When you have children, colds and coughs are part of the territory. Most parents know their child will get through the common colds and viruses going around. Many parents are concerned when what seems to be a normal cold starts to sound much worse, and their child wakes up struggling to breathe, and with a barking cough. It’s likely their child has croup.
While it sounds terrible, croup is actually very common in young children and is mostly treatable at home.
What Is Croup?
Croup is caused by an infection which causes inflammation and swelling in the windpipe (trachea) and the vocal cords. The infection is most commonly cause by the parainfluenza virus, but there are several other respiratory viruses that can cause croup.
Only about one in 10 children who get these respiratory viruses will develop croup.
Children have much smaller airways than adults, which is why croup is rarely seen in adults, who have larger airways and can cope with inflammation.
Croup usually begins like any normal cold, with a runny nose, sore throat, fever and lethargy, but then develops further symptoms:
- Loud, harsh, barking cough, usually worse at nighttime.
- Hoarse voice
- Difficulty swallowing
- Laboured or noisy breathing, especially when inhaling (stridor); it sounds like a high pitched whistle or squeak.
What To Do About Croup
Most cases are mild and don’t require any medical treatment. Mild croup is when your child has the barking cough but no stridor or difficulty breathing.
Way you can treat croup at home:
- Offer lots of comfort, as children can become frightened and upset if they find breathing difficult or have a barking cough.
- Keep your child calm and quiet, as being upset or too active can make breathing more difficult.
- Treat cold symptoms by providing comfort as needed.
- Make your child comfortable if he has a fever (read more about treating a fever here).
- Offer plenty of fluids, which help avoid dehydration if there is a fever, and can soothe a sore throat.
- Make sure your child has plenty of rest, as the night time waking might disrupt sleep for a few nights. It can help to room share so your child is less likely to become upset.
An old home remedy was the use of steamy warm air from a device such as a vapouriser, but research hasn’t shown any benefits from this treatment. If you try warm steam therapy, make sure your child is not at risk of burns from hot water.
Some parents swear by wrapping their child very warmly and taking them into the cold night air. This is said to help reduce the inflammation in the throat and help improve breathing.
Is Croup Dangerous?
Croup is a very common illness in babies, toddlers and preschool aged children. It usually lasts for a few days and then disappears. Some children get the condition several times. Babies should be watched carefully for more severe symptoms of croup.
If your child’s condition becomes severe, it is important to seek medical help at the nearest emergency department. Signs to look for are:
- Struggling to breathe
- The skin between the ribs is pulled in with each breath
- Blue or gray colour around the mouth, nose or fingernails; this is a sign your child isn’t getting enough oxygen
- Extreme irritability
- Signs of dehydration and extreme lethargy
- Drooling and difficulty swallowing.
Medical treatment for croup can include steroids or adrenaline. Steroids relieve the symptoms of croup by reducing the inflammation. Adrenaline may be given in some cases, to relieve the swelling very quickly until steroids can work. A nebuliser is used to give adrenaline as a mist, which is then inhaled.
How To Avoid Croup
It is hard to avoid croup as it is so common among children up to the age of five. As with any contagious virus, your child can be exposed by being in contact with another infected person who has cold symptoms, or by touching something the other person has touched. Viruses can survive on surfaces for some time.
The best way to prevent croup is to avoid anyone who is obviously unwell with a cold. Encourage your children to wash their hands to minimise infection and, if they become unwell, make sure they stay home, to avoid passing on the virus. Children who have a history of croup will usually grow out of it, as it is partly related to the size of their airways.