Sick Days

Croup

Most prevalent in early winter and spring, croup is most often caused by parainfluenza viruses, which inflame the area around the windpipe and voice box and narrow the airway. Croup can be alarming because it often comes on suddenly -- and in the middle of the night. Although it can cause serious breathing problems if the airway continues to swell, for the most part croup's barking cough "sounds more serious than it is," says Alfin G. Vicencio, MD, assistant professor of pediatrics at the division of pediatric respiratory and sleep medicine at the Children's Hospital at Montefiore and Albert Einstein College of Medicine, in New York City.

Symptom

The cough's sound has been likened to a seal's bark.

Prevention

Wash hands frequently, and avoid people with respiratory illnesses.

Treatment

Fever reducers, cool-mist humidifiers, and fluids are your best medicine, along with sitting with your child in a steamy bathroom for 20 minutes. You might also bundle her up for a walk outside. "Some people think the cold air constricts blood vessels and diminishes the swelling, but that hasn't been proven," Dr. Vicencio says. Still, even if these things don't alleviate symptoms, they buy you time to calm your child down, which often allows the airway to relax on its own.

Red Alert

Most croup can be handled at home, but severe cases may require prescription steroids or emergency medical attention, particularly if your child was premature or has asthma. Signs of severe croup include a sleepy or distressed appearance, refusal to eat or drink, and a cough and breathing that get progressively worse. Listen for stridor, a high-pitched, creaky rattle when your child breathes in, and note if the skin around her ribs or the hollow at the base of her throat pulls in when she breathes. If you see a bluish tint around her mouth, she's not getting enough oxygen into her blood and needs immediate medical attention.

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