What you need to know about croup in babies and children

Children pick up their fair share of colds and flus in winter, but croup is also very common in children under five years old. This viral infection of the throat usually starts out as a common cold, then progresses to a distinctive, barking cough. Here’s everything you need to know about it:

What is croup?

Croup is a viral infection that causes inflammation of the throat (larynx) and the windpipe (trachea), and results in a hoarse voice, and a loud, barking cough.

Since children have small, narrow airways, a croup infection causes the lining of the airway to swell, making the airway narrower and more difficult for the child to breathe, especially at night. 

Signs and symptoms

In most cases, croup begins as a regular cold (runny nose, cough, fever, irritability), then progresses to a harsh cough, and noisy breathing, which is called stridor. 

The coughing fits can last for a few hours, and are most severe at night when the temperature drops. In most cases, croup symptoms will disappear after a few days. However in some children, symptoms may worsen and make it difficult for the child to breathe. If this happens, you need to seek urgent medical attention. 

Serious symptoms – when to seek help

See a doctor immediately if your child is not settling, and they’re exhibiting any of the following symptoms:

• High fever
• Difficulty swallowing
• Breathing very quickly, or having trouble breathing
• Won’t lie down
• Very restless, upset, or sweating
• Lips have a blueish tinge
• Making noises while breathing (especially a snoring sound on the out-breath)

In any of these instances, take your child directly to hospital for immediate medical assistance.

Treatment at home

If your child’s symptoms are very mild, you can help them at home by offering lots of fluids and administering an age-appropriate dose of paracetamol (as directed by your doctor). Children do tend to get a bit frightened by the loud and uncomfortable croup cough, so lots of comforting also helps.

Treatment at the doctor

For croup symptoms that don’t settle quickly, you may need to seek medical treatment. Since croup is caused by a virus, antibiotics will not work. Instead, doctors may administer oral or inhaled steroids. For severe symptoms, nebulised adrenalin is administered in hospital to relieve the swelling in the windpipe. 

Prevention

Unfortunately, it’s not possible to prevent croup. There are many viruses that can cause croup, and they are very similar to the common cold. Once contracted, children are usually infectious for up to five days from the first signs of infection. 

While there are no immunisation options available specifically for croup, immunisation against influenza is recommended for children who are aged six months and older. 

Important things to remember

• Croup is a viral infection. It can cause noisy breathing and barking cough. 
• It normally starts as a regular cold, then develops into an uncomfortable cough, which is particularly bad at night.
• While you can treat mild croup symptoms at home, be on the look out for any of the severe symptoms listed above.
• If you’re concerned, call your doctor, dial 000, or visit the emergency department of your closest hospital.