Could Your Child’s Barking Cough Be a Symptom of Croup?

by Baylor Scott & White Staff on January 23, 2013

in Medical Information

croupYour toddler has had a barking, seal-sounding cough for several days, accompanied by a low grade fever. And you notice a strange high-pitched sound when he breathes. These symptoms could be an illness called croup, which is the swelling of your child’s upper airway caused by a virus.

“It’s different from other diseases like asthma or pneumonia, which are in the lower airway—in the lungs,” said Dominic Lucia, MD, Medical Director of Emergency Medicine, McLane Children’s Hospital Scott & White. “Croup involves more of the portion of the upper airway parallel to the esophagus and the upper trachea.”

The disease usually peaks between the ages of six months and three years, and is most common in the second year of life.

“It’s a pretty prevalent disease,” Dr. Lucia said. “About one in 20 kids will get it during that time. You see it most often in the fall or winter. That’s when the viruses that cause croup like to come out and play.”

Croup is most commonly a mild, self-limited disease, which means it will go away on its own after a few days of rest. But if you start to hear noisy breathing, called stridor, then it may be best to have your child seen by a physician.

“If your child ever has difficulty breathing, the general rule is that they need to be evaluated by a medical professional,” the medical director said. “If the child is breathing hard or weird, don’t just wait it out. I worry about that because it may not be croup.”

While it’s always a good idea to have your child assessed when they’re having trouble breathing, some parents, who can recognize the symptoms of croup because of previous experience, may try home remedies before making a doctor’s appointment or a trip to the emergency department.

“Some parents have tried humidifiers or taking them into the bathroom and turning on the hot shower,” Dr. Lucia said. “And some children seem to get better when they’re taken outside into the cool air at night.”

But not every method works for every child, the pediatrician said. And it’s never a bad idea to get a second opinion if you don’t think your child is getting any better.

“If those home remedies resolve some of the symptoms and the child is comfortable, then that’s fine,” Dr. Lucia said. “But if things get worse or don’t get any better, then that’s when they need to be seen by a physician so we can give them an oral steroid, which helps with the inflammation of the upper airway.”

If you do decide to take your child to be evaluated—whether that’s in the doctor’s office or the ER—the doctor will likely diagnose your child with croup based on his or her physical symptoms and the child’s medical history.

“The physician will make sure that there hasn’t been any recent allergic reaction exposure or foreign body ingestion before diagnosing,” Dr. Lucia said. “But most of the time, this time of year, it is croup.”

And if your child has had a bad case of croup before or has lung problems due to asthma or lung disease from prematurity, then he or she could be more susceptible to contracting croup.

“Any time there’s something constricting the airway, it makes it tougher for those kids because they have fewer reserves,” he said. “It becomes an issue quicker than it does with kids who have no previous lung problems.”

Parents should also note that the degree of your child’s symptoms could change from when they were initially diagnosed.

“If they seem to be getting worse or something changes at home, then they may need to be seen again,” Dr. Lucia said.

The illness usually peaks at day two or three, and lasts less than a week.

“A very small percentage of children contract a more severe form of croup,” the doctor said. “My son was hospitalized last year from very severe spasmodic croup. But with all of the kids I’ve seen in my career, I’ve probably  seen less than five children who have ever needed hospitalization for croup.”

Although this common illness is mostly mild, there’s nothing wrong with having your child evaluated by a doctor if you’re unsure of the severity of your child’s symptoms. And Dr. Lucia said the best way to help your child keep from contracting this illness is to instill good hand-washing habits and practice what you preach.

“But it’s very hard to prevent the transmission of viruses among children when they’re in that age group,” he said. “You can do the best you can, but if your child gets it, it’s not because you didn’t do a good job of preventing it. A lot of times it just happens.”

For more information about croup and other childhood illnesses, check out the McLane Children’s Scott & White online health library.

Has your family dealt with croup? What home remedies helped you and your children get a better night’s sleep?

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