Croup is an infection that causes inflammation of the windpipe (trachea) and the vocal cords (voice box). The inflammation is usually caused by the same viruses that cause the common cold.
Your child will usually have symptoms of a cold before the onset of croup, including a runny nose, sore throat, fever and irritability. He then develops a harsh, barking cough, sometimes a hoarse voice, and then noisy breathing (stridor).
The noisy breathing and cough are usually worse at night. They can also get worse if your child gets upset. In most children, the symptoms improve over a few days then disappear.
In a few children, the croup is more severe and causes trouble breathing. In this case, your child needs urgent medical attention, and sometimes observation and treatment in hospital.
Common signs of your child having trouble breathing include:
- the skin (or muscles) between the ribs and under the breastbone gets sucked in as your child breathes
- your child’s nostrils flare
- your child is restless and has trouble feeding and drinking
- your child won’t lie down.
Stridor is a high-pitched whistling sound your child makes when breathing in (called an ‘inspiratory’ noise). It generally indicates some obstruction or narrowing of the windpipe.
Stridor is also occasionally caused by a condition called epiglottitis. It might also be caused by an inhaled foreign body.
When to see your doctor
You should take your child to the doctor if:
- your child is having trouble breathing
- you can easily hear your child’s noisy breathing, even when she’s resting quietly
- your child’s breastbone sucks in when he breathes in
- your child has trouble swallowing
- you’re worried.
If your child’s lips go blue, seek medical attention immediately. Severe croup requires emergency medical attention.
Your doctor will diagnose croup after taking your child’s history and examining your child.
Most children with croup don’t need treatment. You can manage the symptoms in exactly the same way as for a cold.
It’s important to try and keep your child calm, because your child can have more trouble breathing if she’s upset, frightened or stressed.
Croup is most commonly caused by a virus, so antibiotics won’t work. Antibiotics treat only bacterial infections.
Steam therapy, including the use of vaporisors, is no longer recommended.
Your child might need a three-day course of oral prednisolone or dexamethasone (steroids) if he has more severe symptoms. This treatment can reduce his symptoms quickly by helping reduce the swelling in his windpipe. It has no long-term consequences.
A few children with croup need to go to hospital for observation, to ensure that their windpipes don’t get blocked. While in hospital, your child might initially receive adrenaline in the form of mist (nebulised adrenaline). This reduces the swelling in the windipe very quickly while the steroids work.
There’s no way to prevent children from getting croup.