Children and Croup
What is croup?
What are the symptoms of croup?
When should croup be treated at home?
When should croup be treated at the doctor's office or hospital?
National Jewish and croup
What is croup?
Croup is a viral infection that usually affects children between the ages of three months to six years. It is more common in boys than girls. Croup often follows a cold, although croup may begin without cold symptoms. This illness is most often seen in the fall and winter. Croup may reoccur during childhood, but attacks tend to disappear as the child grows.
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Common symptoms of croup include:
- Barking cough
- Hoarse voice
- Stridor (a harsh sound from the windpipe while breathing in)
These symptoms are caused by swelling in the throat and windpipe (trachea). Symptoms are worse in the evening and at night. Croup may last from several days to a week.
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In most cases, croup can be treated at home. Treatment with cool mist may help symptoms. Cool mist therapy may be delivered by placing a vaporizer or humidifier in the child’s bedroom. If you use a vaporizer or humidifier remember to clean it following the manufacturer's instructions. Another option may be to run the shower or tub water in the bathroom with the door closed for fifteen minutes or so. Then sit in the bathroom with your child. These techniques create an environment high in humidity to help symptoms.
In addition to cool mist therapy, the child should receive adequate rest and drink plenty of fluids. Because crying can increase croup symptoms, care should be taken to comfort and soothe the child.
Finally, it is very important to closely monitor the child with croup. Talk with your doctor if your child has symptoms of croup to see if your child should be seen. Parents should be aware of symptoms of worsening croup.
Symptoms of worsening croup may include:
- Increased stridor
- Skin pulling in below the neck or between the ribs while breathing in (retractions)
- Trouble talking
- Blueness around the lips or nail beds (cyanosis)
- Drooling
- High fever
- Having trouble breathing in general
If these symptoms are seen it is important to seek medical care right away.
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Children should be treated at the doctor’s office or hospital in more severe cases of croup (see "Symptoms of worsening croup" above). The doctor’s office or hospital can offer medicine, monitoring, and a special vaccine against very severe forms of croup.
What about medicines for croup?
There are a number of medicines that may be used when a child is seen in the doctor’s office or hospital. They include:
- Corticosteroids
Corticosteroids can decrease swelling in the throat and windpipe to improve symptoms of croup. Corticosteroids may be given as a pill, liquid or as a shot. They may also be given as an inhaled treatment.
- Racemic epinephrine
Racemic epinephrine can also decrease swelling briefly. Racemic epinephrine is given in an inhaled treatment.
- Antibiotics
(only when concerned about bacterial infections) Antibiotics may not be used, because croup is often a viral infection. If your doctor is concerned about a bacterial cause, antibiotics may be prescribed.
What about monitoring of croup?
In addition to medicines, your child can be monitored closely in the doctor's office or the hospital. Doctors and nurses can ensure the child is breathing well and receiving enough oxygen and fluids. This is important in more severe cases of croup.
What about a protective vaccine against severe forms of croup?
The HIB vaccine is given routinely. This vaccine is helpful in preventing a number of illnesses. One illness is epiglottis, which is a severe, often lethal form of croup.
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National Jewish is a recognized leader in the care and treatment of children with respiratory illnesses. The doctors and nurses at National Jewish realize that croup can be frightening for the entire family and have different levels of care that can help you manage this illness. Nurses at LUNG LINE® can answer your questions about croup and other respiratory illnesses.
Click here for more information about our Department of Pediatrics.
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This information has been approved by Carl White, MD (January 2005).
