What is croup? 

Croup,  a common childhood virus which affects the larynx and trachea, is well-known for its sudden onset of  a bark-like cough in young children. In adults we'd call such viral respiratory inflammations, laryngitis. In fact, two  of the conditions associated with  croup are laryngotracheitis  and laryngotracheobronchitis.

In babies, the windpipe may swell up, making it difficult for them to breathe. Croup usually affects  children between 6  months and 3 years old. Occurring mostly in autumn and winter,  the hoarse cough typical  in croup is due to a  mild upper respiratory tract infection caused by a variety of viruses. 

What  are its symptoms? 

If your baby has croup, you'll know. One parent we know was woken up at 5 a.m. by barking –  but she didn't have  a dog. It took her only an instant to know it was croup. Although  the cough is easy to recognise, its bark is worse than its bite in  most cases. 

Croup typically makes its first appearance in the middle of the night. You may discover that the slight cold your baby went  to sleep with has turned into  the unmistakable bark. Don't hesitate to respond: you'll probably find your baby awake, sitting up, breathing noisily, coughing,  and very frightened. It's best to treat  croup right away, especially if your baby  is crying, which only exacerbates the symptoms. 

How  can I treat croup?

Since croup is caused by a virus, antibiotics won't help. But you  can reduce the symptoms dramatically  and help your baby feel  more comfortable  with this time-tested steam treatment: 

• Make  a temporary steam room in your bathroom by running the hot tap or shower at the hottest temperature possible. Close the bathroom door  to keep the steam in. 
• Sit in the bathroom for  at least 15 minutes  with your baby on your lap, holding her and reassuring her. Try reading  a book or singing to her to calm her down if she's agitated by  the cough. Letting her inhale  the warm, steamy air should relieve the cough and allow you  to settle her back to sleep. 

If the steam doesn't help, call your doctor. 

• A humidifier will also help a baby  with croup. 
• It  is very important to encourage your baby  to take extra fluids to prevent dehydration, a common concern with croup. Juice and warm soup may taste especially good if your child has lost her appetite for food. Also make her sip clear liquids frequently to loosen  the mucus  and to help her breathe more easily. 
• Crying  can trigger spasmodic coughing  and aggravate breathing discomfort. Try  to comfort your baby by cuddling her  or talking to her to lessen her anxiety. 
• Sit your baby upright to help her breathe more easily – this will also relieve her cough. You can also prop her up in your lap till her coughing bouts subside. 
• Avoid exposing your baby  to smoke or other irritants. 
• Try to keep your baby away from anyone with  a cold or cough, and wash her hands and your hands often  to reduce the chance  of spreading the  infection.

Should I call  the doctor? 

If it's your baby's first bout with croup, you may want  to call your doctor right away. But as most flare-ups take place in the middle  of the night, it might not always be possible. Try not  to get anxious if you can't talk to your doctor and try home remedies  like giving steam and warm drinks instead. 

If you've been through  croup before, you might still want to stay on the safe side, so call your doctor and describe the  symptoms after you've tried the home remedies mentioned above. You should also call if your baby has a fever over 102 degrees F, shows signs of stridor – noisy breathing and difficulty inhaling –  or stridor  and drooling, which could be a sign of the more serious bacterial infection epiglotittis. 

If your baby doesn't quickly improve  with the home remedies, appears dehydrated, or seems to have particular difficulty breathing, it  is better  to go to the hospital as she may need oxygen or nebulisation therapy  to aid respiration. 

How long will it last? 

Your baby may have  croup for as long as four to six days, peaking on the second or third night. During this time, continue the steam treatments as needed. Once you both get over the surprise  of this nasty cough, it will usually run its course and leave you all a little tired, but well. 

Notes: Dr. M. Kristine Schlossberg

[Watch page ]

EditText of this page (last edited February 27, 2010)