Don’t (Cow)er from Croup!
You are curled up in your bed blissfully sleeping. Subconsciously you think that you are finally going to get a good night’s sleep, like one that you haven’t had since before you had children. Then a faint unease begins to grow in your parent brain. Something is triggering your mama bear instinct. It grows until you are fully awake.
You go into your child’s room and there is your toddler sitting up in bed, sweaty and feverish with tear-stained, bright red cheeks. He/she looks at you, inhales a wheezing breath and coughs out a dry, barking cough like a seal
You contemplate the best treatment – should you go outside and let your child gulp in cold, dry, air, or should you sit in the bathroom with the shower on full blast for hot steamy air?
Whatever you do, you realize it is going to be a long night.
The symptoms of croup. Croup is common in toddlers and young kids, most often affecting kids aged 6 months – 3 years. The scene is repeated throughout many households: you put your kid to bed with a slight cold only to be woken in the middle of the night with a very scary scene – a screaming child struggling to breath and coughing a deep, rattling cough.
The familiar cough can be self-diagnosed by most kids, “Mommy, I have the doggie cough!”
The cough and the difficulty breathing are due to swelling of the lining of the windpipe (trachea) and the voice box (larynx).
Children with croup will often also have hoarse voices, particularly when they cry, stuffy noses and a fever.
If the swelling continues, it can became more difficult for your child to breath, and you might hear a whistling or squeaking sound when they breathe in. This is called stridor, which is caused by a narrowed airway. Your child might also be taking quick breaths and you might see the skin between the ribs pull in when they are breathing (called retractions). In a very severe case, your child might have a pale or bluish tinge around the mouth.
The symptoms are worse at night (lucky you) and when your child is upset or crying. Outbreaks tend to occur in the fall and early winter. Croup symptoms last 3-7 days with a peak around 2-3 days after infection.
What causes croup? Croup is basically an infection of the airway that causes it to narrow. It is similar to laryngitis during a cold in adults, but because children have smaller airways, the narrowing causes more severe symptoms.
Croup is most often caused by, you guessed it, viruses. Common cold-inducing viruses such as parainfluenza virus, adenovirus or respiratory synctial virus are all known to cause croup.
Treatments for croup. Most cases of croup are mild and can be treated at home. If you can, try to get your child to calm down, which will help the coughing and difficulty breathing. Then you can try two different things: having them breathe in moist, warm air (such as a room steamy from the shower or a warm air humidifier) or breathe in cool air outside. Some people even alternate between the two. Breathing in the air helps soothe the windpipe.
Once they are calmed down, you may want to spend the night in their rooms. They will often have several bouts of coughing and difficulty breathing per night. Staying in the room will also let you watch them for signs that they might need to see a doctor.
You can also give them acetominophen or ibruprofen to lower the fever and help with any aches and pains.
When to call your doctor. Only about 5% of children with croup will require hospitalization. You know your child – if they are showing signs of obvious distress and you can’t relieve it, then you need to get help. Signs of distress include:
- Difficulty breathing
- Pulling in of the skin between the ribs when breathing (often seen in younger kids)
- Stridor when inhaling and exhaling
- Pale or bluish tinge around the mouth, nose or fingernails
- Difficulty swallowing
- Extremely sick and tired looking
How to avoid croup. Croup is caused by viruses that travel in respiratory droplets, so basic sanitary practices can go a long way to prevent infection. I can’t stress this enough: The most effective means of avoiding this and any virus, is simple: Wash your hands often and well!
Also you can teach your children to:
- Avoid touching their faces – the eyes, nose and mouth are perfect inlets for viruses
- Love their friends from afar – stay out of their faces, don’t hug and kiss so much, don’t share utensils, straws, etc…
- Stop touching everything in public. Some of these viruses can survive on surfaces for a while.
- Cover coughs or sneezes with the crook of the arm
- Wash hands (again!) after coughing or sneezing
- Use tissues and throw them away for goodness sakes!
Most children that get infected with a croup-causing virus never get croup, they just have a cold. But premature children, children with a prior history of croup, or children with other breathing difficulties are more susceptible. So if your child falls into one of these groups, they may be more likely to develop it.
Croup can be scary. But armed with the right knowledge you can stand tall in the misty bathroom rather than cowering in the corner.
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