Croup | Mate maremare pēpē

Croup is a viral illness in young children, which causes narrowing of the upper airways. Some children have recurring croup and this may need further assessment. This video may take a few moments to load.

Source: Armando Hasudungan(external link)(external link) YouTube 

When you breathe, air passes through the voice box (larynx) and windpipe (trachea) into the lungs. In croup, a viral infection causes inflammation and swelling of the lining of the voice box and windpipe, which become narrowed. When the airway becomes narrowed, breathing in becomes more difficult, and you can hear stridor (a harsh noise when breathing in).

Image credit: 123rf

Babies and children 6 months to 3 years are at most risk of getting croup, but children who are younger or older can also get it. As children grow, their windpipe strengthens, lessening their chance of getting croup. It is common in the autumn and spring. 

Croup is usually caused by a viral infection. If your child has repeated occurrences of croup (more than 1 per year), or is under the age of 6 months or over the age of 6 years and gets croup, you should contact your doctor. Your doctor may arrange further investigation or refer you to a specialist to see if there is another cause. 

Croup often starts like a common cold with a slight fever, red eyes, sore throat and runny nose.

• After a few days, other symptoms develop including a barking, seal-like cough and raspy noise when they breathe in (stridor).
• Symptoms are almost always worse at night and crying generally makes the barking cough and noisy breathing worse.
• Croup is usually worse on the 2nd or 3rd night and can last up to a week, though the cough can last longer. As the child gets better, the cough will usually become looser.
• Croup is contagious for about 4 to 6 days and is spread by droplets in the air from coughs and sneezes.

Some children can have a form of croup that comes on quickly, often at night, but also resolves after about an hour or so. These children may be more likely to already have asthma or to develop asthma.

KidsHealth has plenty ofuseful information and videos with signs that children are struggling to breathe(external link)(external link).

Video: Doctor explains Croup with real example of Croup sounds! | Barking Cough in children

 Source credit: Doctor O'Donovan(external link)(external link) , YouTube 2021

The treatment of croup depends on how severe the illness is. Because croup is caused by a virus, a mild case will usually clear up on its own. You can use simple self-care measures such as those listed in the table below to keep your child comfortable. Moderate to severe cases need observation in hospital, often overnight. 

What not to do

• Don't use steam. It can be dangerous for your child because of the possibility of burns or scalding.
• Don't put anything in your child's mouth to look at their throat. This may make symptoms worse.
• Do not give your child cough medicines. These will dry the mucus, making the airways even smaller.

• Paracetamol can be given if your child has a fever or a sore throat.
• Sometimes steroids (prednisolone) taken by mouth are given for croup. The steroids help reduce the swelling in the airways and this will make breathing easier.
• If the croup is very severe, your child may be given nebulised adrenaline which reduces the airway swelling and makes breathing easier.
• Antibiotics are not used to treat croup unless your child develops a bacterial infection as well. This can be diagnosed by your doctor.