Croup: coughs that go bark in the night

Croup: coughs that go bark in the night

By Benjamin M. Starnes, MD, FAAP
Pediatric Physician

Croup is a common childhood illness that can be very frightening to a parent or child. It often starts with the symptoms of a mild cold, such as a runny nose, or sore throat. The child goes to bed as usual and then wakes suddenly in the middle of the night with a barking cough. Often they gasp in between the coughs and make a high-pitched noise called stridor when they breathe in.

Thankfully, croup is rarely dangerous. Most children can be treated at home. But it can be a scary illness for both the parent and the child.

It is important to know how to treat croup at home and when to seek help from your doctor or the emergency room.

What is croup?

Croup is a viral infection of the vocal cords. It typically occurs between the ages of 6 months and 3 years. Many different types of viruses can cause croup including most of the common cold viruses. The infection causes the vocal cords to become inflamed and it is this inflammation that causes the main symptoms: hoarseness, throat pain, and a tight, low-pitched barking cough.

How is croup treated?

Immediate treatment for a sudden appearance of a croupy cough includes the following:

  • Stay calm. If a child is upset and agitated, it will be harder for them to breath. Snuggle with them. Tell them it will be okay.
  • Warm mist from a steamy bathroom. Take the child into a steamy bathroom for about 15 minutes. The warm, moist air helps relax the inflamed vocal cords.
  • After spending 10 to 15 minutes in a steamy bathroom, wrap your child in a blanket and go outside. This works very well in Seattle, as our nights tend to be cool. The colder the air, the better the relief. If it isn’t cold outside or it’s not possible to go out, have your child stand in front of the open refrigerator for about 10 minutes.
  • If your child doesn’t settle down quickly (within 20 minutes) after the above treatments, of if they continue to have noisy breathing, call your doctor.
  • If your child is in extreme distress, severely agitated or listless, has blue lips, or passes out, call 911.

Croup tends to last about 5 to 6 days. You can help improve the nights by treating croup during the day as well:

  • Run a humidifier. Keep it near the child throughout the day. Cool mist and warm mist are both effective at increasing the humidity of a room.
  • Offer ibuprofen or acetaminophen for sore throats or fevers as needed.
  • For coughing during the day, offer warm fluids to drink.
  • Cough medicines will not help croup. Instead offer honey for children over 1 year of age.
  • Sleep in the same room with your child until they are feeling better. This will have a calming effect and will make the croupy episodes less scary.

Follow up with your doctor for any of the following:

  • Fever with croup for longer than 3 days
  • Noisy breathing that doesn’t improve with humidifiers
  • Croup lasting longer than a week
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