Croup

General Overview:

Croup is a viral infection of the airway below the vocal cords. It is most common in children age 6months to 3 years and is often identified by the classic seal-like barking cough.

Signs and Symptoms:

The most common signs and symptoms associated with croup include:

  • Seal-like barking cough
  • Hoarse voice
  • Stridor – a high pitched, harsh, raspy sound with breathing in http://www.easyauscultation.com/stridor
  • Fever
  • Runny nose

Croup typically lasts for 3 to 5 days and is often worst at night. 

Symptom Management:

  • Breathing cool moist air is helpful for soothing the cough associated with croup.If possible, run a cool mist humidifier in his or her bedroom until throughout the illness
  • For sudden worsening symptoms allow your child to breath in the steam from a hot shower for 10-15 minutes
  • If the cool mist humidifier and steamy bathroom air have not helped, bring your child outside or open the window to provide some fresh cold air

Medications:

Croup is a viral illness and thus cannot be treated with antibiotics. Depending on the type and severity of symptoms a few medications may prescribed by or approved by your physician. You child must be seen in our office to determine if prescription medication is necessary.

  • Oral Steroids such as Orapred may be helpful to reduce the barking cough and stridor associated with croup.  It is typically used is more severe cases.
  • Acetaminophen (Tylenol) and Ibuprofen (Motrin/Advil) may be used for comfort.  As always, it is not necessary to give medication to reduce your child’s fever, but it may help for uncomfortable or fussy infants and toddlers.
  • Over the counter cough and cold medicines are NOT recommended for use in children under age 12 years.Coughing clears the lungs of mucous and is often beneficial to cold resolution. For that reasons cough suppressants may actually delay the resolution of coughs.

When to Call:

Call our office immediately if your child has an attack that lasts for 20 minutes despite trying the above suggestions, your child's lips turn blue or dusky, your child develops retractions (tugging in between the ribs when breathing,) or your child develops drooling, spitting, or great difficulty with swallowing. For less urgent questions about croup, you can reach your physician during call-in time from 8:30 - 9:00 A.M.

Takeaway Message:

Croup is a viral illness characterized by a barking seal-like cough.  It typically resolves in 3-5 day without treatment, but sometimes requires oral steroids to reduce worsening symptoms. 

Additional Resources:

Information about croup from the American Academy of Pediatrics.