What is Croup?

What is Croup?

Croup is a condition that causes a swelling of the voice box (larynx) and windpipe (trachea). The swelling causes the airway below the vocal cords to become narrow and makes breathing noisy and difficult. It is most commonly caused by an infection. Croup most often affects children between the ages of 3 months and 5 years.

Viral Croup

  • This is the most common type of croup. It is caused by a viral infection of the voice box and windpipe. It often starts out just like a cold, but then it slowly turns into a barky cough. Your child’s voice will become hoarse and her breathing will get noisier. She may make a coarse musical sound each time she breathes in, called stridor. Most children with viral croup have a low fever, but some have temperatures up to 104°F (40°C). 

When to Call the Doctor

If you are concerned that your child’s croup is not improving, contact your child’s doctor, local emergency department, or emergency medical services (911) even if it is the middle of the night. Consider calling if your child: 

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

Treating Croup with Medicine

As croup is a viral illness treatment remains symptomatic. Hydration, fever control and rest are key in your child making improvment.

In some cases your child’s doctor may give your child a breathing treatment to decrease the swelling.

A steroid medicine may also be prescribed to reduce the swelling. Steroids can be inhaled, taken by mouth, or given by injection. Treatment with a few doses of steroids should do no harm. Steroids may decrease the intensity of symptoms, the need for other medications, and time spent in the hospital and emergency department.

Antibiotics which treat bacteria, are not helpful in treating croup because they are almost always caused by a virus. Cough syrups are not useful and may do harm. 

Recurrent or Persistent Croup

When croup persists or recurs frequently, it may be a sign that your child has some narrowing of the airway that is not related to an infection. This may be a problem that was present when your child was born or one that developed later. If your child has persistent or recurrent croup, your child’s doctor may refer you to a specialist such as an ENT (ear, nose, and throat specialist) or pulmonologist  (breathing and lung disease specialist) for further evaluation. 

Croup is a common illness during childhood. Although most cases are mild, croup can become serious and prevent your child from breathing normally. Contact your child’s doctor if your child’s croup is not improving or if you have other concerns. He or she will make sure your child is evaluated and treated properly.