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Croup Basics


Updated July 16, 2014

Still in parents bed.
Adriana Varela Photography/Moment/Getty Images
Croup (acute laryngotracheobronchitis) is another viral illness that is easy to recognize, when you know what to look for.

Croup Symptoms

Children with croup usually wake up in the middle of the night with a loud cough that sounds like a barking seal. Other croup symptoms might include a fever, hoarse voice and runny nose.

In more severe cases, children will also have stridor, which the AAP describes as a "coarse, musical sound each time that he breathes in." If a child with croup has stridor while he is quite and sleeping or resting, that is usually a sign that he is having a lot of trouble breathing and you should seek medical attention.

These croup symptoms are caused by swelling and mucus buildup below the child's vocal cords.

Diagnosis of Croup

There is no testing for croup and diagnosis is usually made once you hear the typical barking cough. Although usually not necessary, a lateral (side) neck x-ray might show a "steeple sign."

Croup Treatments

The usual first croup treatment is to take your child into the bathroom, close the door and turn on all of the hot water (don't leave your child unattended around hot water though). As the room gets "steamy," it should help to relieve your child's symptoms.

Other treatments might include using a pain and fever reducer, cough suppressants (although they will likely not be helpful) and a cool mist humidifier.

If that isn't helping and your child is still having trouble breathing, seek medical attention. If necessary, your Pediatrician might prescribe oxygen, special breathing treatments (racemic epinephrine) and/or steroids.

What You Need To Know

  • Stridor is often confused as being wheezing.

  • Croup, although a mild infection in most children, can be severe and even life threatening. If your child has a barking cough and seems like he is having trouble breathing, call your doctor or seek immediate medical attention.

  • The first night of croup symptoms is usually the worst. After a few days, croup symptoms begin to resemble a regular cold, with a runny nose and more normal sounding cough. Symptoms might be better during the day, only to return the next night, so even if your child is much better after a night of croup symptoms, call your pediatrician.

  • Older children and adults usually just get a cold when they are exposed to a child with croup.

  • Since more than one virus can cause croup, your child might get it more than once. Croup is most commonly caused by the parainfluenza virus type I, but other subtypes of parainfluenza, adenovirus, RSV, and influenza can also cause croup.

  • If your child gets croup a lot or continues to get croup after age 6, you might see an ENT specialist. Allergies or reflux might also trigger spasmodic croup, which is similar to typical viral croup, except there is no fever and children have a quicker recovery.

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  6. Croup
  7. Croup Basics - Expert Pediatrics Guide

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