Have you ever heard a cough that sounded like a barking seal or a fog horn?  Once you’ve heard it, you will never forget it - it could be croup. Croup is triggered by a viral infection that affects the throat and the upper airway. Swelling of these can occur, and sometimes breathing difficulties also occur.

Croup is not typically serious, and can most often be treated at home. Since croup is caused by a virus, antibiotics are not necessary. In more severe cases, your child’s doctor will determine if your child needs oral steroids.

Some children may develop croup during or just after a cold.  Croup is most commonly seen in the fall and winter, and most often affects children under the age of 5, with the younger child experiencing more severe symptoms.  Some of the symptoms you may see include:

  • noisy, high-pitched breathing
  • barking cough (can last a few hours up to 1 week)
  • fever (can last 1-3 days)
  • runny nose
  • hoarse voice

Usually after two to three days, the cough will change from the hard, harsh, barky, dry cough into a congested sounding cough, which typically lasts another few days.  Sometimes croup can cause episodes of severe coughing followed by vomiting.

The symptoms are almost always worse at night.  You may hear wheezing or stridor, which is a noisy, rough-pitched breathing. Stridor is usually brief, happens with crying or coughing, and gets better when the child is calm and quiet. Continuous stridor heard with every breath is considered to be a serious symptom.  In rare instances croup can be life-threatening.  Call 911 if symptoms include:

  • episodes of turning blue or grey around the mouth, lips, or nail beds
  • struggling to breathe
  • grunting with breathing (like pushing the air out)
  • excessive drooling
  • inability to swallow 

What can you do to treat croup?  Most importantly, you need to stay calm and comfort your child since crying can make the coughing worse.  If the child is older, have him relax and breathe slowly.  You may want to offer warm liquids to sip.  Take your child into your smallest bathroom and turn the shower on hot to get the bathroom steamy, then remain there for about 20 minutes. Be sure to stay with your child for safety reasons.  If the steamy bathroom fails to make the cough and stridor better, take your child outside to breathe in the cool night air.  This can help calm the cough.  If stridor is still present after trying steam and cool air, you should immediately take your child to the emergency room.

Children can return to school and normal activities when their fever is gone for 24 hours without taking any fever-reducing medication (i.e. Tylenol or Ibuprofen). 

Good hand-washing is the best preventative measure.  If you have concerns about your child’s health, it is always appropriate to contact your doctor.

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