Croup

Topic Overview

• The noisy coughing and breathing that come with croup sound scary, but croup is rarely serious and can usually be treated at home.
• Breathing in moist air seems to help with croup attacks. Sit with your child in a bathroom full of steam. Or take your child outside to breathe the cool night air. Try a cool mist humidifier.
• Stay calm during an attack. This will help your child stay calm. Crying can make it harder to breathe.
• If your child’s symptoms don't get better after 30 minutes, call or see your doctor. If the attack is very severe or is in the middle of the night, consider calling 911 or taking your child to the emergency room.
• Call your doctor if your child does not gradually get better in a few days. The doctor can prescribe medicine to decrease the swelling in the airways.

What is croup?

Croup is a common respiratory problem in young children. Its main symptom is a harsh, barking cough. Croup causes swelling and narrowing in the voice box, windpipe, and breathing tubes that lead to the lungs. This can make it harder for your child to breathe.

An attack of croup can be scary, but it is rarely serious. Children usually get better in several days with rest and care at home.

What causes croup?

Croup usually occurs a few days after the start of a cold and is usually caused by the same viruses that cause the common cold. As children grow older and their lungs and windpipes mature, they are less likely to get croup.

What are the symptoms?

Symptoms of croup are caused by narrowed airways. They include a barking cough; a raspy, hoarse voice; and a harsh, crowing noise when breathing in. The cough is very distinctive, so you'll know it when you hear it. It is often compared to the sound of a barking seal. Sometimes children breathe fast and need to sit up to breathe better.

Symptoms of croup often improve during the day and get worse at night. Sometimes children have croup attacks that wake them up in the middle of the night for a couple nights in a row, but the illness usually improves gradually in 2 to 5 days.

How is croup diagnosed?

Your doctor will probably be able to tell whether your child has croup by examining him or her and asking about symptoms. Sometimes doctors can identify the distinctive barking cough of croup over the phone.

Because croup can make breathing harder, your doctor may place a small clip called a pulse oximeter on your child's finger, toe, or earlobe to make sure that enough oxygen is reaching the blood.

How is it treated?

Even though your child's coughing and troubled breathing can be frightening, home treatment usually eases the symptoms.

Try to stay calm during an attack, and soothe your child. Crying can make the swelling in the windpipe worse and make it even harder to breathe.

Breathing in moist air seems to help during a croup attack. Fill your bathroom with steam from the hot water faucets, and sit in the room with your child for 10 minutes. Or hold your child directly over a cool mist humidifier, and let the vapour blow directly in his or her face.

Breathing cool night air also seems to help sometimes. Dress your child in warm clothes, and go outside for 10 minutes.

If symptoms improve with these methods, put your child back in bed with the cool air humidifier blowing nearby. Do not smoke, especially in the house. If the symptoms happen during the middle of the night, it is a good idea to sleep in or near your child's room until morning.

It is important to keep your child well hydrated. Offer water, flavoured ice treats (such as Popsicles), or crushed ice drinks several times each hour.

If your child’s symptoms don't get better after 30 minutes, call or see your doctor. If the attack is in the middle of the night and you are very worried, consider taking your child to the emergency room.

If your child has severe difficulty breathing, call 911 or other emergency services immediately.

If your child has severe croup or has not responded to home treatment, medicines may be used to decrease airway swelling. These are usually given in a doctor's office or an emergency room. Rarely, a child needs to stay in the hospital for treatment.

Frequently Asked Questions

Learning about croup:	What is croup? What are the symptoms? What conditions can cause similar symptoms? Who is affected by croup?
Being diagnosed:	How is croup diagnosed?
Getting treatment:	How is croup treated? What kinds of home treatment can help? How can I help manage an episode of croup?

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Author:	Amy Fackler, MA Carrie Henley	Last Updated: October 16, 2006
Medical Review:	Adam Husney, MD - Family Medicine Michael J. Sexton, MD - Pediatrics Thomas Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics
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