Croup

What is croup?

Croup is a common childhood illness which effects both babies and young children. It is an illness of the Larynx (Voice box) and the trachea (windpipe). These are the upper and lower parts of the breathing tube, which connects the mouth to the top of the lungs. Croup can cause your child’s vocal cords to become swollen and sore making them produce more mucus.

This is usually caused by a viral infection and is more common during late autumn and early Winter and may start with cold like symptoms (runny nose, cough, and fever) but can also appear without any other illness. Croup is most contagious during the first few days of the illness and is spread like the common cold making it difficult to prevent. Regular handwashing and cleaning surfaces are the main defence against croup.

Symptoms of croup:

‘Croupy ‘Cough – A harsh barking cough (sounds like a seal bark) this is due to the swelling around the vocal cords and is often worse at night.

Breathing symptoms – Your child may have a harsh crowing sound (Stridor) on each inward breath and a high-pitched whistling (wheeze) while breathing out. Symptoms can worsen in dry chilly air (frosty weather).

Other symptoms – Hoarseness and complaints of a sore throat.

Treatment:

Symptoms are usually mild and can normally be managed at home, with the worst of the symptoms seen in 2-3 days, however, the cough and wheeze may linger for another 1 – 2 weeks. The symptoms of croup can be very distressing therefore It is important for your child to try and stay calm as crying can make their symptoms worse. Keep your child sitting in an upright position and offer them comfort. Your child’s appetite may decrease during the illness, but it is important to keep offering regular sips of fluid (cold drinks will be soothing for their sore throat) to ensure they remain hydrated. Their appetite will increase as they start to feel better within a few days.

If you feel your child is in discomfort, it is fine to give some paracetamol and/or Ibuprofen to help with their symptoms. Your child may return to nursery or school when their temperature is normal, and they feel better. Even if the cough is still lingering this is no reason to keep them at home.

Treatments to avoid:

We would not recommend the use of steam, there is no evidence to support this as being effective and it may put you or your child at risk of being scalded. Do not give your child cough mixtures as these can cause drowsiness and will not help them when they need to make extra effort to breath and could be dangerous.

How serious is croup:

You should seek advice from your doctor’s surgery, NHS 111 helpline or bring them to the Urgent Care Centre out of hours if you feel frightened or your child’s condition gets worse. A diagnosis is usually made by the doctor examining your child and no other special tests are normally required. In some children croup can be severe and your child may need to be admitted into hospital for further observations, but most children are usually discharged home within 24 hours.

Treatment in hospital:

A steroid called Dexamethasone or prednisolone is usually prescribed to treat more moderate episodes of croup, which will help to reduce the swelling in the airways and make your child breathe easier. Often only a one-off dose is needed however it can be repeated after 12 hours if required. In some cases, your child may be given Adrenaline and oxygen through a mask (nebuliser) for more severe episodes. Because croup is caused by a viral infection, antibiotics are not routinely prescribed.

Videos

Thank you to ASKSNIFF for providing this video.

Useful links

The Black and Asian Family (Barnardos) helpline