FAQ: Croup in Infants and Babies

Sometimes a cough is just a cough, but other times it can be a sign of a more significant condition that may require medical treatment. Croup is an inflammation of the upper airways that can cause your young child to cough with a barking sound. Find out more about what croup is, what its symptoms are, and how it can be treated.

What Is Croup and What Causes It?

Croup is an inflammation of the larynx (voice box), trachea (windpipe), and bronchi (bronchial tubes) that is quite common in children as young as 3 months up to 5 years old. The inflammation causes these passageways to narrow, which can make breathing more difficult.

Croup is most often caused by the parainfluenza virus, which is more likely to be spread during the fall and winter. Your child can catch the virus by coming into contact with another infected child. Just like other respiratory viruses, it is passed through contact with droplets, so when your child touches his nose or mouth, there is a chance he may get the virus.

Although this infection can be uncomfortable for your little one, croup typically lasts from three and five days and can often clear without treatment from your baby’s healthcare provider. If it does linger any longer or if your child has a more severe bout, take him to his provider for diagnosis and treatment.

What Are the Symptoms of Croup and How Long Do They Last?

You may think your child has the common cold at first because the early symptoms of croup can include a stuffy nose.

Eventually the following symptoms can develop and are often worse in the evening:

  • Fever
  • A barking cough that can get worse with crying, coughing, agitation, and anxiety
  • A squeaking or whistling sound (known as stridor) when breathing.
  • Fast breathing that may cause the skin between your child’s ribs to retract
  • A hoarse-sounding voice
  • Heavy breathing.

How Can You Treat Croup at Home?

Since croup is caused by a virus, there is no specific at-home treatment for it. It can’t be treated with antibiotics, which are used to treat bacterial infections but are not effective for viral infections.

Experts also recommend avoiding over-the-counter medicines like cough syrup, as these will not work and may be unsafe.

When your child has croup, focus on keeping her comfortable and calm, as agitation and crying can exacerbate the symptoms. These are some things you can try:

  • Reading or singing to her
  • Hugging her
  • Offering her a favorite toy or blankie
  • Speaking in a soft, soothing voice.

If your child (who is older than 6 months) has a fever of 100.4 degrees Fahrenheit or higher, you can try to bring it down with acetaminophen or ibuprofen. But be sure to check with her healthcare provider first. Always check with the provider when your baby who is 3 months old or younger has a fever. During a fever, make sure your child is getting lots of fluids so she doesn’t get dehydrated.

When Should You See Your Healthcare Provider?

If your little one’s symptoms worsen or linger for longer than five days, it’s time to contact her healthcare provider.

To make a diagnosis, your provider may observe how your child breathes, listen to her chest, and examine her throat. In some cases, your provider may order an X-ray to rule out the possibility of another condition.

If croup is diagnosed, the provider may prescribe your child one of the following medications:

  • A steroid, which helps reduce the airway swelling. After a dose, your child may begin to feel better in a matter of hours.
  • Epinephrine, which can also reduce inflammation. This may be given with a nebulizer so that your child inhales the medication, resulting in quick relief.

In very severe cases, if your child is having breathing difficulties, your provider may recommend your little one be hospitalized until her breathing improves.

When Should You Take Your Child to the ER?

Croup can cause your child’s airway to swell and narrow, which can make breathing difficult. Difficulty breathing may also result in your child stopping eating and drinking. He may even become too tired to cough.

If you see the following, take your child to the emergency room right away:

  • He struggles to breathe
  • He breathes faster than normal
  • He makes a whistling sound (stridor) when he inhales or exhales, even when he’s not crying or agitated
  • Swallowing is difficult or he drools excessively
  • He has trouble speaking
  • He is very sleepy or fatigued, or even anxious
  • His skin looks blue around the nose, mouth, or fingernails.

The Bottom Line

Croup may be an uncomfortable childhood illness, but in time it will go away. In the meantime, all you can do is comfort your little one while you wait for the infection to pass, and see your healthcare provider if her condition worsens. In typical cases, she’ll be back to her usual self in less than a week.

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