Croup is an infection that causes swelling of the larynx and the trachea that in turn makes the airway just beneath the vocal cords become swollen and narrow. When there is both swelling and narrowing of the airway breathing becomes more difficult and the noisy sound that is made with each breath almost like a barking seal is described as being croupy.
Croup is quite common in young children and the sound can be both scary and to concerning to both parent and child.
Children between the ages of 6 months and 3-4 years are most likely to get croup. As a child gets older the airway is larger so the symptoms may not be as severe. When adults get this same virus it often causes laryngitis rather than croup.
Most cases of croup are caused by a common virus so croup is not treated with antibiotics. The best treatment for croup is symptomatic and taking your child into the bathroom to sit in the steam while the hot shower is running may be all that is needed. I would awaken to the sound of a croupy cough, walk right to the bathroom and turn the shower on hot and close the door, grab the child and a few books and head back to sit in the steamy bathroom while calming the barking child. After a few minutes in the hot steam the cough should calm down and the child should appear less anxious and more comfortable. If the steamy bathroom does not seem to be working try taking your child out into the cold night air. This often seems to help open the airway and relieve some of the cough.
You always want to be watching your child for signs of respiratory distress. Your child may cough so hard they turn red, but they should never turn blue. Red is good and means they are oxygenating, blue is bad. Look to make sure they are not using their chest muscles or abs to breath, which is called retracting. Watch for nasal flaring or grunting with each breath. If your child is having any respiratory distress call 911 for emergency help.
For children who have mild distress or continuous coughing an oral steroid may be prescribed. Children who are having respiratory distress or problems with oxygenating will require hospital admission for management.
For some reason children with croup always seem to be worse at night. If your child has sounded croupy make sure you put them to bed with a cool mist humidifier in their room which will provide some moisture to their airway and may lessen their cough.
Remember to look at your child's chest and how they are breathing and watch their color. If you have concerns in the middle of the night, call your pediatrician for further advice.
I'm Dr. Sue with The Kid's Doctor helping parents take charge.