Croup in children: What you need to know

Croup cough in children: all you need to know

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Any parent who has been woken up in the middle of the night to the sound of their child coughing so bad it sounds like a barking seal will know just how terrifying an ordeal it is. It’s heartbreaking to see our tiny babes so sick and as the chilly winter months press on, croup is, unfortunately, a very common illness. 

Hearing a barking cough in kids can often cause us to panic, but the good news is that most cases of croup cough usually get better in a few days. To help parents understand how best to deal with croup cough, we spoke to Sarah Hunstead from CPR Kids about the signs and symptoms of croup, how best to treat it, and when you should be concerned about it. 

What is croup? 

Croup is a condition caused by a viral infection. The virus leads to swelling of the voice box (larynx) and windpipe (trachea). This swelling makes the airway narrower, so it is harder to breathe. 

Croup is more common in winter and mostly affects children between six months and five years old, but it can affect older children as well. 

Signs and symptoms of croup:

  • Croup usually begins like a normal cold e.g. fever, runny nose, and cough.
  • Your child’s cough will change to become harsh and ‘barking’. Many parents say it sounds like a dog or seal barking. 
  • Your child’s voice may be hoarse.
  •  When your child breathes in, they may make a squeaky, high-pitched noise, which is called stridor.

In severe cases of croup, you may notice sucking in around the tummy and/or between your child’s ribs, or at the base of your child’s neck (in between the collar bones). They may struggle to breathe. The symptoms are often worse at night. 

The signs and symptoms of croup may last for three to four days. However, the cough may linger for up to three weeks. The stridor should not linger.

If you believe your child has croup or you are concerned about their symptoms for any reason, seek medical advice. 

When should I be concerned about croup cough? 

Call 000 immediately if your child:

  • Is breathing very quickly
  • Is struggling to breathe
  • Is difficult to rouse
  • Has a colour change e.g. turning blue

Note that vaporisers and steam treatments are no longer recommended to help relieve symptoms of croup, as they have not been shown to help croup symptoms.

Croup treatment

In most cases, children usually get better around three to four days without any treatment. Your doctor may prescribe liquid steroid medicine (prednisolone or dexamethasone) that can help your little one get better in a few hours. The steroids help reduce the swelling of the airways and will help them breathe easier. 

Children who are very unwell with croup and have laboured breathing should be taken to the hospital, where they may be administered medicine through a mask.

Which is the best way to care for a child with croup?

Try to keep your little one as calm as possible to avoid coughing fits, and offer pain relief such as paracetamol or ibuprofen​​ if they are uncomfortable with a fever (always follow the dosing instructions on the bottle). 

Lots of cuddles on the couch, rest time, and movies are also exactly what the doctor ordered. You can also sleep next to them at night so they don’t get distressed if a coughing fit strikes. 

What can I do to prevent croup in my child?

Encourage good hygiene at all times (frequent hand-washing, coughing/sneezing into their elbow) and keep your child away from anyone who is sick. 

Croup in children can indeed be scary — but remember that more often than not, they’ll be back to their normal, happy selves in a few days. But it’s also totally OK to seek medical advice if you’re worried, too. Never hesitate to call triple zero or go to the emergency room if you’re concerned about your child’s breathing. 

References: 
Information via Children’s Health Queensland Hospital and Health Services
Sydney Children’s Hospital fact sheet on croup
Royal Children’s Hospital Melbourne fact sheet on croup

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