Croup

Croup is a common respiratory problem in young children. It tends to occur in the fall and winter. Its main symptom is a harsh, barking cough. Croup causes swelling and narrowing in the voice box, windpipe, and breathing tubes that lead to the lungs. This can make it hard for your child to breathe.

An attack of croup can be scary, but it is rarely serious. Children usually get better in several days with rest and care at home.

Symptoms of croup are caused by narrowed airways. They may include:

• A barking cough. The cough is often compared to the sound of a barking seal. You'll know it when you hear it.
• A raspy, hoarse voice.
• A harsh, crowing noise when breathing in. Sometimes children breathe fast and need to sit up to breathe better.

Symptoms of croup often improve during the day and get worse at night. Sometimes children have croup attacks that wake them up in the middle of the night for a couple of nights in a row. Unless the illness is severe, a child with croup is usually alert and active. The child's temperature is usually normal or only slightly higher than normal.

Your doctor will probably be able to tell whether your child has croup based on your child's symptoms and a physical exam. The doctor may be able to identify the barking cough of croup over the phone.

The doctor may place a small clip called a pulse oximeter on your child's finger, toe, or earlobe to make sure that enough oxygen is reaching the blood.

Even though your child's coughing and troubled breathing can be frightening, home treatment usually eases the symptoms.

The illness usually improves in 2 to 5 days.

When home treatment isn't enough, medicines such as glucocorticoids or epinephrine may be used to decrease airway swelling. These are usually given in a doctor's office or an emergency room. In rare cases, your child may need to stay in the hospital to get extra oxygen or other treatment.

Medicines

• Have your child take medicines exactly as prescribed. Call your doctor if you think your child is having a problem with any medicine.
• Give acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for fever, pain, or fussiness. Do not use ibuprofen if your child is less than 6 months old unless the doctor gave you instructions to use it. Be safe with medicines. For children 6 months and older, read and follow all instructions on the label.
• Do not give aspirin to anyone younger than 20. It has been linked to Reye syndrome, a serious illness.
• Be careful with cough and cold medicines. Don't give them to children younger than 6, because they don't work for children that age and can even be harmful. For children 6 and older, always follow all the instructions carefully. Make sure you know how much medicine to give and how long to use it. And use the dosing device if one is included.
• Be careful when giving your child over-the-counter cold or flu medicines and Tylenol at the same time. Many of these medicines have acetaminophen, which is Tylenol. Read the labels to make sure that you are not giving your child more than the recommended dose. Too much acetaminophen (Tylenol) can be harmful.

Other home care

• Offer plenty of fluids. Give your child water or crushed ice drinks several times each hour. You also can give flavored ice pops.
• Try to be calm. This will help keep your child calm. Crying can make breathing harder.
• Give your child a hug, or offer a favorite toy.
• Sleep in or near your child's room to listen for any increasing problems with their breathing.
• Keep your child away from smoke. Do not smoke around your child or in your house, and avoid being around others who are smoking.
• Wash your hands and your child's hands often so that you don't spread the illness.