Topic Overview

What is croup?

Croup is a common respiratory problem in young children. It tends to occur in the fall and winter. Its main symptom is a harsh, barking cough. Croup causes swelling and narrowing in the voice box, windpipe, and breathing tubes that lead to the lungs. This can make it hard for your child to breathe.

An attack of croup can be scary, but it is rarely serious. Children usually get better in several days with rest and care at home.

What causes croup?

Croup usually occurs a few days after the start of a cold and is usually caused by the same viruses that cause the common cold. Croup is contagious. The germs that cause it can be passed from one person to another through coughing and sneezing and through close contact. Regular hand-washing and limiting contact with others can help prevent spreading croup to others.

As children grow older and their lungs and windpipes mature, they are less likely to get croup. Getting a flu shot each year may help your child fight off some of the viruses that can lead to croup.

What are the symptoms?

Symptoms of croup are caused by narrowed airways. They include a barking cough; a raspy, hoarse voice; and a harsh, crowing noise when breathing in. The cough is very distinctive, so you'll know it when you hear it. It is often compared to the sound of a barking seal. Sometimes children breathe fast and need to sit up to breathe better.

Symptoms of croup often improve during the day and get worse at night. Sometimes children have croup attacks that wake them up in the middle of the night for a couple of nights in a row, but the illness usually improves gradually in 2 to 5 days.

How is croup diagnosed?

Your doctor will probably be able to tell whether your child has croup by examining him or her and asking about symptoms. Sometimes doctors can identify the distinctive barking cough of croup over the phone.

Because croup can make breathing harder, your doctor may place a small clip called a pulse oximeter on your child's finger, toe, or earlobe to check if enough oxygen is reaching the blood.

How is it treated?

Even though your child's coughing and troubled breathing can be frightening, home treatment usually eases the symptoms.

• Try to stay calm during an attack, and soothe your child. Crying can make the swelling in the windpipe worse and make it even harder to breathe.
• Breathing in moist air seems to help during a croup attack. Fill your bathroom with steam from the hot water faucets, and sit in the room with your child for 10 minutes. Or hold your child directly over a humidifier, and let the vapor blow directly in his or her face.
• Breathing cool night air also seems to help sometimes. Dress your child in warm clothes, and go outside for 10 minutes.
• If symptoms improve with these methods, put your child back in bed with the humidifier blowing nearby. Do not smoke, especially in the house. If the symptoms happen during the middle of the night, it is a good idea to sleep in or near your child's room until morning.
• Be sure to keep your child well hydrated. Offer water, flavored ice treats (such as Popsicles), or crushed ice drinks several times each hour.

If your child’s symptoms don't get better after 30 minutes, call or see your doctor. If the attack is in the middle of the night and you are very worried, consider taking your child to the emergency room.

If your child has severe difficulty breathing, call 911 or other emergency services immediately.

If your child has severe croup or has not responded to home treatment, medicines may be used to decrease airway swelling. These are usually given in a doctor's office or an emergency room. In rare cases, a child needs to stay in the hospital for treatment.

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