Croup occurs most often in children between age 6 months and 3 years. This is because young children have a smaller airway. Airways become wider as children grow. This decreases the chance of croup in older children and adults.
Factors that may increase the risk of croup include:
- Attending day care
- History of croup
- Family history of croup
- Frequent upper respiratory infections like colds or sinus infections
- Colder months: October through March
At first, croup may seem like a common cold. The symptoms can come on suddenly. They often appear at night. Symptoms of croup can include:
- Cough spasms
- Cough that sounds like a barking seal
- A harsh, high-pitched sound when your child breathes in, especially when crying or upset
- Trouble breathing, especially breathing in
- Poor appetite and fluid intake
More serious symptoms of croup that may require immediate medical attention include:
- Call for emergency medical help right away if your child has:
- Bluish color of nails, lips, or around the mouth
- Decreased alertness
- Restlessness or agitation—This can be due to dangerous lack of oxygen.
- Struggling for each breath
- Harsh, high-pitched breath sounds even at rest
- Trouble swallowing
- Inability to speak due to trouble breathing
- Nausea and vomiting
- Rapid, irregular heartbeat; chest pain
- Rash or hives
- High fever
You will be asked about your child's symptoms and health history. A physical exam will be done. The doctor may assume croup based on the symptoms.
Tests are not always needed. If croup is severe or not clear, your doctor may request:
- Blood tests—to check for signs of infection
- Neck x-rays—to look for changes caused by croup
- Laryngoscopy—a thin tube is passed down the throat to collect sample and view area
The infection will pass on its own in 5 to 7 days. Severe symptoms will usually pass in 3 to 4 days.
Treatment can help to lessen symptoms and keep airways open. Treatment options include:
Breathing trouble can make it hard to sleep. Moist air may help a child breathe easier. The following methods may help:
- Use a cool humidifier in the bedroom.
- Use the bathroom as a steam room. Bring the child into the bathroom and close the door. Turn the shower on the hottest setting. Sit in the steamy bathroom with the child. Breathing should improve within 15-20 minutes.
- Cool night air may also help. Sit with the child near an open window or step outside.
Encourage your child to drink plenty of fluids. Choose water and unsweetened juices.
The doctor may recommend:
- Acetaminophen or ibuprofen—to ease discomfort. Follow instructions on bottle.
- Steroids—to reduce swelling in the airways. They can decrease the need for a hospital stay.
- Racemic epinephrine—through breathing treatments. It is temporary help until steroid medications start to work.
- Antibiotics—not helpful if a virus is the cause. May be needed if there is there is another infection.
A child with serious croup may need to stay in a hospital. Hospital care may include:
- Breathing tube—inserted into the throat to help keep the airway open
- IV fluids
- Monitoring oxygen level and heart rhythms to spot problems early
- Tracheotomy—an airway is created in the throat
Take steps to decrease your child's chance of catching colds and flu. Wash your hands often. Encourage them to do the same. Avoid contact with people who have cold or flu when possible.
Yearly flu vaccines can prevent croup caused by flu. It is strongly recommended for all children between the ages of 6 months and 5 years.
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
Edits to original content made by Denver Health.
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Healthy Children—American Academy of Pediatrics http://www.healthychildren.org
Kids Health—Nemours Foundation http://www.kidshealth.org
About Kids Health—The Hospital for Sick Children http://www.aboutkidshealth.ca
Health Canada https://www.canada.ca
Croup. Family Doctor—American Academy of Family Physicians. website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/croup.printerview.all.html. Updated March 2017. Accessed September 21, 2017.
Croup. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114811/Croup . Updated May 3, 2017. Accessed September 21, 2017.
What is croup and how is it treated? Healthy Children—American Academy of Pediatrics website. Available at: http://www.healthychildren.org/English/health-issues/conditions/chest-lungs/pages/Croup-Treatment.aspx. Updated November 21, 2015. Accessed September 21, 2017.