Dr. Mom: When a child has croup, it's best to stay calm

02/21/2012 12:00 AM

02/26/2013 8:10 PM

Croup is still in full swing around the country, and if you've ever had a child with croup, you know that telltale barking cough.

That harsh sound will jolt you out of sleep at 2 a.m. and send you screeching into your toddler's room.

Croup is a viral upper respiratory illness caused most frequently by the parainfluenza virus. It results in swelling and inflammation of the larynx (voice box) and trachea (airway). It is most common in the fall and winter months but can be seen year-round.

The infection starts out like a typical cold, with runny nose and congestion. Some children will endure a few days of high fever, up to 104 degrees in some cases.

Then you hear it. That hoarse, harsh, barking cough, and of course, it's commonly worse at night.

As with most viruses, croup is transmitted by droplets from sneezing, coughing and hand-to-mouth transmission. Consequently, teach your child to cough and sneeze into his elbow and to practice good hygiene. That includes washing hands before eating, after using the bathroom, after playing outside and upon returning home from school.


Since croup is a virus, antibiotics are not necessary. The illness will run its course, usually in three to seven days, with the worst of it peaking on the third day. However, that cough is distressing. Here's what you can do.

Stay calm. That cough can rattle even the calmest of parents, and children will often look worried and scared, too. When your child starts that terrible coughing in the middle of the night, take her with you into the bathroom. Sit her on your lap while you run a hot shower. The steam will help calm her airway and throat. Continue to reassure her.

You could also use exposure to the outside cold air. Although this sounds counterintuitive, the cold air works much in the same way as the steam, helping to soothe the inflamed airway.

We often hear stories of parents packing up their child and heading to the emergency room, only to discover that once they get there, their child has stopped coughing. A therapeutic drive to the ER.

Cool mist humidifiers also allay that cough. Once you suspect croup, run one in your child's room while he's sleeping. That cool, moist air will soothe and coat those little airways, decreasing the irritation and inflammation.

If your child's fever is climbing above 102 degrees, she will likely start to feel and look droopy. Give her a fever reducer and keep her well hydrated through it all.

When to worry

Although croup is typically a mild, self-resolving illness, complications can arise. If your child makes a high-pitched squeaking sound when she breathes in (known as a stridor), this indicates more severe airway swelling and could potentially interfere with her breathing.

If your child looks very ill, is dehydrated or is visibly having difficulty breathing, seek immediate medical attention. Significant airway swelling can quickly turn into a medical emergency.

In these cases, your child's doctor may give some steroids to decrease the airway swelling, and she may or may not need a breathing treatment and a period of observation in the emergency department.

The most important thing to remember is to stay as calm as possible. If your child gets scared and is crying, this will only exacerbate the coughing and breathing difficulties.

Remember that you can help your child with that barking cough by taking the above precautions, and never hesitate to contact your child's doctor with concerns or questions.


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