Croup

Croup has an unmistakable sound, a harsh, repetitive cough similar to the noise of a seal barking. Attacks of croup often jar children awake and leave them frightened and gasping for breath. Croup can be scary for parents, too, but it's usually not serious. At its worst, croup can be treated in the doctor's office most of the time.

The harsh, barking cough is the result of swelling around the vocal cords (larynx) and windpipe (trachea). When the cough reflex forces air through this narrowed passage, the vocal cords vibrate with a barking noise. Because children have small airways to begin with, those younger than age 5 are most susceptible to croup.

Fluids, moist air and other self-care measures can speed recovery from croup. If you stay calm, you can quiet your child's cough so that everyone can get back to sleep.

Croup is often caused by the parainfluenza virus. Less often, respiratory syncytial virus, the measles virus or various other viruses cause croup.

Your child may contract a virus by breathing infected respiratory droplets coughed or sneezed into the air. Virus particles in these droplets also may survive on toys and other surfaces. If your child touches a contaminated surface and then touches his or her eyes, nose or mouth, an infection may follow.

Rarely, croup may be caused by a bacterial infection.

Croup is most common in children age 5 and younger, particularly those who were born prematurely. Signs and symptoms are typically most severe in children age 3 and younger.

Most cases of croup can be treated at home. Seek immediate medical attention if your child:

• Makes noisy, high-pitched breathing sounds when inhaling (stridor)
• Begins drooling or has difficulty swallowing
• Seems agitated or extremely irritable
• Struggles to breathe
• Develops blue or grayish skin around the nose, mouth or fingernails

Croup is typically diagnosed based on symptoms and a physical exam. The doctor will observe your child's breathing, listen to your child's chest with a stethoscope and examine your child's throat. Sometimes X-rays or other tests are used to help make the diagnosis.

Most cases of croup are mild. Rarely, the airway swells enough to interfere with breathing. Ear infection and pneumonia are other rare but potentially serious complications.

Self-care measures at home, such as breathing moist air and drinking fluids, can speed your child's recovery. More aggressive treatment is rarely needed.

If your child's symptoms persist or worsen, his or her doctor may prescribe corticosteroids, epinephrine or another medication to open the airways. Antibiotics are effective only if your child has a bacterial infection.

For severe croup, your child may need to spend time in a humidified oxygen tent. Rarely, a temporary breathing tube may need to be placed in a child's windpipe.

Croup can be scary, especially if it lands your child in the doctor's office, hospital or emergency room. Hold your child, sing lullabies or read quiet stories. Offer a favorite blanket or toy. Speak in a soothing voice. Your presence can help keep your child calm.

Healthy Trust Immediate Medical Care serves the Chicago North Shore Communities of Lake County, Wheeling, Prospect Heights, Lincolnshire, Deerfield, Buffalo Grove, Northbrook, Highland Park, Long Grove, Riverwoods, Des Plaines, Palatine, Glenview, Highwood, Northfield, Libertyville, Winnetka, Arlington Heights, Mount Prospect, Lake Bluff, Lake Forest, Mundelein, and Bannockburn.