Croup can leave a child feeling miserable and parents in a panic. An infection of the upper airway below the vocal cords, croup is characterized by inflammation and swelling that can lead to a variety of uncomfortable symptoms, most notably a harsh, “barking” cough. While many cases of croup can be treated at home, this condition can become serious, so it’s important to know when to seek medical care.
To help eliminate confusion for parents, here are seven key facts about croup and when it’s time to talk to a reputable medical provider.
- Croup occurs most often in babies and toddlers.
Most cases of croup develop in young children between the ages of 3 months and five years old. The most common age to experience croup is two years old. This is because younger children have small airways, so even a modest amount of swelling can affect breathing and trigger symptoms of croup.
- Croup is usually caused by a virus and often starts out as a cold.
The majority of croup cases are caused by a viral infection. For this reason, croup is more common in the fall and winter months when cold and flu viruses tend to spread. Some of the most common viruses that cause croup are parainfluenza (a group of viruses that are not the flu, yet cause flu-like symptoms), respiratory syncytial virus (RSV), influenza (the flu), and adenovirus or enterovirus (common viruses that can lead to colds, bronchitis, pneumonia, and other conditions).
- There are other causes of croup besides infection.
When this occurs, it is called “spasmodic croup.”
Although a viral infection is the most common cause of croup, it’s not the only one. Allergies to food or triggers in the environment may also cause croup symptoms. Reflux (when stomach acid and food move back up into the esophagus) can cause this illness, as well. Both allergies and reflux can narrow the airways and lead to croup symptoms. In these cases, croup is referred to as “spasmodic croup.”
- The characteristic “barking cough” is just one of several croup symptoms to look for.
The classic symptom of croup is a cough that can sound like the high-pitched bark of a seal. Other symptoms may include:
- Fever
- Hoarse voice
- Wheezing
- Loud or labored breathing
- A high-pitched whistling noise when inhaling (this is called “stridor”)
- A congested or runny nose
Symptoms are usually worse at night and can also be aggravated by crying or frequent coughing. Most cases of croup last for about three to five days.
- For most croup symptoms, home remedies may be enough.
If your child is experiencing the symptoms of croup described above, there are steps you can take at home to ease symptoms until the virus has run its course. For example:
- Give children’s acetaminophen or ibuprofen according to package directions to reduce fever.
- Add moisture to the air in your home by using a humidifier, or have your child sit in the bathroom while a hot shower is running.
- Cool air can also help to open up the airways a bit — try taking your child outside in the colder months for a few minutes to breathe the cold air.
- Make sure your child is getting plenty of fluids by providing ample water, breast milk, or formula.
- Try to keep your child calm, comfortable, and well-rested in order to avoid excessive crying, as this can make symptoms worse.
- Keeping your child’s head elevated may help to make breathing easier, as well.
One thing that won’t be helpful in treating croup at home is over-the-counter cold and cough medicines. These will not lessen the symptoms of croup and they aren’t recommended for children under the age of six, according to the American Academy of Pediatrics.
- If any of these croup symptoms develop, you should seek medical care.
While the measures listed above will be enough to treat most cases of croup, it’s important to remember that croup is a condition that can worsen quickly and become serious. Be sure to keep a close eye on your child so that you can act quickly if symptoms worsen — you may even want to sleep near your child since nighttime is when symptoms are usually at their most severe.
If you notice any of the following more serious symptoms of croup — or if symptoms don’t seem to improve after three to five days of at-home care — you should call your doctor or seek medical care at a fully equipped urgent care center :
- Labored breathing – If the skin around your child’s ribs pulls in tight when he or she is breathing in, this is a sign that breathing has become too difficult. (If breathing becomes rapid or appears to be extremely difficult, call 911 immediately.)
- Stridor even when your child is at rest – Stridor (high-pitched whistling noises when breathing in) that occurs while the child is crying, coughing, or active is not as much of a concern.
- Excessive sleepiness, sluggishness, or listlessness – This may result from your child having labored breathing.
Most importantly, if your child has excessive drooling or difficulty swallowing, or if their skin starts to turn blue around the mouth, nose, or fingernails, this is a medical emergency. Call 911 immediately or head straight to the nearest emergency room.
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Most cases of croup are contagious.
Since viruses cause the majority of croup cases, it’s possible for one child with croup to spread that virus to another child. Frequent hand washing and reminding your child to cover their cough or sneeze with the inside of the elbow can help to limit the spread of croup-causing germs.
It’s also important to keep up on your child’s vaccinations. Be sure to visit their pediatrician for your child’s annual physical and routine vaccinations. Many urgent care centers can also provide pediatric flu shots.
Where to Find Help
Visit Get Care Now at Yale New Haven Health to explore your options. Or, just visit a Yale New Haven Health urgent care location.
