Your toddler has a harsh cough that gets worse in the evening. Now she’s woken up gasping for air. Chances are she has croup. This is an infection of the voice box (larynx) and windpipe (trachea). Croup causes the airways to swell, making it hard to breathe. It also causes a cough that can sound something like a seal barking.
Causes of croup
Croup mainly affects children between 6 months and 3 years of age, especially children younger than 2 years. But it can occur up to age 6. Older children have larger airways, so swelling isn’t as likely to affect their breathing. Croup often follows a cold. It is usually caused by a virus and is most common between October and March.
When to go call 911
Mild croup can usually be treated at home with the home care methods listed below. Call your health care provider right away if you suspect croup. Take your child to the ER if he or she has moderate to severe croup. And seek emergency care if you’re worried, or if your child:
Makes a whistling sound (stridor) that becomes louder with each breath.
Has stridor when resting
Has a hard time swallowing his or her saliva or drools
Has increased difficulty breathing
Has a blue or dusky color around the fingernails, mouth, or nose
Struggles to catch his or her breath
Can't speak or make sounds
What to expect in the emergency department
A doctor will ask about your child’s health history and listen to his or her breathing. Your child may be given a medicine that usually relieves swollen airways and other symptoms. In rare cases, the doctor may use a tube to help your child breathe.
Home care for croup
Croup can sound frightening. But in many cases, the following tips can help ease your child's breathing:
Don't let anyone smoke in your home. Smoke can make your child's cough worse.
Keep your child's head raised. Prop an older child up in bed with extra pillows. Never use pillows with an infant younger than 12 months old.
Sleep in the same room as your child while he or she is sick. You will be able to help your child right away if he or she has trouble breathing.
Stay calm. If your child sees that you are frightened, this will make your child more anxious and make it harder for him or her to breathe.
Offer words of comfort such as "It will be OK. I'm right here with you."
Sing your child's favorite bedtime song.
Offer a back rub or hold your child.
Offer a favorite toy.
If the above tips don't help your child's breathing, you may try having your child breathe in steam from a shower or cool, moist night air. According to the American Academy of Pediatrics and the American Academy of Family Physicians, no studies prove that inhaling steam or moist air helps a child's breathing. But other medical experts still support this approach. Here's what to do:
Turn on the hot water in your bathroom shower.
Keep the door closed, so the room gets steamy.
Sit with your child in the steam for 15 or 20 minutes. Don't leave your child alone.
If your child wakes up at night, you can take him or her outdoors to breathe in cool night air. Make sure to wrap your child in warm clothing or blankets if the weather is chilly.
December 15, 2017
Croup (Acute Laryngotracheobronchitis). McInerny TK. Textbook of Pediatric Care. 2009, p. 340., Croup: An Overview. Zoorob R. American Family Physician. 2011;83(9):s1067-73., Croup: Clinical Features, Evaluation, and Diagnosis. UpToDate., Patient information: Croup in infants and children (Beyond the Basics). UpToDate.
Adler, Liora C, MD,Fraser, Marianne, MSN, RN,Godsey, Cynthia, MSN, APRN, MSHE, FNP-BC