Croup

Caring for a child with a loud, “seal-like” bark of a cough can be unsettling, especially when the cough is accompanied by difficulty breathing. In this article, we’ll walk you through how to recognise and manage this condition, known as croup, and what you should do when it becomes serious.

If your child begins to show worrying croup symptoms or you’re unsure whether your child needs urgent care, contact us at Pediatric Associates of Austin. We’re here when your little one needs reassurance and care.

What is Croup?

Croup is an infection of the upper airway that leads to swelling in that region. It affects the voice box (larynx), windpipe (trachea), and often the bronchi. The swelling causes the classic “barking” cough and noisy breathing (stridor) when your child breathes in.

While most children recover with simple home care, episodes of moderate croup or severe croup may require medical intervention.

Is Croup Contagious?

Yes, croup is contagious because it is usually caused by viruses that spread easily from person to person.

The viruses responsible for croup can be passed through coughs, sneezes, or touching surfaces contaminated with the virus. Keeping your child away from others while ill and practicing good hygiene helps reduce the spread.

What Causes Croup?

Croup is most often caused by a viral infection that leads to swelling in the upper airway. Common culprits include:

• Parainfluenza virus (most frequent)
• Respiratory syncytial virus (RSV)
• Influenza virus, adenovirus, enterovirus
• In rare cases, a bacterial infection may complicate things and lead to a more severe scenario.

Who is at Risk of Getting Croup?

Most children at risk are young, typically between 6 months and 5 years of age. Children at this age have a narrower upper airway, so swelling makes more of a difference in breathing.

It can happen in any season but tends to peak in fall and winter.

Symptoms of Croup

Your child may have the following symptoms with croup:

Mild Croup Symptoms

When your child has mild croup, you might notice:

• A “croupy cough”, referring to a loud, barking cough that resembles a seal.
• A hoarse voice or scratchy cry.
• Runny or stuffy nose and low-grade fever before coughing.
• The symptoms are usually worse at night.

Moderate to Severe Symptoms

If the coup progresses, your child may develop the following symptoms:

• Stridor (a high-pitched “whistle” when breathing in), especially when upset or crying.
• The skin may pull in around the ribs or sternum as the child works to breathe.
• In severe croup, the child may have significant difficulty breathing, blue or grey lips or face, and more severe symptoms of airway obstruction.

How long does croup last?

Most children get better within 2 to 5 days, although sometimes symptoms linger up to a week.

When to Call Your Child’s Provider

You should contact your child’s provider if you notice:

• A persistent barking cough that isn’t improving.
• Your child’s breathing is laboured or fast, or you hear stridor at rest (not just when upset).
• Blue or grey tinge around the lips or face.
• The child is very distressed, tired, drooling, or unable to swallow.
• The symptoms last more than a week or get worse instead of better.

If you observe signs of severe croup, such as trouble breathing or a child’s ribs visibly sucking in with each breath, go to the emergency room immediately.

How is Croup Diagnosed?

Diagnosis is primarily based on clinical evaluation. Your child’s characteristic barking cough, hoarse voice, stridor, and the pattern of symptoms indicate croup.

Providers may rule out other serious conditions of upper airway blockage (such as foreign body, epiglottitis), but in most cases, no special tests are needed.

How is Croup Treated?

Most cases of Coup can be treated at home. If symptoms make it difficult for your child to breathe, further medication may be needed.

Treatment at Home for Mild Croup

• Keep the child calm, as crying and upset can make airway swelling worse.
• Use a cool-mist humidifier or sit together in a bathroom with steam for moist air, or step outside for cool air.
• Offer clear fluids to maintain hydration.
• Elevate the child’s head slightly if they are over 12 months old.
• Avoid cough medicines for young children unless advised by a provider.

Moderate to Severe Croup Treatment

If symptoms worsen, then your provider may give your child the following medications:

• A dose of corticosteroids (such as dexamethasone) to reduce airway swelling. It will start helping in a few hours.
• Children with breathing difficulties or more severe symptoms may need an inhaled Racemic epinephrine (nebulized epinephrine) to rapidly reduce swelling.
• In very severe cases, hospitalization, oxygen support, or even airway management may be needed.

Throughout any scenario, it’s important to remain calm (so the child stays calm), monitor the child’s breathing, and respond promptly if things worsen.

Preventing Croup

While you can’t guarantee prevention, you can lower the risk via:

• Good hand hygiene and avoiding close contact with sick children.
• Keeping immunizations up-to-date (influenza, etc) reduces viral infections.
• Avoiding smoke exposure and keeping your child’s immune system supported.
• Keeping toys and surfaces clean to reduce viral spread.

Caring Support for Croup in Austin, Texas

If you’re concerned your child may be developing croup, don’t wait until the situation worsens. At Pediatric Associates of Austin, we’re available to assess your child’s symptoms and guide you on whether home care is sufficient or if urgent intervention is needed. 

When it comes to breathing treatment and airway swelling, timely care matters. Contact our office in Austin, Texas, today so your child can breathe easier sooner.