What is croup?
Croup is a viral infection (typically caused by a parainfluenza virus) that causes swelling and inflammation of the voice box (larynx) and upper airway (trachea). Find a great illustration here. This infection starts out like the common cold with runny nose and congestion but quickly evolves into that telltale barking cough. Fever (up to 104 F in some cases) usually goes along with it.
Who gets it?
Croup is most common in infants to toddlers (think 6 months to 3 years old), but can be seen in older children particularly if they’re prone to croup during any respiratory illness and/or with the onset of seasonal allergies. It occurs most often during fall and winter.
What are the symptoms?
Runny nose, congestion and fever soon give way to that harsh, barking cough that is croup. Most children who do get croup have a mild, self-limited case that consists of this barking cough (usually worse at night) and a hoarse cry. If they are crying and/or agitated, you may notice a harsh or squeaking sound as they breathe in (called stridor).
Some children, especially infants, may have more severe symptoms such as stridor at rest, difficulty breathing as evidenced by retractions as they work harder to get oxygen into their lungs. These children require prompt medical evaluation and treatment.
What parents can do
For mild cases, as described above, the number one thing you can do is stay calm and keep your child calm. Have her sit on your lap in the bathroom while you run a hot shower. The warm mist will calm her airways and decrease that horrible sounding cough within 10-20 minutes.
Another alternative, if weather permits, is to bring her out into the cold night air. Running a cool mist humidifier in her room at night during her bout with croup will help too.
Croup typically lasts 3-7 days and the first 3 days are usually the worst of it. Your child's doctor may want to give your child an oral steroid to minimize the progression of airway swelling and decrease severity of coughing.
For more severe cases where a child is having difficulty breathing and stridor at rest, treatment in the ER and/or hospital may be in order for observation, treatment with an inhaled medication and oral/IM/IV steroids.
Dr. Mom's bottom line ^The good news is that most cases of croup are mild and improve within five days. Using a cool mist humidifier, keeping your child hydrated, and treating their fever when necessary will work wonders in helping your child stay calm and feel better.