What is that Croupy Cough?
Croup announces its aggravating presence around the office and emergency room a few times a year and I can hear it a mile away. The croupy cough is unmistakable, and it worries parents to no end.
What is croup?
Croup is a viral infection that causes the larynx (voice box) and airways to swell. This causes shortness of breath and a distinctive barky cough. The croupy cough sounds like a dog or seal barking. Some children will also have stridor, a high-pitched sound you hear on breathing in. The cough and stridor worsen when the child is upset and crying, and settles when the child calms down.
Who gets croup?
Croup usually affects kids 6 months to 3 years of age. This is because they have smaller airways and are more likely to suffer from swelling around the voice box. Some children get croup symptoms each time they have a cold. When children get croup before age 5, they are at risk of the symptoms above. When older than 5, they have laryngitis, or sore throat with a hoarse voice.
What does croup look like?
- Barky excessive coughing
- Runny nose
- Sore throat
- Difficulty breathing in
- High-pitched sound on breathing in, called stridor
- Worsening symptoms at night
When is croup at its worst?
We normally find croup most symptomatic in the middle of the night.
How long does it last?
Croup usually lasts 4-7 days. The second or third night is typically the worst.
What is the treatment?
If you hear the croupy cough or stridor, or if your child is having trouble breathing, please see a doctor. It is worth checking out how severe it is.
Many children with croup will respond well to humidified air. A great toddler cough remedy is using a humidifier in the child’s room, or taking him or her outside or into a bathroom with the shower running so they can inhale the steam.
Giving a liquid steroid called dexamethasone can help decrease the inflammation and help your child breathe more easily (and quietly). Dexamethasone takes 4-6 hours to work.
Some children will require inhaled epinephrine in hospital to settle the inflammation, though this treatment lasts only a few hours and is not a cure.
As with all viral illnesses, ensure your child is drinking enough and maintaining their hydration. Ibuprofen or acetaminophen can help control the fever. Using a nasal suction can help relieve the nasal congestion. Do not give your child over the counter cough medicines. They are not helpful and may cause further complications. I think the best cough medicine for kids OVER 1 YEAR of age is honey. It shortens the duration of viral illnesses and soothes the throat. Do not give a child younger than 1 year of age honey, as it can cause botulism.
When to see a doctor
If your child:
- Is struggling to breathe
- Has an uncontrollable cough
- Has a persistent cough for more than a week
- Has a paroxysmal cough – classically from a pertussis infection
- Isn’t drinking
- Is lethargic
- Has a blue color on the face or lips
- Has an uncontrollable fever
- Is less than 3 months of age