MyFOXChattanoogaWhen your child has croup

By Louis Neipris, M.D., Staff Writer, myOptumHealth

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Your daughter goes to bed with a runny nose and fever. Hours later she's crying. It's not her tears that worry you so much as the loud, barking cough coming from her room. This is croup, and you were told it's not serious unless your child has trouble breathing. But it's a tough call when your son or daughter may be in distress.

What is croup?

Croup is a viral infection of the upper airway. Children get croup most often between 3 months and 5 years old. In croup, the virus causes inflammation and swelling of the windpipe (trachea) and voicebox (larynx). The barking cough and trouble breathing are because the child's airway is much smaller than that of an adult.

Is croup contagious?

Croup is caused by a virus in the respiratory system, so it can be spread when someone coughs or sneezes. Outbreaks tend to occur in the fall, winter and early spring. Not all kids who come in contact with the virus that causes croup develop the cough, though. They, and exposed adults, often just have a cold.

What are the symptoms?

Usually croup starts with a cold. Your child goes to bed not feeling well, then wakes up with the classic harsh, barking cough that sounds like a seal. This can be scary to parents who don't know that most cases of croup are mild. The condition can get worse if a child is tired and upset. Luckily, though, the symptoms are usually gone within a week after a couple restless nights.

Other symptoms are:

• A runny nose
• Low fever (although temperature can be as high as 104 degrees F)
• Hoarse voice

A croupy cough can sometimes come on suddenly without any cold symptoms and without fever. This is called "spasmodic croup."

If croup gets worse, breathing can become difficult. In addition to a croupy cough, a child with worsening croup could start having stridor. That's a harsh, raspy, whooping sound when breathing in. Call 9-1-1 if you think your child has stridor or trouble breathing.

Treating croup at home

You can treat mild croup at home:

• Set up a steam room. Take your child into the bathroom. Close the door and run the hot water from the shower. Let the bathroom steam up. Sit with your child for 10 to 15 minutes. Repeat this treatment if croup returns.
• Take your child outdoors. If it's a cold or cool evening, bundle your child in warm clothes or a blanket and take him outdoors. The cool air often relieves the symptoms. Standing with your child in front of an open freezer may also provide some relief.
• Use a cold water vaporizer or humidifier. Place a cold-water vaporizer or humidifier in your child's room for the next two or three nights.

What medications treat croup?

If your child has trouble breathing, call 9-1-1. The doctor in the ER may need to give your child epinephrine, through an aerosol inhalation or a shot, to help him breathe. Epinephrine helps to open up the airway.

Corticosteroid drugs can also reduce airway swelling to help breathing. Corticosteroid taken as a liquid or injection for a few days will not usually cause side effects. Your child's doctor may also prescribe steroid inhaler, which may be especially helpful for spasmodic croup.

Children's or infant's acetaminophen or ibuprofen can help ease fever and discomfort.

When to call the doctor

Croup is usually not a dangerous condition and you don't always need to call the doctor at the first signs of it. But you should call the doctor if your home treatment is not helping or if your child spikes a high fever. Also call the doctor if your child has symptoms of croup and is 12 weeks old or younger.

Call 9-1-1 if your child:

• Is struggling for breath
• Makes a high-pitched sound when breathing in
• Starts drooling or has trouble swallowing
• Is very irritable, agitated, confused or listless
• Wheezes (makes whistling sound when she breaths)
• Develops blue or grayish color around the nose, mouth or fingernails

Take your child to the emergency room if he is 12 weeks old or less and has a fever of 100.4 degrees F or higher. Or if an older child has a fever of 105 degrees F or higher.

View the original When your child has croup article on myOptumHealth.com 

SOURCES:

• American Academy of Pediatrics. Parenting corner Q&A: Croup. Accessed: 06/01/2009

• Knutson D, Aring A. Viral croup. American Family Physician. 2004;69(3):535-540. Accessed: 06/01/2009

• Roosevelt GE. Croup. In: Kliegman RN, Behrman RE, Jenson HB, Stanton BF. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, PA: Saunders Elsevier; 2007.