The Barking Cough: Understanding CROUP

“My kid sounds like a dolphin, no… a dog… no, a seal… He’s got this barking cough. What do I do?!” 

Have your kiddos ever experienced this? Well, it might be CROUP. The cough can sound rather alarming, but you need not worry. Let’s understand this common virus! 

WHAT IS CROUP:

  • A common condition that irritates and causes inflammation in a child's upper airways.

  • As the airway below the vocal cords becomes narrow, it makes breathing difficult.

  • Breathing becomes noisy, causing the cough to sound “barky,” like a dog or seal.

  • Caused by a viral infection, and in general, can be managed at home. 

  • Over 200,000 cases each year in the U.S. 

  • Often has a sudden onset and will often worsen during nighttime. 

SYMPTOMS MAY INCLUDE: 

  • Stuffy/runny nose

  • Fever

  • Barking cough (sounds like a barking dog or seal) or hoarse voice/cry

  • Stridor (a high pitched or squeaking noise when breathing in)

  • Fast breathing

  • Retractions (pulling in of skin underneath or between ribs while breathing)

*Note: Stridor and respiratory distress will worsen when the child is upset or crying. 


IS CROUP CONTAGIOUS?

  • Croup is a symptom that comes from a variety of viruses; so, two siblings could have the same virus, but one could develop croup as a symptom, and the other might not get croup as a symptom.

  • Viruses are spread through droplets of mucus from an infected person, which can be spread through coughing or sneezing, or on infected surfaces like counters, doorknobs, hands and clothing. Thus, it’s not the croup that’s contagious, it’s the virus. Croup is a symptom that some children develop a symptom of a virus.  

  • Croup impacts all individuals differently; the swelling of the airway that is the hallmark of croup may not happen to every person who contracts croup. 


HOW WILL A DOCTOR DIAGNOSE CROUP?

  • Healthcare providers listen for the telltale barky cough and stridor.  

  • They will also ask about medical history and any recent illnesses that caused a fever, runny nose or congestion. 

  • If the croup is severe, the doctor may order an X-ray of the neck to look at the swelling in the airway.


TREATMENT:

  • Most cases of croup are mild and can be treated at home.  

  • If stridor and inflammation are bad, breathing in cold air can help 

  • Using a cool mist humidifier in the child’s room or creating a moist, steam-filled bathroom where you can sit with your child for 10 minutes can be helpful.

  • In cold weather, taking your child outside in the cool air may help symptoms; you can also try taking your child for a drive with the car windows opened just a bit.

  • Cold liquids including cold drinks, popsicles, or slushies can aid inflammation.

  • Consistent fluids are key! 

  • Rest to allow your child’s immune system to function properly

  • Your provider may prescribe a steroid medication to help decrease inflammation in the airway.

  • If the croup is severe and causing your child to have significant respiratory distress, your provider may administer a breathing treatment of racemic epinephrine that can temporarily decrease inflammation until the steroids have time to take effect. 

  • For more information on treatment tips for the home, check out my AT-HOME REMEDIES BLOG.

CAN CROUP BE PREVENTED?

  • Although there is not a specific way to prevent your child from getting croup from whatever virus they may come in contact with, there are universal ways to prevent kids from getting viruses:

    • Wash hands frequently

    • Keep kids separated from other sick children

    • Stay hydrated and eat foods rich in nutrients (see my Healthy Eating Blog for tips)

    • Supplements/Vitamins (head to my VITAMIN BLOG for all the deets)


SEEK MEDICAL CARE IF CHILD EXPERIENCES ANY OF THE FOLLOWING:

  • Difficulty breathing, with rapid or labored breathing

  • Retractions (pulling of skin underneath or between ribs when breathing)

  • Stridor (noisy high pitched squeaking sound when breathing in) while calm or at rest that isn't helped by cool air

  • Drooling or trouble swallowing

  • Is very sleepy or hard to awaken

  • Signs of dehydration (dry lips, sunken eyes, decreased urine output)

CALL 911 FOR:

  • Severe respiratory distress

  • Pale or bluish coloring around the mouth

  • Unresponsive

Viruses can be worrisome, but they don’t have to be! With effective care, time, and love, your little one will get back to their normal self in no time! For more information, check out my course: Mastering Medical Emergencies At Home. 

Shan Tripp