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Croup – A Parent’s Guide

Croup is an infection that causes the trachea (windpipe) and larynx (voice box) to swell. It is usually part of a cold. Croup occurs most commonly in children 1 to 3 years old, although it can be seen in older children up to 8 years of age.

Croup causes a fever, hoarseness and a barking, hacking cough. It also may cause a crowing noise (called stridor) when the child breathes in through the narrowed windpipe. (See video demonstration of barking cough and stridor.) Parents often may confuse this sound with wheezing. Croup usually lasts 5 to 6 days, and the symptoms are usually worse at night – ESPECIALLY THE 2nd NIGHT!

It is important to note that, despite the apparent deep nature of the cough, it is due to upper airway inflammation and not “in the chest.” Additionally, any sore throat associated with hoarseness (or cough) is very unlikely to be strep throat. Antibiotics are rarely useful or indicated in the treatment of croup.

What should you do if your child has croup?

Despite the fact that croup is one of the most common reasons that parents go to an emergency room or call an ambulance at night, most children with mild croup can be safely treated at home. You should make your child as comfortable as possible. Make sure that your child gets plenty of rest and plenty to drink. When your child has a croupy cough, it is very important to increase the amount of liquids that your child drinks. You may give your child Tylenol or Motrin for his or her chest discomfort or discomfort due to fever.

If your child has a mild attack of stridor, try having him or her breathe moist air. This is called mist treatment. You can give your child a mist treatment at home by running hot water in the shower with the bathroom door closed. Once the room has become steamy, sit with your child in the room for 10-15 minutes. If this does not help, dress your child warmly and take your child outside in the cool air for 10-15 minutes. If this still causes no improvement, get into the car and drive around with the window down for 10-15 minutes. If you are seeing no change at this point please call us!Additionally, the use of oral steroids for 24 hours is a very safe and effective way to decrease the inflammation of the airway and reduce croup severity. Steroids generally start to work within 2 hours. We may call a prescription in for you. This should be given if your child has stridor (the high-pitched inspiratory sound) now or if he/she had it last night. If your child has not had any stridor, the prescription should be filled and kept on hand. It should be given if your child develops stridor or has worsening symptoms. Remember, croup is usually worse the second night!

Please call us immediately if:

  • your child starts drooling or has trouble swallowing
  • your child’s lips and skin are bluish or turn dark
  • your child is cranky or is constantly uncomfortable
  • your child’s breathing becomes more difficult
  • your child seems to feel worse
  • your child looks frightened when trying to lie down
  • you are worried