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Kids' Health

Barking Cough Signs and relief for the croup. By Dr. Jeff MuskettPublished: November, 2006

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KIDS HEALTH NOVEMBER 2006 What’s Inside: Breath  Easy | Women | Kids | Birth  to 5 Signs and relief for the croup Croup is a common condition in children and is characterized by a barking, harsh “seal-like” cough. Croup causes inflammation, swelling, and narrowing of the voice box (larynx) and windpipe (trachea). When it becomes intense, there is an associated high-pitched sound when inhaling (strider). Croup can be caused by allergies but is more commonly caused by viruses. Croup is usually caught from someone who is infected by air droplets or from one’s own hand which transfers to the nose and eyes. Croup occurs most often in the fall and winter months but can occur throughout the year. Children between 3 months and 3 years of age are most commonly affected. As a child grows, the windpipe and voice box enlarge and mature. A larger windpipe decreases the chances that throat swelling from croup will cause respiratory distress. When it hits Croup usually develops after a day or two of “cold-like” symptoms, such as nasal stuffiness or a runny nose. The child may have a fever and cough. After a day or two, the cough sounds more like a seal barking. Croup usually becomes worse at night and improves during daytime hours. At times, a child may have an “attack” of croup that wakes him or her up in the middle of the night. Croup can intensify rapidly, causing “strider.” Strider is a high-pitched sound when inhaling. This is a sign of more significant airway (throat) narrowing. Strider will worsen when a child cries or becomes upset. If your child has an attack of croup, it is important to comfort your child if they are crying or upset. Remain calm because the child may sense your anxiety and fear and become more anxious themselves. This could cause the airway to narrow even more. Even when croup is severe enough to cause strider, it can be treated by a parent at home in most cases. Humidifying the air is helpful. Steaming up the shower with hot water seems to work well. Inhaling the warm, humidified air should improve your child’s breathing within 15-20 minutes. For the remainder of the evening use a cold-water vaporizer or humidifier next to your child’s bed. Do not use hot water in a vaporizer or humidifier and only use plain water. Be sure to empty, clean, and completely dry out the vaporizer or humidifier between use to prevent mold growth. Warning signs If intense symptoms of croup (severe strider) do not improve after 30 minutes of home treatment, take your child to the emergency department immediately. If you are concerned that your child is going to tire out and stop breathing, call 9-1-1. If your child makes a whistling sound that gets louder with each breath or if your child is so out of breath that she cannot cry or speak, take her to the emergency department or call 9-1-1. If your child can no longer eat or drink, this may be a sign that the child’s breathing is tiring out. A parent should also seek medical attention in their child turns blue when coughing. In the emergency department, doctors can give medication and oxygen, which will usually turn around symptoms quickly. It is often the case that your child will not have to spend the night in the hospital. When in doubt whether to seek medical attention, it is always better to err on the side of caution and get help. Decongestants, cough medicines and antihistamines are not helpful in treating croup. Antibiotics are not helpful in treating croup but can be helpful when there is secondary bacterial infection, such as an eat infection. As with any upper-respiratory infection, have your child drink plenty of fluids if he is sick with croup. Do not smoke in the house as this can worsen many childhood medial conditions, including croup. Dr. Jeff Muskett is a pediatrician at the Kaiser Permanente Colton Medical Offices. Information: 909.370.3040.

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