Perhaps one of the most frightening of the common childhood illnesses that we deal with as parents is croup. Your child may wake up in the middle of the night with a barky cough, or even gasping for breath, and leave you feeling panicked. This is what croup is all about:

Croup actually describes a group of illnesses that cause inflammation (swelling) of the larynx (vocal cords) and trachea. That’s why children tend to get a dry, barky cough or hoarse voice when they get croup. Croup is almost always caused by a virus – most commonly parainfluenza – although influenza, RSV, rhinovirus, and others may also cause croup. Unfortunately, this means that antibiotics will not help cure croup. These illnesses are most common in the spring and fall/early winter, though they can occur year round. A typical infection tends to last about five days and may be accompanied by fevers (sometimes quite high), decreased appetite, and sore throat. Some children have recurrent episodes of croup, or spasmodic croup, which tends to be triggered by a mild cold or allergy. Most children with spasmodic croup do not have a fever.

There are a few important therapies that you can provide for croup. The first is humidification. Run a humidifier (warm or cool – it doesn’t matter) in your child’s room. The second is hydration. It is very important to keep your child well hydrated when he/she is sick! If your child awakens in the middle of the night coughing or gasping, first try to calm him/her down. You may notice that croup “attacks” worsen when children are upset. Sit your child directly in front of a humidifier, or sit in bathroom with a steam shower running, or take your child outside if the night air is cool. Spasmodic croup may respond to asthma medicines. Give him/her something cool to drink. If he/she is running a fever, you may give an appropriate dose of acetaminophen or ibuprofen. The humidifier/steam treatments almost always work. Try this for about 15-20 minutes if your child wakes up at night, but if you’re having trouble, call us!

You should call a doctor if:

  • after trying to calm your child down, you think he/she is having significant difficulty breathing
  • is blue around the mouth
  • is drooling, having difficulty swallowing
  • has noisy, musical breathing (stridor) at rest

Croup can be very scary, both for children and their parents, but most of the time, kids end up doing just fine and fighting off the infections on their own. Occasionally we will put kids on oral steroids to help decrease the inflammation around the larynx, if there’s stridor. Call us if you have any questions!