soup or frozen fruit pops can help.
• Encourage rest: Getting enough sleep helps your child's body fight off the infection.
• Avoid cold medicines: Cough and cold medicines are not recommended for children of any age, and they can be dangerous for children under 2. These medicines won't help croup either.