Croup

What could be more frightening than to awaken during the night to the sound of your child gasping for air and “barking like a seal”. Yet these are the classical signs of croup, a respiratory infection that typically affects children between the ages of 3 months and 3 years. While it may sound frightening, croup is rarely cause for concern. Croup usually lasts from 3 to 7 days. Generally, it worsens at night and tends to improve during the day. Sometimes steroid medication that is prescribed early in the illness helps to ease the severity of the symptoms.

A virus is the most common cause of croup. Infected by a virus, cells in the voice box and windpipe react by secreting mucous that narrow these air passages. The secretions dry and thicken, making it even more difficult for your child to breathe. Dissolving the dried secretions with steam is often all that is needed to relieve your child’s discomfort. Children usually outgrow croup as they get older and the windpipe becomes wider.

Sometimes croup is confused with another condition called epiglottitis (an inflammation of the structure behind the root of the tongue). Typically seen in children older than three years, epiglottitis is often more serious than croup because it can completely block the airway and cause meningitis (an inflammation of the lining of the brain and spinal cord), or respiratory arrest. Children with epiglottitis tend to drool, tilt their heads forward, have a fever and jut their jaw out as they try to breathe.

Sometimes what sounds like croup may instead indicate that your child has inhaled a foreign object. If the object blocks the windpipe, your child will have trouble breathing and will need immediate emergency care.

• Run a humidifier near your child’s bed for several nights after the first attack. Use a cool mist vaporizer if your child has a fever because warm moist air can raise body temperature. Clean the vaporizer after each use.
  
• Purchase a humidifier for your furnace if croup is a recurring problem. Change the filter often.
  

• Try not to panic. While wheezing and barking sounds are frightening, remaining calm will lessen your child’s fear and anxiety.
  
  
  
  • Hold your child to comfort him or her. Helping your child to relax may help stop the windpipe from constricting and make breathing easier.
    
  
  
• Use a hot bath or shower to help relieve the congestion:
  
  
  
  • Take your child to the bathroom and close the door.
    
  • Turn on the hot water in the sink and shower to fill the room with steam.
    
  • Do not put your child in the shower. Instead, sit your child on the toilet or a chair, but not on the floor. Try reading a book to your child to pass the time and ease any fears.
    
  • Open the window to let in cool air. This helps to create more steam.
    
  • Allow a good 15 minutes for the steam to ease the symptoms. If the symptoms continue, carry your child out-of-doors to breathe the cold night air. If this doesn’t ease the breathing difficulties, seek emergency care.
    
  
  
• Use a vaporizer in your child’s room. Cold-mist vaporizers are preferred because they give off cool air and avoid the risk of scalding with hot water.
  
• Clean the vaporizer after each use.
  
  
  
  • Make a “croup tent” by placing the vaporizer under the crib or bed. Drape a blanket over the crib near the child’s head, or over an umbrella if your child now sleeps in a bed, to trap the steam. Never leave your child alone while he or she is in a croup tent. Stay awake to monitor your child.
    
  
  
• Crying is a good sign. It means that your child’s symptoms are subsiding. A crying child is able to breathe.
  

Questions to Ask

Is your child’s breathing very labored and is your child unable to swallow?
Is your child drooling, breathing through the mouth, sticking out the chin and gasping for air?
Are your child’s lips and nails turning blue or dark?
If you child is making a sound like a barking seal and finding it hard to breathe have you used steam for more than 15 minutes and taken your child outside in the cold night air for 15 minutes without getting relief for your child’s symptoms?
Is your child making a sound like a barking seal?