Child coughing? Be alert for croup

One of the scariest events for new parents is when their baby has croup. Although it’s a common childhood illness, the sight of a baby or toddler gasping for breath is alarming. Call your doctor right away if your baby's breathing sounds labored.

Exactly what is croup?

Croup is an inflammation of the larynx (voice box) and the windpipe. The airway becomes narrow, and breathing is noisy and difficult. Children between the ages of 6 months and 3 years are most likely to get croup. After age 3 the windpipe is bigger, so swelling doesn't inhibit breathing so much. Croup is more common between October and March.

There are two kinds of croup

Spasmodic croup comes on in the middle of the night as the result of an upper respiratory infection. You may put your baby to bed with the sniffles and find him gasping for air a few hours later. His voice will be hoarse and he will have a cough that sounds like a seal barking. This kind of croup doesn't come with a fever.

Viral croup comes from a viral infection. It starts with a cold and slowly turns into a barking cough. The airway swells, fluids are secreted and breathing becomes labored and noisy. There is a condition called stridor in which breathing makes a coarse musical sound. Stridor is common with mild croup, but if a child has it while resting it can signal a severe case of croup. This kind of croup is commonly accompanied by a low-grade fever.

Home care for croup

Moist air is the emergency form of treatment until you can reach the doctor. Take your child into the bathroom and run the shower at the hottest setting so the room steams up. Within 15 to 20 minutes breathing should improve, although the barking cough will remain.

After the moist warm air treatment and for several nights following, use a cold-water vaporizer or humidifier in the room.

Keep the child upright and offer plenty of fluids.

Never probe a baby or young child's airway with your fingers. You can't clear it because the swollen tissue can't be reached. Doing this can make breathing even harder.

You will need to stay awake as long as there are any symptoms of croup to be sure your child is breathing well.

When is croup an emergency?

Call for emergency medical help (911) if your child:

Makes a whistling sound that gets louder with breathing.

Cannot speak because he doesn't have breath.

Has a bluish mouth or tinge to fingernails.

Has symptoms of stridor at rest.

Has difficulty swallowing saliva.

Hospitals treat croup by putting the baby in a "croup tent" to receive oxygen. Severe croup may require intravenous food and medication. Fortunately, severe croup doesn't occur very often.

Date last reviewed: October 2002.

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