Family doctor

Overview

• Croup is common and may be frightening
• Most cases settle well at home
• It is best to get medical advice to confirm the diagnosis and help with treatment
• Occasionally it can be dangerous, so do not delay seeking advice

What is it?

Croup means "noisy breathing" which describes the sounds sufferers make.

It is an infection of the upper airways affecting mainly the voice box (larynx). This infection is common in infants and children from 3 months to 3 years of age. However older children may get croup. It usually occurs during late autumn, winter, and early spring. A child who gets croup seems to have a tendency to get any flu or cold infection in the voice box whereas other children just get ordinary flu symptoms. Thus a child with croup will often get it more than once.

What are the symptoms?

Croup is usually caused by a virus (germ). Your child may first have a mild cold with a cough and sore throat which goes on to a barky cough with noisy breathing, or a hoarse voice.

Other signs may be fast breathing or problems swallowing and your child may be restless. Croup attacks usually occur during the evening or night. Your child may be sickest on the first 2 to 3 days of the croup attack.

What can be done to help?

Your child's breathing may be helped by sitting with him/her in a steamy bathroom. Turn on the hot water in the sink, shower, or bathtub and close the windows and bathroom door. When the room is steamed up, bring your child into the room and sit with him/her on your lap for at least 15 minutes. Do not leave your child alone. Steam does not help all children with croup however.

The humidifier may loosen the mucus in your child's throat and make it easier to breathe. Keep your child warm. Give him/her clear liquids once he/she is breathing better, such as apple juice or water. It is important to give your child warm water or juice to keep the mucus thin. The liquids should not be cold.

Do not let anyone smoke around your child. The smoke can make his/her breathing and coughing worse. Try to stay calm and have your child rest as much as possible. Your child's breathing and coughing will become worse if he/she is afraid and crying.

Most croup may be treated at home if your child is not having increased trouble breathing or more coughing. It may be 5 to 6 days before your child feels better. Antibiotic medicines will not work for treating croup. For severe croup nebulised adrenaline and oral steroids may be used.

Getting help

Call for ambulance help (111 in New Zealand) if your child has trouble breathing or swallowing or if the skin between your child's ribs is being sucked in with each breath or if your child's lips or fingernails are turning blue or white.