Croup is an inflammation of the voice box (larynx) and windpipe (trachea). When a child has croup, the airway just below the vocal cords becomes narrow. This makes breathing noisy and difficult. Some children get croup often, such as whenever they have a respiratory illness. Children are most likely to get croup between 6 months and 3 years of age. After age 3, it is not as common because the windpipe is larger, so swelling is less likely to get in the way of breathing. Croup can occur at any time of the year, but it is more common between October and March. There are different types of croup:
- Spasmodic croup is usually caused by a mild upper respiratory infection or allergy. It is often frightening because it comes on suddenly in the middle of the night. Your child may go to bed with a mild cold and wake up in a few hours, gasping for breath. They will be hoarse and have a cough that sounds like a seal barking. Most children with spasmodic croup do not have a fever. This type of croup can reoccur.
- Viral croup results from a viral infection in the voice box and windpipe. This kind of croup often starts with a cold that slowly develops into a barking cough. As your child’s airway swells and they secrete more fluid, it becomes harder for them to breathe. Their breathing will also get noisier, and it may make a coarse musical sound each time they breathe in. This condition is called stridor. Most children with viral croup have a low fever, but some have temperatures up to 104°F.
As your child’s effort to breathe increases, they may stop eating and drinking. They may also become too tired to cough, although you will hear the stridor more with each breath. The danger with croup accompanied by stridor is that the airway will keep swelling. If this happens, it may reach a point where your child cannot breathe at all. Stridor is common with mild croup, especially when a child is crying or moving actively. But if a child has stridor while resting, it can be a sign of severe croup.
Steam Treatment – If your child wakes up in the middle of the night with croup, take them into the bathroom. Close the door and turn the shower on the hottest setting to let the bathroom steam up. Sit in the steamy bathroom with your child. Within 15 to 20 minutes, the warm, moist air should help their breathing. (Though they will still have barking cough.) For the rest of that night and 2 to 3 nights after, try to use a cold-water vaporizer or humidifier in your child’s room.
Steam almost always works. If it does not, take your child outdoors for a few minutes. Inhaling cool night air may loosen up the air passages so that they can breathe more freely. If that does not help, consult your pediatrician about other options.
If your child’s breathing becomes a serious struggle, call 911.
Treating with Medication – If your child’s breathing is not better after the steam treatment, we may prescribe a steroid medication to reduce swelling in the throat or shorten the illness. Antibiotics (which treat bacteria) are not helpful because the problem is almost always caused by virus or allergy. Cough syrups are not recommended because they do not affect the larynx or trachea, where the infection is located. These may also get in the way of your child coughing up mucus from the infection.
Call for emergency medical services immediately if he/she:
- makes a whistling sound that gets louder with each breath
- cannot speak for lack of breath
- seems to be struggling to get a breath
- seems very pale or has a bluish mouth or fingernails
- has stridor when resting
- drools or has extreme difficulty swallowing saliva