This upper airway infection makes it harder to breathe and causes a barking cough. It involves swelling around the voice box, windpipe and bronchial tubes.
Croup refers to an infection of the upper airway, which becomes narrow, making it harder to breathe. Croup also causes a cough that sounds like barking.
The cough and other signs and symptoms of croup are the result of swelling and irritation around the voice box (larynx), windpipe (trachea) and bronchial tubes (bronchi). When a cough forces air through this narrowed passageway, the swollen vocal cords produce a noise like a seal barking. Taking a breath often produces a high-pitched whistling sound called stridor.
Croup most often occurs in younger children. It usually isn't serious. Most children can be treated for croup at home.
This shows a child's healthy airway.
Croup often begins as an ordinary cold. If there's enough swelling, irritation and coughing, a child can develop:
Symptoms of croup are often worse at night and usually last for 3 to 5 days.
Contact your child's health care provider if symptoms are severe, worsen, last longer than 3 to 5 days or aren't responding to home treatment.
Seek immediate medical attention if your child:
Croup is usually caused by a viral infection, most often a parainfluenza virus.
Your child may get 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 surface with a virus on it, and then touches the eyes, nose or mouth, an infection may follow.
Children between 6 months and 3 years of age have the highest risk of getting croup. Because children have small airways, they're likely to have more symptoms with croup. Croup rarely occurs in children older than 6 years of age.
Most cases of croup are mild. In a small number of children, the airway swells enough to cause problems with breathing. Rarely, a bacterial infection of the windpipe can occur in addition to the viral infection. This can result in trouble breathing and requires emergency medical care.
Only a small number of children seen in the emergency room for croup require a stay in the hospital.
To prevent croup, take the same steps you use to prevent colds and flu.
To prevent more-serious infections that may cause croup, keep your child's vaccinations up to date. The diphtheria and Haemophilus influenzae type b (Hib) vaccines offer protection from some of the rarest — but most dangerous — upper airway infections. There isn't a vaccine yet that protects against parainfluenza viruses.
Croup is usually diagnosed by a health care provider. The provider:
Sometimes X-rays or other tests are used to rule out other possible illnesses.
Most children with croup can be treated at home. Still, croup can be scary, especially if your child needs a visit to the health care provider's office, emergency room or hospital. Treatment is usually based on how severe the symptoms are.
It's important to comfort and calm your child because crying and distress can worsen airway swelling, making it harder to breathe. Hold your child, sing lullabies or read quiet stories. Offer a favorite blanket or toy. Speak in a soothing voice.
Also, make sure that your child drinks plenty of fluids to stay hydrated.
Your child's health care provider may prescribe these medicines:
For severe croup, your child may need to spend time in a hospital to be monitored and receive more treatments.
Croup often runs its course within 3 to 5 days. In the meantime, keep your child comfortable with a few simple measures:
Try a fever reducer. For treatment of fever or pain, consider giving your child infants' or children's over-the-counter fever and pain medicines such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) as a safer alternative to aspirin. Read the directions carefully for dosing. Ask your health care provider about the right dose if you're not sure.
Use caution when giving aspirin to children or teenagers. Though aspirin is approved for use in children older than age 3, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye's syndrome, a rare but potentially life-threatening condition, in such children.
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 symptoms worsen.
In most cases of croup, your child won't need to see a health care provider. However, if symptoms are severe or aren't responding to home treatment, you should call your provider.
Before your appointment, make a list of:
Your child's health care provider will likely ask a number of questions to help determine the best course of treatment:
Your health care provider will ask other questions based on your answers and your child's symptoms and needs. Preparing and anticipating questions will help you make the most of your time with the provider.