Am Fam Physician. 2004;69(3):541-542
What is croup?
Croup is a common infection that causes swelling in the trachea (windpipe) and larynx (voice box).
Who gets croup?
Croup occurs in children six months to 12 years of age. It is most common in children one to three years of age. Because croup is caused by a virus, it can spread to other children through coughing and sneezing. The virus also is spread by dirty hands, shared toys, and shared drinking glasses or spoons and forks.
How can I tell if my child has croup?
Symptoms of croup include:
A mild fever
A barking cough
In more severe cases, you may hear a harsh, loud, high-pitched noise (called stridor) when your child takes a breath. Other symptoms of severe croup include:
Fast or difficult breathing
Retractions (your child's chest and stomach muscles suck in)
A blue tint to the lips and fingernails
Symptoms of croup may be worse at night.
How is croup treated?
Most cases of mild croup can be treated at home. Children often like to sit up or be held upright. Crying can make the symptoms worse, so keep your child quiet and comfortable. Your child should have lots of rest and plenty to drink. Cough medicines usually don't help. You can give your child acetaminophen (brand name: Children's Tylenol) or ibuprofen (brand name: Children's Advil or Motrin) for fever or chest discomfort.
What if my child has stridor?
If your child has stridor, it may help to take him or her outdoors into the cool air for 10 minutes. You also can use a cool mist vaporizer. In addition, try having your child breathe warm moist air. This can be done in several ways:
Run hot water in your shower with the bathroom door closed. After the bathroom becomes steamy, sit with your child in the room for about 10 minutes.
Have your child breathe through a warm, wet washcloth lightly placed over the mouth and nose.
In some cases, your doctor may prescribe medicine to help your child breathe easier. Occasionally, your child may need to stay in the hospital.
How long does croup last?
Croup may last for three to five days.
However, the child can have a mild cough for a few days longer. Most children with croup get better without problems.
How can I prevent croup?
To help prevent croup, you should:
Ask everyone in your home to wash their hands often.
Throw away dirty tissues from runny noses and sneezes right away.
Frequently wash toys in hot soapy water if a child with a respiratory infection has had the toy in his mouth.
Ask anyone with a cough to avoid kissing or playing with your child.
When should I call the doctor?
Watch your child closely and call the doctor if your child:
Starts drooling or has trouble swallowing
Has blue lips and fingernails
Becomes restless or confused
Does not sound better after the moist air treatment or going outdoors
Has more trouble breathing
Where can I get more information?
Centers for Disease Control and Prevention
1600 Clifton Rd., NE
Atlanta, GA 30333
Telephone (toll free): 1-800-311-3435
American Academy of Pediatrics
141 Northwest Point Blvd.
Elk Grove Village, IL 60007-1098
Telephone (toll free): 1-847-434-4000
American Lung Association
New York, NY 10006
Telephone (toll-free): 1-800-586-4872