What Is Croup?

“Croup is a common childhood illness,” said Nancy Lynn Uythoven, MD, Catholic Health Pediatrician. “Although most cases of croup are mild, it can still be scary for children and parents. Knowing the symptoms and when to seek care can help prevent croup from worsening.”

What is croup?

Croup is caused by a viral respiratory infection that affects babies and young children. This infection causes swelling of the voice box and windpipe, which narrows the airways, making it hard for a child to breathe. A distinctive barking cough sets croup apart from other respiratory infections. Children with croup may also experience stridor, which causes a high-pitched, whistling sound when they inhale.

What causes croup?

Viral infection is the most common cause of croup, although bacteria can sometimes cause it. Viruses that can cause croup include:

• Adenovirus
• Enteroviruses
• Influenza virus (flu)
• Respiratory syncytial virus (RSV)
• Parainfluenza virus

“The viruses that cause croup are contagious and spread through direct contact with someone with the disease,” said Dr. Uythoven.

She explained that children with croup can be contagious for up to three days prior to symptoms appearing, for the duration of the illness.

Who is at risk for croup?

Croup is most common in children three months to five years old. It is not as common in older children because their windpipes get larger, and swelling is less likely to affect their breathing.

Adults rarely get croup since their airways are larger. If adults get croup, their symptoms may be more severe and need medical attention.

Most cases of croup occur during the fall and winter months, and it is possible to get croup more than once.

What are the symptoms of croup?

A barking cough and stridor are the most common symptoms of croup. Other symptoms include:

• Fever
• Rash
• Runny or stuffy nose
• Scratchy voice
• Swollen lymph nodes

Croup symptoms are usually worse at night. The symptoms may seem better in the morning but worsen as the day progresses. Most cases are mild and get better within three to five days.

Severe cases of croup are rare but may cause:

• Difficulty breathing
• Drooling or trouble swallowing
• Pale, blue-tinged skin
• Retractions (sucking in of the skin around the ribs and the top of the breastbone)
• Severe coughing episodes

How is croup diagnosed?

“You can typically tell if your child has croup based on their symptoms,” said Dr. Uythoven. “Call your pediatrician, who can review the symptoms and confirm a diagnosis with a physical exam, including listening to your child’s breathing.”

Your pediatrician may order additional exams to rule out other causes of your child’s symptoms.

How is croup treated?

Treatment for croup depends on the severity of the condition.

“Croup usually goes away on its own without needing treatment,” said Dr. Uythoven. “Before beginning home treatments, speak to your pediatrician first to confirm a diagnosis. Severe cases of croup can be life-threatening, so it is important to monitor symptoms.”

Home remedies include:

• Keep your child hydrated
• Take your child outside into cool night air or open a window to let the cool air in
• Treat a fever with over-the-counter medication such as acetaminophen or ibuprofen
• Use a cool-mist humidifier to soothe dry airways

Take your child to the nearest emergency room if they show symptoms of a severe illness. Treatment for severe croup may include:

• Breathing tube
• Humidified air
• IV fluids
• Medication such as steroids or breathing treatments

“If your child has croup, try to keep them calm and comfortable,” said Dr. Uythoven. “Crying can make it harder for them to breathe.”

She also noted that you should avoid giving your child milk and thick liquids, which can thicken phlegm and make your child cough more.

When should I seek medical attention for croup?

Call your pediatrician if your child is not responding to home treatment or if they become more irritable.

Seek emergency care if:

• Your child’s breathing does not improve or gets worse
• Your child begins drooling
• Your child has trouble swallowing
• Your child becomes restless and cannot sleep

“Croup can be easily treated and managed, but talk to your pediatrician to ensure proper diagnosis and treatment,” said Dr. Uythoven.