If you are a parent, chances are you've been rousted out of bed at least once by the barking cough of croup. Croup is a catch-all term for childhood inflammation and swelling of the area of the throat that includes the vocal chords. The swelling blocks airflow through the windpipe (trachea) and triggers coughing that sounds a lot like a seal (or for those who live in the California Bay Area, a sea lion).
Usually, one of several viruses cause croup. Not all kids who catch these viruses will get croup; some kids will simply have cold symptoms. About 2 out of every 100 kids get croup each year. Bacteria can cause croup also, but it's much less common.
Does My Kid Need to See the Doctor?
Sometimes (see below), but probably not. Croup is usually mild and will go away on its own in most cases. Since it's probably caused by a virus, antibiotics won't help.
When to Go to the Doctor
If croup is uncomfortable enough, kids will benefit from seeing a doctor. The doctor may be able to prescribe steroids or inhaled epinephrine to help with the swelling. Sometimes, croup can lead to a dangerously swollen throat and windpipe. In those cases, call 911 or go straight to the emergency department. Take your child to the doctor or call 911 if she has any of the following:
- Shortness of breath
- Stridor (loud raspy breathing that sounds like a cross between Darth Vader and Jason from the Halloween movies)
- Is abnormally tired
- Changing colors (getting pale, purple or blue)
- Fever over 102 F
If you're worried about your child and aren't sure whether he should go to the doctor -- go ahead and take him. Trust your instincts. When it comes to our kids, our guts are usually right. No research supports that advice, except for a case study in raising five kids that I'll probably never finish.
Lastly, croup isn't the only thing that causes the barking coughs. Croup-like coughing and stridor can also come from stuff stuck in your child's airway as well as severe allergic reactions. Coins, erasers, marbles, Legos and other little objects have been found in the airways of otherwise healthy kids who show up to the emergency department barking away.
If your child suddenly develops stridor or a barking cough but hasn't shown any other signs of being sick, it's time to go to the doctor. If a barking kid starts scratching or complaining of itching -- or if redness or hives appear -- call 911 immediately.
Home Remedies for Croup
You can't do much for the barking cough of croup. Many healthcare providers suggest moist or humid air -- breathing steamy air from a hot shower, for example. But no evidence shows that moist air helps at all. Skip the shower and the humidifier for fixing croup.
One theory holds that it isn't the moist air which helps kids with croup, rather the soothing presence of mom or dad. When a parent sits in a steamy bathroom holding a poor, barking child close and comforting, the croup goes away. Try skipping the shower and just hold Junior the next time he starts barking; he might feel better.
Cough syrup probably won't help and cough medicine for kids is not recommended.
Honey has shown some success in suppressing nighttime coughing. The study wasn't actually aimed at croup, but honey -- in kids older than a year -- isn't going to hurt them and might help the cough. Besides, it's the best-tasting medicine they'll ever get.
Time is the only surefire home remedy for croup. As long as kids aren't worsening, they will eventually get better. If your child has that barking cough for more than 3 days, it's time to see if the doctor can help.
Bjornson, Candice and David Johnson. "Croup in the paediatric emergency department." Paediatr Child Health. July 2007.
Fitzgerald, D.A. and H.A. Kilham. "Croup: assessment and evidence-based management." Med J Aust. Oct 6 200.