- Suitable for 0-8Years
Croup
Croup is very common in young children. It is usually associated with a cold (and is therefore more common in winter), and for the most part is not serious. It is occasionally severe enough to cause breathing difficulties. In this case the child needs urgent medical attention, and sometimes observation and treatment in hospital.
When to see the doctor
- If your child has difficulty breathing.
- If stridor is easily heard even when the child is resting quietly.
- If you are worried.
What causes it?
The croup, or stridor, that is heard when the child breathes in, is caused by swelling of the breathing tube, just below the vocal cords. The swelling is caused by one of the viruses that are responsible for the common cold.
What are the symptoms?
Your child will usually have symptoms of a cold before the onset of croup, including a runny nose, sore throat, fever and irritability. They then develop a harsh, barking cough, sometimes a hoarse voice, and then noisy breathing. The noise is heard when they breathe in (in contrast to asthma, in which the wheeze occurs as the child breathes out).
The stridor and the cough are usually worse at night and when the child is distressed. In the majority of children, the symptoms improve over a few days and then disappear.
In a small number of children the croup is more severe and the child has difficulty with breathing.
Sometimes there will be:
- a drawing in of the child’s breastbone and the muscles between the ribs
- flaring of the nostrils
- restlessness and trouble feeding and drinking
- not wanting to lie down.
Is there a test?
No special tests are necessary. (Croup is a clinical diagnosis.) Croup is diagnosed from the history given by the child's carer and by looking at and listening to the child.
How is it treated?
Most children with croup do not need treatment. You can manage the symptoms in exactly the same way as for a cold. Antibiotics are not necessary because the condition is caused by a virus, and antibiotics only treat bacteria. Some children may need a three-day course of oral prednisolone or dexamethasone (steroids) if they have more severe symptoms. This treatment can reduce their symptoms rapidly, and has no long-term consequences. A small number of children with croup will to go to hospital for observation, to ensure that the breathing tube does not become blocked.
How can I prevent it?
There is no way you can prevent children from getting croup.
What is stridor?
Stridor is a sound like the bark of a seal that a child makes when breathing in (called an ‘inspiratory’ noise). Most commonly caused by croup, stridor generally indicates some obstruction or narrowing of the windpipe (trachea).
Stridor is also occasionally caused by a condition called epiglottitis, which is due to a germ and which is serious and potentially life-threatening (and for which immunisation is now available). It may also be caused by an inhaled foreign body.
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- Last reviewed15-05-2006
