Conquering Croup
Your 1-year old son has a cough like a trained circus seal: Deep throated, congested and rough. It is unrelenting and sounds like he can’t catch his breath. He also has a fever. Before the cough he had a runny nose. He could have croup.
Croup is a viral infection of the throat, airways and lung breathing tubes that occurs most often in children ages 1 and 2. The infected structures swell, and the subsequent acute airflow obstruction produces a shrill inhalation and hoarse, barking cough. It sounds a lot worse than it is.
Croup is caused by a virus, not bacteria so antibiotics won’t do any good. Some signs that croup is turning into an emergency are stridor (the noise you make when breathing) heard both in the inspiration and expiration of breath, a drawing inward of the breastbone on inspiration, along with agitation and anxiousness on the baby’s part. These children should be taken to the emergency room immediately.
In fact, there’s evidence to suggest that the cool crisp air during the night helps ease the breathing problems of croup. The soothing vibration of the car might also be beneficial in terms of recovery from the illness. But some experts believe it may not be the change in air temperature but the presence of a comforting parent that makes the difference.
Annually in the United States, croup accounts for 7 percent of hospitalizations in children younger than five years of age. Like all respiratory infections, according to physicians, croup strikes boys more often than girls.
The chief cause is a viral infection, most from one of the parainfluenza viruses that peak during the autumn months. Older children and adults are less susceptible to croup because their airways are large enough and strong enough not to collapse from any inflammation caused by the virus.
While most cases are mild enough to be treated at home, about 10 percent need hospital treatment because of breathing problems. Croup usually lasts for three to five days and is accompanied by a high fever.
It peaks in the first couple of days. The coughing tends to occur late at night or in the wee hours of the morning. Then your child can be fine during the day and then it recurs during the night.
Parents seeing their first case of croup can be alarmed by the cough, which is highly congested. For mild cases, a child should get plenty of fluids and rest. Crying and fatigue can worsen the condition.
The key to treatment is moisture and lots of it. In less severe cases, the steam from the shower can produce a calming effect when it comes to easing croup symptoms. A cool mist in your child’s bedroom may have the same effect.
Over-the-counter cough medicines that have an expectorant (like plain Robitussin or yellow Triaminic) may loosen things up a bit and provide some symptomatic relief, but avoid antihistamines, because they can be a little too drying. Fever is quite high in croup, which really exacerbates the breathing problems (fever for any reason will make you breathe harder and faster and this is especially noticeable in croup) so be generous with Tylenol and/or ibuprofen.
In some cases, your doctor may prescribe steroids to reduce the swelling. Studies show that steroids may be beneficial even in mild croup, resulting in faster clinical improvement and increased sleep for the whole family.
If needed, your child could be given epinephrine (adrenalin) which can be administered by a nebulizer.
The most important thing you can do to help your child is to consult your doctor when in doubt about your child's condition. Holding and comforting a croupy child keeps him upright and reduces agitated breathing, helping to alleviate symptoms. The illness simply has to run its course and your child will recover within days.
