An Overview of Croup

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 cords.

This swelling blocks airflow through the windpipe (trachea) and triggers coughing that sounds a lot like a seal. Sometimes it might make sense to take your child to a healthcare provider, but probably not. In most cases, croup is usually mild and will go away on its own.

This article describes the symptoms of croup and its causes. It explains how croup is diagnosed and treated and when to get medical care.

Symptoms of Croup

There are only two symptoms of croup:

Croup may start out as a mild cold with a low-grade fever for several days before a barking cough develops. A barking cough can be accompanied by a hoarse voice.

Usually, the cough is worse at night. It can last for five to six nights, and the first nights are usually the worst.

Stridor is a high-pitched sound that goes with breathing. It comes from swelling in the upper airway near the vocal cords. In severe cases with very pronounced stridor (which is very rare), a person can exhibit shortness of breath.

Causes of Croup

In the United States, approximately 3% of children are affected by croup each year. It is most common in children between the ages of 6 months and 3 years.

One of several viruses usually causes croup, but 75% of all cases are caused by parainfluenza virus. However, not all kids who catch these viruses will get croup; some will simply have cold symptoms.

Additionally, bacteria can cause croup, but it's much less common. And since croup is most likely caused by a virus, antibiotics won't help. It will just need to run its course.

How Croup Is Diagnosed

Croup is diagnosed by a healthcare provider doing a thorough history and physical exam. There is no test for croup. Instead, the provider might do other tests to see if the child's symptoms could be related to some other respiratory condition. It's called a diagnosis of exclusion because croup is what is left over when all other causes for a barking cough have been ruled out.

What Is the Best Treatment for Croup?

There are, however, a couple of home remedies that you can try to help alleviate your child's symptoms. Be aware, though, that most of them don't have a lot of scientific evidence to support their use.

Breathe in Humid Air

Many healthcare providers suggest exposing your child to moist or humid air, like breathing steamy air from a hot shower or opening the windows on a cool night. But no evidence shows that moist air actually helps. (If using the shower is too awkward or difficult, try a humidifier.)

Drink Plenty of Fluids

Healthcare providers also frequently advise patients with any form of viral infection to drink fluids. Staying hydrated may help the body fight infection. However, research has found little evidence to support this advice, and some non‐experimental (observational) studies actually suggest that increasing fluid intake may cause harm.

Give Your Child Tylenol

You can help make your child more comfortable by giving your child Tylenol (acetaminophen). Tylenol can also help lower fever, which will help your child breathe more easily.

When to See a Healthcare Provider

Anytime a child develops stridor they should see a healthcare provider. In many cases of mild croup, children can be safely treated at home with supportive care. As long as kids aren't worsening, they will eventually get better.

Talk to a healthcare provider if your child has a barking cough for more than a week or the cough comes back often. If the child is severely uncomfortable, the healthcare provider may be able to prescribe steroids or inhaled epinephrine to help with the swelling.

Summary

Croup is an extremely common condition. It's primary symptom is a cough that sounds like a barking seal. A good majority of the time, croup is the result of a viral infection, but could also be due to a bacterial infection.

In most cases, croup will go away on its own. Treatment for croup usually involves home remedies, but prescription medication may be needed for severe cases.

If a cough lasts longer than a week or keeps coming back, get in to see a healthcare provider who can run tests and provide treatment as necessary.