What is Croup: Signs, Symptoms and Treatment

Have you ever found yourself furiously Googling ‘What is Croup’ at 2am?

Feeling panicked because your child is terrified with a harsh, barking cough and you’re worried they’ll soon struggle to breathe?

It’s definitely not fun at all.

Croup can be scary for both you and your child, so it’s important that you feel confident knowing how to identify it and manage it.

While I thought I was done with the dreaded bark of Croup, I woke up with a fright the other night to my 8 year old daughter showing classic Croup symptoms. I was surprised to learn that 8 is the upper age limit for it and I now truly hope it is in our past.

What is Croup?

Interestingly, Croup is a reaction to a virus, rather than a virus in itself.

The reaction causes a viral infection in the throat, which leads to swelling around the vocal chords and windpipe, which sounds scary.

If your child has Croup, they develop a harsh, barking cough and can also make a noisy, high-pitched sound each time they breathe in, which is called ‘stridor’.

In severe cases the swelling can make it harder to breathe.

If your child is having problems breathing or you are unsure how severe the croup is, please seek urgent medical attention.

Who is at risk of Croup?

Croup is most common in babies and children between six months and five years old, predominantly during winter.

For the most part it is a mild illness, but can worsen quickly.

When your child is little – they have soft, small windpipes. The swelling of Croup and a build-up of mucus narrows the airways, which can make it difficult to breathe.

As your child grows, so does the size of their windpipe. But interestingly, it is because the strength of the windpipe also improves, and this is why it is less common for older children to have Croup.

Because Croup is a reaction rather than a specific virus you cannot ‘catch’ Croup, but some children are more susceptible to reacting to the virus that causes Croup. Some children get Croup several times.

What are the Symptoms of Croup?

Unfortunately, the worst symptoms typically occur suddenly at night when the air is cold and dry. Believe me, 2am feels like a very lonely, worrying place when your child is sick and scared.

These symptoms can be worse on the second or third night of the illness and can become worse when your child is upset.

Croup usually begins with common cold symptoms such as sore throat, runny nose and fever, which can progress suddenly. Croup symptoms include:

Your child may have a hoarse voice.
Your child develops a harsh, barking cough (like a seal).
You notice a squeaky, high pitched noise when you child breathes in – called stridor.
They may have fast or laboured breathing.
In severe cases of croup, they may struggle to breathe and the skin between your child’s ribs or under their neck may suck in when they breathe.

The best rule of thumb is – don’t hesitate to seek help!

Croup is so often mild but can worsen quickly. Seek urgent assistance if your child has laboured, hard breathing (stridor) or if you are unsure just how severe the illness is.

A child with severe Croup will need prompt treatment so dial 000 for an Ambulance.

Home Treatment of Croup

In mild cases of Croup your child may have a ‘barking’ cough, but no trouble breathing. In mild Croup, they also don’t have stridor when they are calm and settled.

This is best cared for at home, but monitor your child for signs of worsening Croup, such as difficulties breathing.

Here are some tips for home care:

Keep calm: The croupy bark scares babies, toddlers, children and parents. But being panicked only makes it worse! Wherever possible, calm your child down so that you can accurately assess their breathing. (And try to remember yourself that if they are crying they are breathing). Give cuddles, sing nursery rhymes, read a book, listen to relaxing music, watch TV or do what you can do to help them relax.
Keep sipping water: Offer your child plenty of small sips of water, especially if they have a fever.
Sit up: Prop your child up in bed with pillows to help make it easier to breathe.
Be prepared: Croup is most often worst at night when the air is cold and dry. You may find that your child is more settled if someone stays with them.
Offer pain relief: If your child has a fever or is miserable, you may offer paracetamol. Make sure you carefully check the label for the correct dose and that you are not giving your child any other products containing paracetamol.

Please note: Steam therapy and humidifiers are no longer recommended as treatment. There is also NO proof that medications to treat allergies (antihistamines) or cold remedies (decongestants) are beneficial for treating Croup. Antibiotics will also not help, as remember that Croup is caused by a virus.

When to see a Doctor

Your GP is a valuable source of information and will be able to help you further understand for your child what signs and symptoms can be managed at home and when you need to seek urgent medical assistance if things deteriorate.

It is a good idea to take your child to the GP if they have signs of mild Croup and:

they are under 6 months of age.
it is their first bout of Croup or you are unsure what it is.
if the Croup is not improving after a few days.
you have any questions.

Dial 000 for an Ambulance to seek urgent Medical Assistance if your child:

has obvious difficulty breathing.
becomes floppy or hard to wake.
looks very sick and goes pale and drowsy.
has lips blue in colour or a blue tinge around the mouth.
starts to drool or can’t swallow.
has difficulty drinking, feeding or talking.
sucks their breastbone in or the skin between their ribs in when breathing in.
has stridor (noisy breathing) at rest.
is very distressed or their symptoms are getting worse.
Or, if you are worried for any other reason.

How will a Doctor help your child?

Your child may receive prednisolone or dexamethasone. These are steroids to be taken by mouth, that help by reducing the swelling in your child’s airways, making it easier to breathe. It takes about one hour for it to start to work.

If the Croup is severe, other medicine may be given in hospital to help your child breathe easier until the prednisolone starts to work.

If your child has severe Croup, they will need to remain in hospital so that they can be closely monitored.

What can you expect with Croup?

In the majority of cases, Croup lasts between one and four days.

With some children, it can last up to a week, and may also be present during the day. Symptoms are usually the worst during the night and in the first two days of having the illness.

While it can be easier said than done – the best advice is to stay calm. This way you can help your child stay calm because breathing is harder when your child is upset.

No medical treatment is needed for mild cases, but keep in mind that Croup can get worse quite quickly.

If your child is having problems breathing or has any of the emergency symptoms listed above, do not hesitate to seek urgent medical help.

Contact me now to find out what course would best suit your needs or book into my next Community Parent/Caregiver First Aid course on Thursday 23 March.