It’s not unusual to hear someone remark, “Oh, he sounds so croupy,” upon hearing your young child’s loose, rattling cough. Medically speaking, however, this isn’t accurate. Croup isn’t characterized by a phlegmy-sounding cough; instead it’s associated with a sharp, barking cough. While this symptom alone can often be used to identify croup, there are other symptoms and risk factors that can lead you to a diagnosis of croup. Knowing the progression of symptoms and how to treat them can ease your mind and your child’s discomfort.
Symptoms of Croup
The hallmark sign of croup is a tight, barking cough that many people liken to the sound of a seal. This harsh cough–the distinctive sound of which is caused by swelling and inflammation of the vocal cords–is frequently accompanied by more typical cold symptoms like a runny or stuffy nose. The swelling can also make it tough to breathe, causing another common symptom of croup: stridor. Stridor is the high-pitched, whistling gasp that a child with croup makes when he inhales. It is not typically heard upon exhalation.
Cause of and Risks for Croup
Croup is a viral infection that causes inflammation in the larynx and increased mucus in the surrounding bronchial tubes. It most often affects children under the age of 5 or 6, with toddlers between the age of 1 and 2 years old most severely affected because their bronchial tubes are smaller and more easily blocked. Children who were born prematurely or have compromised immune systems are more susceptible to the virus than their full-term, healthy peers.
Duration of Croup
If your child develops croup, you can expect the infection to last nearly a week, though you may not recognize it as such at first. While sometimes croup comes on suddenly and unexpectedly, it also can arise from a cold or respiratory infection, in which case the barking cough and stridor tends to peak in intensity on the second or third day. While he’ll be uncomfortable during the day, the croup cough tends to increase at nighttime, which may interfere with his sleep (and yours).
Treatments to Try at Home
Most cases of mild croup don’t require prescription medications and can be treated with home remedies. Steam, cool air and mist can ease your child’s discomfort considerably and settle his cough. Running a cool mist humidifier or vaporizer or sitting in the steamy bathroom while the shower runs are two of the most commonly used home treatments. If your child has croup in the springtime (when the virus is most frequently seen), taking him outside in the cool night air can also relieve some of the swelling. If his throat or chest hurt from coughing or he’s running a fever, you can give him ibuprofen or acetaminophen–just make sure to use the recommended dosage for his weight (see Resources below).
When to Call the Doctor
A child who is playful, eating well and seems to be minimally bothered by croup symptoms doesn’t warrant a trip to the doctor’s office. However, since croup affects breathing, it has the potential to become a serious medical concern. If your child seems to have to think hard about drawing breath (his stomach will suck in and his neck and shoulders become taut when he breathes), his stridor increases or he has trouble swallowing, immediate medical attention is needed.