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What is croup? — "Croup" is the term doctors use for a group of infections that affect the trachea, the main airway through which we breathe (figure 1). Croup is common in children between 6 months and 3 years of age. It is uncommon after the age of 6 years. Croup causes a barking cough. In most children, croup goes away on its own. But some children with croup need to be seen by a doctor or nurse.
What are the symptoms of croup? — Croup usually begins like a regular cold. Children who get croup start off by getting a runny nose and feeling stuffed up. A day or 2 later, they usually:
●Get a cough that sounds like a seal barking
●Become hoarse (lose their voice or get a scratchy voice)
●Get a fever (temperature greater than 100.4ºF or 38ºC)
●Start having noisy, high-pitched breathing (called "stridor"), especially when they are active or upset
The symptoms are usually worse at night.
Should I take my child to see a doctor or nurse? — Many children with croup do not need to see a doctor. But you should watch for some important symptoms.
Call for an ambulance (in the US and Canada, dial 9-1-1) if the child:
●Starts to turn blue or very pale
●Has a very hard time breathing
●Can't speak or cry because they can't get enough air
●Is very upset
●Seems very sleepy or does not seem to respond to you
Call your child's doctor or nurse if you have any questions or concerns about your child, or if:
●Their cough won't go away
●They start to drool or can't swallow
●They make a noisy, high-pitched sound when breathing, even while just sitting or resting
●The skin and muscles between their ribs or below their ribcage look like they are caving in (figure 2)
●They are younger than 3 months and have a fever (temperature greater than 100.4ºF or 38ºC)
●They are older than 3 months have a fever (temperature greater than 100.4ºF or 38ºC) for more than 3 days
●The symptoms of croup last for more than 7 days
How is croup treated? — The main treatments for croup are aimed at making sure the child is getting enough oxygen. To do that, the doctor or nurse might give:
●Moist air or oxygen to breathe
●Medicines to reduce swelling or open up the airways
The doctor will probably not offer antibiotics, because croup is caused by viruses, and antibiotics do not work on viruses.
Is there anything I can do on my own to help my child feel better? — Yes. You can:
●Sit in the bathroom with the child while the hot water is running in the shower, creating steam. You can also use a humidifier in the room where the child sleeps.
●Have the child breathe outdoor air, if it is cold out. You can do this by opening a window for a few minutes. Wrap the child in a blanket to keep them warm.
●Treat fever with over-the-counter medicines, such as acetaminophen (sample brand name: Tylenol) or ibuprofen (sample brand names: Advil, Motrin). Never give aspirin to a child younger than 18 years old.
●Make sure the child gets enough fluids. If they are older than 1 year, feed them warm, clear liquids to soothe the throat.
●Sleep in the same room as the child, so that you know right away if they start having trouble breathing.
●Keep the child away from people who are smoking. Do not allow anyone to smoke in your home.
How did my child get croup? — Croup is caused by viruses that spread easily from person to person. These viruses live in the droplets that go into the air when a sick person coughs or sneezes.
Can croup be prevented? — To lower the risk of croup, you can:
●Wash your hands and the child's hands often with soap and water, or use alcohol hand rubs.
●Stay away from other adults and children who are sick.
●Make sure the child gets all the recommended vaccines, including the flu shot. Get a flu shot for yourself, too.
Patient education: Cough, runny nose, and the common cold (The Basics)
Patient education: Fever in children (The Basics)
Patient education: Flu (The Basics)
Patient education: What you should know about vaccines (The Basics)
Patient education: Sore throat in adults (The Basics)
Patient education: Cough in children (The Basics)
Patient education: Croup in infants and children (Beyond the Basics)