By Jennie Gropper Biggs, MD
As printed in Around Town Publishing, August 2007
You hear a barking noise coming from your child’s bedroom in the middle of the night, but you are fairly certain that you do not have a dog or a pet seal. More likely than not your child has just developed croup! This scary and mysterious ailment has plagued children for centuries and leads to many trips to the emergency room during the night.
Croup is a viral illness that is known for it characteristic “barky” cough. The virus causes swelling in the large airways in the throat, leading to sore throat, hoarse voice, cough, fever, noisy breathing, and, in more severe cases, difficulty breathing. The illness usually starts suddenly, and for unknown reasons it seems to always be worse at night. While people describe different kinds of coughs as “croupy”, the true cough that comes with croup is a very distinctive bark that sounds most like a seal. Since croup is caused by a virus, there are no medications or antibiotics that can cure it. But there are numerous methods to treat the symptoms of croup while we wait for the body to fight off the virus.
Some of the old fashioned techniques for caring for a child with croup are as good as any modern inventions. Steaming up the bathroom and allowing the child to breath in that warm moist air seems to help the most. Ironically, cool moist air, delivered best by opening up the freezer or going outside if the weather is cool, seems to work just as well. It is thought that the moist air decreases the swelling in the airway and temporarily eases symptoms. Cough suppressants can sometimes be used (only under the guidance of your pediatrician), and anti-inflammatory medications (such as ibuprofen) can be useful to decrease any associated throat pain or fever. Most importantly, try to keep your child calm. The barking cough and difficulty breathing can be scary, and these symptoms always seem to be made worse when the child is upset. If your child has trouble catching his breath or has noisy breathing (known as stridor), you should seek medical attention right away. Some children may require steroids or special breathing treatments to decrease the swelling in their airways, while in more severe cases oxygen may be needed. In most patients, the barking cough resolves after a few days and turns into a wet cough and a runny nose that last about a week. Croup is contagious. It tends to affect younger children, who have smaller airways, worse. But anyone can be infected. It is always best to have your child checked by the pediatrician when an illness such as croup occurs.