Croup in Kids

Croup is a common illness caused by a viral infection that causes swelling of the voice box (larynx) and windpipe (trachea) and makes breathing difficult and noisy. People of all ages can contract the virus, but children are the most at risk because of their small airways.  

What Are the Symptoms of Croup?  

Croup typically causes mild, cold-like symptoms but they can develop into:    

  • Runny nose and congestion  
  • Loud, barky cough
  • Hoarse voice  
  • Noisy, labored breathing (stridor
  • Low-grade fever of 100.4°F up to 104°F

How Is Croup Treated?  

If your child has viral croup, your doctor may give them a breathing treatment with epinephrine (adrenaline) to decrease the swelling and observe them for 3 to 4 hours to ensure symptoms do not return. Steroid medicine may also be prescribed to reduce swelling and decrease symptoms. Antibiotics, which treat bacteria, are not helpful for treating croup because they are typically caused by a virus.  

Most mild croup cases can be treated at home. For children older than 6 months, ibuprofen and acetaminophen can help reduce a low-grade fever. Avoid cough syrups as they may do more harm but ensure your child stays hydrated with plenty of fluids. Try to keep your child relaxed and breathing calmly. If they have trouble sleeping at night, comfort them with a back rub or bedtime song.  
While steam treatment may have been an advised treatment in the past, there are no studies to prove that inhaling steam for croup is effective.

How Does Croup Spread?  

Croup can be contracted by breathing infected respiratory droplets coughed or sneezed into the air. Virus particles may also survive on other surfaces, so your child can develop an infection if they touch a contaminated surface and touch their eyes, nose or mouth. 

How Can I Prevent My Child from Contracting Croup? 

The best croup prevention for all ages is to stay away from anyone who is sick. Frequent handwashing with soap and water or using an alcohol-based hand sanitizer is essential. Teach your children to sneeze or cough away from others and immediately discard tissues after use.  

When Should You Contact a Doctor?  

Seek out immediate medical care if your child's symptoms are not improving or worsening, including:  

  • Making a whistling sound that gets louder with each breath  
  • Cannot speak or make verbal sounds for lack of breath  
  • Struggling to catch their breath
  • Has bluish lips or fingernails  
  • Has stridor when resting  
  • Drools or has extreme difficulty swallowing saliva  

What Is Recurrent Croup? 

If your child has repeated or persistent croup, it can be a sign that they have a narrowing of the airway unrelated to infection. This can be a problem that was present when a child was born or developed over time.  

With persistent or recurrent croup, you should talk to your child’s doctor as they may want to refer your child to see a specialist such as an otolaryngologist or  pulmonologist for evaluation.  

What Are Complications with Croup?

Although uncommon, some children with moderate to severe croup are at risk for respiratory failure if not enough oxygen is able to get to their organs. Bacterial infections, such as pneumonia or bacterial tracheitis, may arise from croup and can be life-threatening. In addition, complications related to croup also include fluid buildup in a child's lungs (pulmonary edema), air getting trapped in the chest in the space in between the lungs (pneumomediastinum), and air from the lungs leaking into the chest (pneumothorax). All of these complications may require hospitalization.