When you’re a parent, you know the familiar sounds of kids in the house: giggling, high-pitched squeals and the pitter-patter of their little feet.
What you may not expect to hear, however, is something that sounds like a barking seal on a wildlife TV show.
What are the symptoms?
“There are two hallmark characteristics of croup,” said Jaya Wadhawan, MD, a pediatrician at OSF HealthCare. “One is a cough that sounds a lot like a barking seal. The other is called stridor – a high-pitched, wheezing or whistling sound a child makes while breathing, which can be a sign of difficult breathing.
“While no parent likes to see their child sick, it’s important for them to stay calm because if a child with croup gets anxious, it can make breathing even harder for them.”
Other symptoms vary as the illness moves from the nose to the lungs, and they include fever, runny nose and a lost voice. Symptoms tend to get worse as the day progresses into the evening.
Who does it impact?
Croup tends to impact children from age 3 months to 5 years, but it’s most common in 2-year-olds.
“The reason younger children are impacted is because of the small size of their airways,” Dr. Wadhawan said. “Since their airways are smaller than those in older kids and adults, any inflammation restricts their breathing more and results in the barking cough and stridor.”
How is it treated?
Since croup is caused by a virus, the illness has to run its course, which usually takes three to seven days. However, there are two effective medications for addressing the symptoms.
The barking cough is treated with a steroid that’s taken orally or as an injection, and stridor is treated with an inhaled medication, which reaches the lungs and larynx immediately.
But there are also a couple of easy home remedies to provide temporary relief of symptoms.
“It’s funny, but dry, cold air and warm, moist air both work well in reducing inflammation in the airways and, as a result, reduce coughing and stridor,” Dr. Wadhawan said. “Cold air works immensely well. You can open a window of your home, bundle a child up and take them outside, or even take them for a ride in the car with the window cracked open. Any of those options will allow the cold air into their airways and immediately reduce inflammation.
“On the other hand, steam also works very well. So, parents can sit with their child in a bathroom with a hot shower running, and the steam will reduce inflammation, open their airways and break up any mucus.”
When to see a doctor
Croup rarely leads to complications, but it’s possible if an obstruction is bad enough. So, it’s important to know when to see a doctor.
“If symptoms are mild and a child is responding well to home remedies, it’s not always necessary to see their pediatrician,” Dr. Wadhawan said. “However, if they’re not responding to treatment, starting to have trouble breathing, having a hard time swallowing, are unable to speak, or their stridor is becoming louder, that’s the time to see their doctor. If symptoms seem severe enough, call 911.”
Also, if your child has more than two bouts with croup during the year or is battling croup at age 6 or older and isn’t improving, they should be seen by a doctor to determine if there’s an underlying condition, such as:
- Allergies (food, environment): Symptoms – coughing, wheezing and stridor – can be mistaken for croup.
- Asthma: The wheezing can be confused for croup.
- Foreign bodies: Young children tend to put things in their mouths, so it’s important to make sure there isn’t an object obstructing their airway.
How to avoid it
Like many other viruses, croup is spread through coughing and airborne droplets. So, it’s important to teach kids to cough into their elbow, wash their hands often and to use hand sanitizer.
It’s also important to keep sick children away from babies as croup can impact babies worse than older children.