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The Blog

Managing Croup

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Croup is inflammation of the voice box (larynx) and trachea. Let’s dive into what you need to know as a parent.

Check out the PedsDocTalk YouTube Video: Croup Cough Sound and Treatment, for more information and guidance on symptoms of croup, examples of a croup cough, examples of stridor, risk factors for croup, how to manage croup at home, and when to seek medical attention.

Let’s talk about croup! Croup is a viral inflammation of the voice box or larynx and trachea. What are the symptoms? What causes it? How can you manage it? When should you seek medical attention? I go over all of these questions and more in this blog post so let’s dive in!

Causes of croup

Croup is mostly caused by viruses. Many viruses lead to inflammation and then inflammation can happen in the vocal cords, leading to narrowing. Croup can be caused by common viruses, foreign bodies, and allergies.

Symptoms of croup

Croup is more common in kids because their airways are smaller. Imagine already having a smaller airway as it is and when you get a virus, it causes inflammation, which can restrict that. Now you are breathing from a narrower passage way. Below are some symptoms to look out for.

  • You might hear a barky cough at rest or with activity. Many people will also describe it as a barking seal sound.
  • Croup can cause a sound called stridor which is a harsh, tight sound when breathing in. Stridor as a sound can be caused by things besides croup, but that’s for another blog post!
  • Because it’s caused by a virus, you will also likely see a fever. However, some kids can just have a runny nose, cough and no fever. 

When is it most common?

Croup is most common between 3 months to 5 years although I do know some children who have it into their late school years. This has to do with their anatomy. As they get older, their airways get larger and thus inflammation won’t cause as much of an issue. It can happen year round but it is most common in the fall and winter. 

Watch this PedsDocTalk YouTube Video for examples of a croup cough and examples of stridor.

So is it croup or wheezing?

Croup and wheezing can both be caused by viruses as they lead to inflammation but they are in different parts of the airway. Croup is the upper airway and larynx whereas wheezing is the lungs. They can sound similar to a parent, but croup is more of a barking seal sound whereas wheezing is more of a classic wheeze. 

Risk factors for developing croup + how to manage at home

We don’t know why some children may get it more than others. It is likely more to do with anatomy than anything else. Most children will just have the barky cough but not be labored in their breathing. If your child has that stridor sound (harsh sound when breathing in), try a warm mist in a closed bathroom for 20 minutes

For some kids, COOL mist will help! Weird! Try going outside if you’re in a cold weather climate OR standing in front of the freezer. I would try the warm first and move to cool second. If you have a known croupy child, you can go to whatever works best. Below are some other tips to help manage at home.

  • Keep them calm.
    • I know this is tough when a child is sick, so do the best you can. If they’re cranky above baseline it’s okay to give ibuprofen, acetaminophen, or pain reducers. Crying can make the croup worse so speak in low volume, and comfort them as much as you can.
  • Use a humidifier.
    • If your home is dry, run a humidifier in their room. Dryness can make the symptoms worse. 
  • Manage the viral symptoms.
    • Remember viral croup is caused by a virus so check out my cough and cold YouTube video for more information and guidance. If they have a fever, treat for comfort. Irritability can make them cry and make that croup worse so it’s okay to use these meds. More info in my Fever 101 YouTube video.
  • Keep them hydrated.
    • Liquids can help coat the throat and prevent it from getting too dry, so focus on hydration.
  • Avoid tobacco smoke or irritants in home.
    • This can make the croup worse so try to avoid if you can.

Seek medical attention if:

  • Your child has difficulty breathing (faster breathing than normal) or cannot speak or make verbal sounds (because they cannot breathe).
  • There is a stridor (high-pitched sound) while at rest.
  • Your child is listless.
  • There is a persistent fever for more than 5 days.
  • Your child is inconsolable despite pain-reducing medicines like Motrin or Tylenol.
  • You see drooling with shortness of breath.

What may happen at the hospital or doctor’s office

Depending on the severity, some interventions in our office include steroids or you may get a breathing treatment with epinephrine. Steroids are typically used in outpatient first with moderate stridor or increased work of breathing. We usually give a medicine called Decadron which can be taken by mouth or injection. Prednisolone is another option but Decadron is typically preferred. In more severe cases, racemic epinephrine is done as a breathing treatment. Children who receive this usually need to be observed for 3-4 hours to make sure they don’t have a rebound of symptoms. If at a hospital, a child with croup may need monitoring inpatient overnight or for a few days to monitor breathing and hydration – but there are great outcomes with intervention!

Watch this PedsDocTalk YouTube Video for more information about when recurrent croup is a concern.

How long can symptoms last?

Viral croup is caused by viruses so the actual croup symptoms can last anywhere from 3-6 days with the viral symptoms lingering longer. Your child can return back to childcare when they are fever free for 24 hours and med free as well and feeling good enough to be in usual activities. 

Remember this!

Most croup is managed at home with warm or cold mist, comfort, and fluids. Watch for difficulty breathing especially that stridor at rest!

WATCH THE PEDSDOCTALK YOUTUBE VIDEO ON CROUP HERE

Hungry for more info?? Check out my library of FREE resources here.

Dr. Mona Admin

Hi there!

I’m a Board Certified Pediatrician, IBCLC, and a mom of two.

I know the ups and downs of becoming a mom and raising kids.

I help moms ditch the worry and second-guessing so you can find more joy in motherhood.

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All information presented on this blog, my Instagram, and my podcast is for educational purposes and should not be taken as personal medical advice. These platforms are to educate and should not replace the medical judgment of a licensed healthcare provider who is evaluating a patient.

It is the responsibility of the guardian to seek appropriate medical attention when they are concerned about their child.

All opinions are my own and do not reflect the opinions of my employer or hospitals I may be affiliated with.