Croup, which is marked by a harsh, repetitive cough similar to the noise of a seal barking, can be scary for children and their parents.
The barking cough of croup is the result of inflammation around the vocal cords (larynx) and windpipe (trachea). When the cough reflex forces air through this narrowed passage, the vocal cords vibrate with a barking noise. Because children have small airways to begin with, those younger than age 5 are most susceptible to having more-marked symptoms with croup.
Croup usually isn't serious. Most cases of croup can be treated at home. Sometimes, your child will need prescription medication.
The classic sign of croup is a loud, harsh, barking cough — which often comes in bursts at night. Your child's breathing may be labored or noisy. Fever and a hoarse voice are common, too.
When to see a doctor
Croup is often caused by the parainfluenza virus. Less often, respiratory syncytial virus or various other respiratory viruses cause croup.
Your child may contract a virus by breathing infected respiratory droplets coughed or sneezed into the air. Virus particles in these droplets may also survive on toys and other surfaces. If your child touches a contaminated surface and then touches his or her eyes, nose or mouth, an infection may follow.
Rarely, croup may be caused by a bacterial infection.
Croup is most common in children age 5 and younger. Signs and symptoms are typically most severe in children age 3 and younger because of their smaller airways.
Most cases of croup are mild. Rarely, the airway swells enough to interfere with breathing. Pneumonia is a rare but potentially serious complication.
Preparing for your appointment
In most cases of croup, your child won't need to see a doctor. However, if your child's symptoms are severe or aren't responding to home treatment, you should make an appointment.
Your child's doctor will likely ask a number of questions to help make a diagnosis and determine the best course of treatment. Being ready to answer these questions may reserve time to go over any points you want to spend more time on. Questions may include:
Tests and diagnosis
Croup is typically diagnosed based on signs, symptoms and a physical exam. The doctor will observe your child's breathing, listen to your child's chest with a stethoscope and examine your child's throat. Sometimes X-rays or other tests are used to help make the diagnosis.
Treatments and drugs
In most cases, self-care measures at home — such as breathing moist air and drinking fluids — can speed your child's recovery. More aggressive treatment is rarely needed.
If your child's symptoms persist or worsen, his or her doctor may prescribe corticosteroids, epinephrine or another medication to help open the airways. Antibiotics are effective only if your child has a bacterial infection.
For severe croup, your child may need to spend time in a hospital receiving humidified oxygen. Rarely, a temporary breathing tube may need to be placed in a child's windpipe.
Croup can be scary — especially if it lands your child in the doctor's office, hospital or emergency room. Hold your child, sing lullabies or read quiet stories. Offer a favorite blanket or toy. Speak in a soothing voice. Your presence can help keep your child calm.
Lifestyle and home remedies
Croup often runs its course within three to seven days. In the meantime, keep your child comfortable with a few simple measures.
Your child's cough may improve during the day, but don't be surprised if it returns at night. You may want to sleep near your child or even in the same room so that you can take quick action if your child's symptoms become severe.
To prevent croup, take the same steps you use to prevent colds and flu. Frequent hand washing is most important. Also keep your child away from anyone who's sick, and encourage your child to cough or sneeze into his or her elbow.
To stave off more-serious infections, keep your child's immunizations current. The diphtheria, Haemophilus influenzae type b (Hib) and measles vaccines offer protection from some of the rarest — but most dangerous — forms of upper airway infection.
Last Updated: 2010-08-05
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