What Is Croup?

Croup is a common childhood illness that affects the upper airways, causing a distinctive barking cough, hoarseness, and difficulty breathing. It’s usually caused by a viral infection and is most common in children between 6 months and 5 years old, especially during the fall and winter months.

While it can sound scary, croup is often mild and treatable at home. In some cases, it may require medical attention if breathing becomes more difficult.

Causes?

Croup is typically caused by a viral infection, most often by the parainfluenza virus. Other viruses that can cause croup include:

• Influenza (flu)
• Respiratory syncytial virus (RSV)
• Adenovirus
• Measles virus (in rare cases)

These viruses cause swelling and inflammation in the larynx (voice box), trachea (windpipe), and sometimes the bronchi (airways to the lungs).

Symptoms?

Croup often begins like a common cold, but the symptoms become more specific after a day or two. Typical symptoms include:

• Barking cough that sounds like a seal
• Hoarse voice
• Stridor – a high-pitched, wheezing sound when breathing in
• Difficulty breathing
• Fever
• Runny nose and congestion
• Restlessness or trouble sleeping

Symptoms are usually worse at night and may improve during the day.

Diagnosis?

Doctors usually diagnose croup based on:

• A physical exam and listening to the child’s cough
• Asking about symptoms and how long they’ve been present
• In rare cases, imaging (like an X-ray) may be used if the diagnosis is unclear or to rule out other issues

Treatment?

Most cases of croup are mild and can be managed at home. Treatment may include:

• Comfort care:
  • Keep your child calm, as crying can worsen symptoms
  • Offer fluids to prevent dehydration
  • Keep the air moist with a humidifier or cool mist vaporizer
• Medications (if prescribed by a doctor):
  • Steroids like dexamethasone to reduce airway swelling
  • In more severe cases, a breathing treatment with epinephrine
• Hospital care:
  • Rarely needed, but may be necessary if a child has severe breathing trouble or needs oxygen

When to Seek Medical Help?

Go to the doctor or emergency room if your child:

• Has trouble breathing or is breathing very fast
• Has stridor even while resting
• Shows signs of dehydration (dry mouth, no tears when crying, fewer wet diapers)
• Has blue or pale lips or skin
• Seems very tired or difficult to wake

Prevention?

While it’s not always possible to prevent croup, you can lower the risk by:

• Practicing good hand hygiene
• Keeping your child away from people with respiratory infections
• Staying up to date with vaccinations (including the flu shot)