All About Croup in Babies and Toddlers

Croup is a common respiratory illness in which the vocal cords (larynx) and the area below them in the windpipe (trachea) are inflamed. The illness often pops up in late winter, and it tends to target children between the ages of 3 months and 5 years. Most children get a harsh barking "croup cough" and noisy breathing. Parents can usually treat croup with various home remedies, but hospitalization may be required in severe cases. Keep reading to learn more about the causes, symptoms, and treatment options for croup in infants and toddlers.

What Causes Croup?

Croup is usually caused by a virus, such as the parainfluenza virus, adenovirus, or respiratory syncytial virus (RSV). Sadly, it's difficult to prevent your child from developing croup, as a number of common cold viruses can cause the condition. It spreads through respiratory droplets from coughing, sneezing, and touching contaminated surfaces. Frequent hand washing and avoiding close contact with people who are sick may reduce the risk of infection.

Croup Symptoms and Signs

Croup usually begins as a common cold with a stuffy or runny nose and fever. After a few days, the child's voice will seem hoarse and he or she will develop a harsh croup cough, described as sounding like a seal's bark. They may also have problems drawing air into the lungs because of inflammation in the airway; the whistling noise that results when breathing in is called stridor.

Croup symptoms most often occur after bedtime or in the middle of the night. Cough and breathing difficulties become more severe if the child is upset or crying. Symptoms generally last for three to five days.

Note that your child may also have recurrent "spasmodic croup"— a croup-like cough without any signs of infection present. It's usually the result of an allergic reaction in the windpipe or trachea. A child with spasmodic croup may not have cold symptoms initially, but the cough and breathing problems are the same as in children with infectious croup.

Best Home Remedies for Croup

In general, croup goes away by itself within a few days. Antibiotics are not helpful since it's usually caused by a virus, not by bacteria. Parents can usually treat it with the following home remedies for croup.

• Anxiety and agitation can make croup symptoms worse. It helps to comfort your child and provide reassurance. Also, sleep near enough to your child so you can follow the course of the illness.

• Give your child plenty of liquids to drink. Warm fluids (like chicken noodle soup or decaffeinated tea) and cold liquids may be especially soothing.

• Prop your child up in bed with pillows. He'll breathe better with his upper body raised.

• Some children feel better when they breathe in cool, damp air. Take your child to an open window or freezer door, or try a cool mist humidifier.

• Other children improve after breathing warm, steamy air. Take the child into the bathroom after filling it with hot shower steam. Sit in the room for about 10-20 minutes. Have your child inhale the humid air directly or through a damp towel. You can also use damp towels to increase the humidity in your child's room.

• If your child has fever, consider giving him acetaminophen like Tylenol. You should never give cough medicine or cough syrup to children under the age of 4; it could have potentially dangerous side effects, according to the American Academy of Pediatrics. Plus, there's no evidence that these medicines work for those under age 6.

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Contact a doctor if your child does not start breathing more easily with the treatments. He may need hospitalization to receive oxygen, steroid medications to open the airway, intravenous fluids for dehydration, or other treatments. Antibiotics may also be necessary if the child has a bacterial infection.

Croup Complications in Babies and Kids

Although croup usually resolves without any problems, symptoms can occasionally become severe. Children who are born prematurely are most at risk for these complications.

Contact your doctor if croup lasts longer than 3-5 days or is becoming worse. Also call your provider immediately if your child has the following symptoms:

• Labored or rapid breathing
• High-pitched breathing sounds (stridor) while inhaling or exhaling
• Drooling
• Inability to swallow saliva
• High fever
• Signs of dehydration
• Appearing extremely agitated or fatigued
• Gray-blue skin around the mouth, nose, and fingernails