Croup: Symptoms, Treatment, and Prevention

Highlights

• Croup is a viral infection that causes swelling in the voice box (larynx) and windpipe (trachea).
• Children with croup often develop a characteristic “seal bark” cough.
• Croup can cause stridor, which is high-pitched breathing, especially when inhaling.
• Most children with croup recover within 4 days, although it can cause breathing problems that need medical attention.
• Symptoms tend to worsen in the evening and overnight, with the condition more common in colder months.

In This Article

• What is croup?
• What causes croup and how is it spread?
• What are the symptoms of croup?
• How is croup diagnosed?
• How is croup treated?
• When should I see a doctor about my child’s croup?
• When should I call an ambulance?
• Can croup be prevented?
• What you can do
• Are there any complications from croup?
• Tools and Assistance

What is Croup?

Croup is a viral infection that affects babies and young children, causing swelling in the voice box and airways. While there is no specific treatment for mild croup, steroid medications may be given if the child experiences difficulty breathing due to airway swelling.

Some children experience “spasmodic croup,” where coughing occurs mostly at night, with symptoms typically improving within an hour. This condition is more common in children with asthma or a family history of allergies.

What Causes Croup and How is it Spread?

Croup is caused by several viruses, including respiratory syncytial virus (RSV), influenza, adenovirus, and enteroviruses. It can also result from allergies or bacterial infections. Since croup is contagious, children with croup should be kept away from others.

Not all children exposed to the virus will develop croup, but it is common in children aged 6 months to 5 years.

What Are the Symptoms of Croup?

Croup often starts with cold or flu symptoms, with the cough becoming worse at night. Symptoms include:

• A “barking” cough
• Hoarseness when crying or talking
• A high-pitched sound when breathing in (stridor)
• A high fever, runny nose, and cough
• Severe cases may lead to “intercostal recession” (skin pulling in between ribs or under the neck).

Most children improve after a few days, although the cough can persist.

How is Croup Diagnosed?

Croup is typically diagnosed by a doctor based on the distinctive symptoms. The cough is a key indicator, making it easily identifiable even before a medical examination.

How is Croup Treated?

Most children with croup recover at home with supportive care. Key recommendations include:

• Keeping the child calm and well-rested
• Ensuring proper hydration, even if the child has a reduced appetite
• Paracetamol for fever or sore throat relief, as directed by a doctor
• Oral steroids and adrenaline may be prescribed if breathing issues occur

Steam and humidifiers are no longer recommended due to lack of proven effectiveness.

When Should I See a Doctor About My Child’s Croup?

Consult a doctor if you are concerned about your child’s symptoms. Immediate medical attention is necessary if:

• Your child is under 6 months and shows symptoms of croup.
• The skin between the ribs or neck is drawn in when they breathe.
• They have stridor even when resting.
• They seem very distressed or their symptoms are worsening.

When Should I Call an Ambulance?

Call an ambulance if your child is:

• Struggling to breathe
• Appears very sick, lethargic, and has pale skin
• Shows a blue color around the lips
• Cannot swallow and starts dribbling

Urgent medical help is necessary for any signs of breathing difficulty.

Can Croup Be Prevented?

While there is no specific way to prevent croup, vaccines for influenza can help reduce the likelihood of croup caused by the flu virus. Good hygiene practices can reduce the spread of viruses that cause croup.

What You Can Do

You can reduce the spread of croup-causing viruses by:

• Keeping your child away from others who have cold symptoms
• Ensuring frequent handwashing, especially before meals
• Properly disposing of used tissues
• Teaching your child to cover their nose and mouth when coughing or sneezing
• Encouraging them to avoid touching their eyes, nose, or mouth

Are There Any Complications from Croup?

Croup typically does not lead to lasting complications, and there is no permanent damage from an episode.

Tools and Assistance

If you’re looking for support with managing your child’s croup, the following tools and resources can be helpful:

• Health Advice Lines: Consult pediatric healthcare professionals via phone or online platforms for quick advice.
• Local Health Services: Visit your nearest healthcare provider for in-person consultations and treatments.
• Parent Support Groups: Join online communities for advice and shared experiences from other parents dealing with croup.
• Emergency Contact Information: Keep a list of local emergency services and helplines handy.