DESCRIPTIONCroup is infection, inflammation, and swelling of the larynx (vocal cords) and surrounding tissue including the throat and bronchial tubes (windpipe). Croup may occur in older children but is most common in children under age 6. It may require emergency care if the windpipe is blocked. This blockage causes labored
breathing and a characteristic "barking" noise with each inhalation or cough.
SIGNS & SYMPTOMSFever (sometimes).
Barking cough and difficult breathing, especially at night.
Chest or throat discomfort or pain.
Contagious viral or bacterial infection.
PREVENTING COMPLICATIONS OR RECURRENCE
To prevent recurrent attacks, run the humidifier at the child's bedside for several nights after the first attack.
If croup is a recurring problem in your family, consider adding a humidifier to your home's heating and air-conditioning system.
Your own observation of symptoms.
Medical history and physical exam by a doctor.
X-rays of the chest.
POSSIBLE COMPLICATIONSAirway obstruction and death (rare).
Croup can be frightening, because attacks usually happen at night and the child has trouble breathing. In most cases, croup is not serious, and symptoms can be relieved. If attacks happen during the day and are accompanied by fever, the illness is more serious.
Stay calm. Anxiety increases the child's breathing difficulty.
Take the child into the bathroom and close the door.
Turn on the hot water full force in the sink and shower to saturate the air with moisture. Open the windows to let in cold air.
Allow 10 minutes for the steam and cold air to relieve symptoms. If severe symptoms don't improve in 10 minutes, take the child to the nearest emergency room.
Stay in the steamed bathroom until you are ready to leave. Don't be afraid to take the child out in the cold night air--it may lessen breathing difficulty.
If breathing improves in 10 minutes, take the child with you while you call the doctor or wait for a return call. While waiting, use a cool-mist humidifier in the room.
Keep the child comfortable in a semiseated position. Use TV, radio, or a story to distract the child so he can relax.
If breathing worsens again, return to the steam-filled bathroom.
Run the humidifier by the child's bed for several nights after an attack--even if the child appears well. Simple croup often recurs.
MEDICATIONIf croup is caused by a bacterial infection, your doctor may prescribe antibiotics. However, most cases are viral, so antibiotics are ineffective.
See Medications section for information regarding medicines your doctor may prescribe.
Decrease the child's activity and encourage rest as long as croup attacks are occurring. Don't allow the child to play outside in cool night air -- this may trigger attacks (although cool air can help relieve symptoms during an attack).
DIET & FLUIDS
Croup usually depresses appetite. Offer frequent small amounts of fluid, such as water, ginger ale, tea, juice, or cola -- not milk. Coughing may cause vomiting, so don't give the child solids during an attack.
OK TO GO TO SCHOOL?When fever disappears, appetite and activity at home return to normal. Approximately 1 week.
CALL YOUR DOCTOR IF
Your child is having trouble breathing and cannot swallow saliva or water. This is an emergency! Call and ask your doctor to meet you at the nearest emergency room.
Breathing rate increases to 80 breaths a minute.
Breathing is labored, and retraction (the drawing in of neck and chest with each inhalation) is pronounced.
Nails or lips become dark or blue.
Mild croup symptoms don't improve with 30 to 60 minutes of cool-mist treatment.