Croup is a very common childhood sickness that occurs most often in the fall or winter but that can occur at any time of year.
Croup is a viral illness that affects the larynx (voice box) and wind pipe (trachea). The virus will cause irritation and inflammation to both, causing a very distinct sounding cough — usually described as a harsh, barky, seal-like cough. Sometimes the irritation and inflammation will cause a high-pitched “sweaky” sound when the child inhales. This sound is described as a stridor.
Croup, which is spread through respiratory droplets and passed from person to person, is often it’s worse at night time. The most commonly affected age group is 3 months to 3 years, but it can occur at any age.
Most of the time croup can be managed at home with supportive measures. Moist air can help to calm the cough. The easiest way to provide an environment in which the child can inhale moist air is by turning the shower on and getting the bathroom hot and steamy. The child does not have to be in the water, which allows you to use hotter water to create more steam. Keeping the child calm is helpful, since the more worked up she becomes, the more the cough and breathing will worsen.
Cool air is also helpful in calming the cough. If it’s winter time, you can bundle the child well and head outside to allow him to get a few breaths of cold air. Opening a window and allowing the child to breath the air from the window is also helpful. If it;s not cool enough outside, you can try opening the freezer door and allowing the child to breath that cold air. (NOTE: If you suspect or know your child has asthma do not attempt to use the cold-air method.)
What to Watch For
The greatest danger associated with croup is if the inflammation progresses and decreases the airflow past the trachea and larynx. A child will need immediate medical attention if:
- You feel she can’t take a breath in,
- He/she is unable to speak because of shortness of breath,
- He/she gets excessively sleepy or turns blue when coughing.
Hearing a stridor when the child takes a deep breath, either when crying or between coughs, is common. It is NOT common to have the stridor with every breath that does not resolve as the child calms. If the child is calm but still breathing with a stridor, medical attention is also necessary.
Sometimes we will prescribe steroids to help with the inflammation and irritation. Antibiotics will not be helpful in the treatment of croup. We do not recommend any cough syrups or medication under the age of 2 and strongly discourage their use under the age of 6. Honey is a good natural cough suppressant that can be mixed with a decaffeinated tea or given by itself. There are also over-the-counter cough medications that are honey-based that are fine to use for children over the age of one.
As always, if you have any questions, please call the office!
Stacey Stratton is a member of the American Academy of Physician Assistants and the Society for Physician Assistants in Pediatrics.