Definition: Croup is diagnosed when your child has symptoms that include a cough that is tight and sounds like a barking seal. Often the voice is hoarse. Sometimes stridor can occur with croup. With stridor, there is a harsh, raspy, vibrating sound that is heard when your child breaths in, and breathing can get very difficult. Generally, stridor indicates the croup is more severe. However, how the child looks is more important than how the child sounds when he/she breathes or coughs. If your child is able to drink and lay down without difficulty, we will be less concerned than if he/she is pulling in at the notch above the breastbone during breathing and is restless and unable to eat or drink.
Cause: Croup is a viral infection of the vocal cords. It is usually part of a cold. The hoarseness is due to swelling of the vocal cords. Stridor occurs as the opening between the cords becomes narrower due to the swelling. The viruses that cause croup are quite contagious.
Expected course: Croup usually lasts for 5 to 6 days and generally gets worse at night. The worst symptoms are seen in children less than 3 years of age.
Home Care and Treatment
Mist: Dry air usually makes coughs worse. Keep your child’s room humidified. Run a cool mist humidifier in your child’s room 24 hours per day. When your child is having a bad coughing spell, it may be very helpful to bundle him/her up in a blanket and take him/her out into the cold moist air. Another way to expose your child to lots of moist air is to bring him/her into the bathroom and shut the door. Turn the shower on hot and sit in the bathroom with your child as he breathes in the moist air for 15-20 minutes or until the cough subsides enough for your child to rest.
Warm fluids for coughing spasms: Sometimes coughing spasms may be due to sticky mucus caught on the vocal cords. For older children, warm, clear fluids, such as apple juice or lemonade, may help relax the vocal cords and loosen the mucus.
Cough medicine: We strongly advise against the use of any type of cough medicine when your child has croup.
Acetaminophen and Ibuprofen: Using over-the-counter pain and fever reducing medications such as Tylenol or Motrin (Motrin in children over 6 months of age) may help decrease your child’s fussiness and/or fever.
Call the office…
* Your child is struggling to breath, such as the area above the breastbone and collarbone pulling in while breathing, or using neck muscles.
* Your child’s chest and/or abdomen in pulling in and out with each breath. (Retractions)
* You notice that the lips, nose, or fingertips are bluish.
* Your child is drooling much more than usual.
* The mist fails to clear up a bad coughing spell or stridor in 20 minutes.
* Your child starts acting very sick.
During regular office hours if:
* A fever over 102 degrees occurs with the illness
* Your child is not drinking much.
* The coughing spasms are getting worse and/or happening frequently during the day as well as night.
* You have other concerns or questions. Please call us early with any questions you may have, as there are some things we may be able to do to help your child through this illness.
There is a condition called epiglottitis that requires immediate attention. This condition rarely occurs in immunized children, but it bears mentioning here. If you child has the following complex of symptoms, please call immediately.
* Fever > 102 and
* Unwilling to lay down and
* Hoarse voice and
* Drooling and Very ill appearing