Facts and advice about croup and barking cough. By your paediatrician online. When a child gets croup, you will hear a harsh cough, normally during the night. Sometimes your child will struggle breathing.
Barking cough can be croup cough
In this video you can hear a child with typical croup cough. You may also notice how she struggles breathing (look at her chest and rib cage wihere each breath causes retractions of her skin between the ribs).
A child with a light croup episode will only show some harsh cough while a child with more severe croup will struggle breathing. Every inhalation will sound harsh and loudly.
What is the cause of croup?
In some children, the voice box (larynx) gets swollen when the child contracts a cold. This swelling causes the cough and also the harsh breathing sounds known as stridor.
When do you need to seek medical care for croup?
If your child just have a light croup cough, but is breathing calmly and is not too distressed about their cough, it is wise to stay at home taking care of the symptoms. On the other hand, if your child struggles breathing, you should seek medical attention. As it is most common to get croup during night time, it will probably be at an emergency department.
More severe croup episodes where your child struggles breathing and each inhalation sounds harsh, definitely need emergency medical care. If your child has a medical condition involving malformation of their upper airways, croup might be life threatening if not treated immediately.
What should I do when my child gets croup?
Calm your child!
When your child gets a croup cough attack, you should:
1. Calm your child!
2. Calm your child!
3. Calm your child!
It's so important! When a child with croup gets upset, the barking cough starts, and it might even aggravate the swelling of the airways. So take up your child in your arms, caress and sing their favorite lullaby. If yur baby stops coughing and falling asleep, sit gently with them half upright against your chest in bed and let them sleep there. If your child sleeps quietly for an hour, you can put them in bed.
Does cold air help for croup?
Cold air is often recommended as a remedy for croup. There is no scientific evidence supporting its use.
But why not try it? If calming your child does not help against the cough, try sitting with your child in your lap, well dressed close to an open window if it is wintertime and cold outside.
When should I go to the hospital?
If your child has croup cough disturbing them for a longer period of the night, seek medical care. There are effective medications.
If your child has croup cough and has difficulties breathing: go to the ER!
If your child has croup cough and is finding it so hard to breathe that the child panics, or must devote so much energy to breathing that they are just lying down and struggling breathing: call an ambulance!
Treatment for croup
There are two effective medications against croup.
1. Inhaled adrenaline (epinephrine). Helps well within 30 minutes but the effect does not last longer than two hours.
2. Cortisone tablets (dissolve in water before giving them to the child). Takes effect within 6 hours for 12, but not 24 hours after the dose.
Prescribed medications against croup?
Unfortunately, at least in Sweden, there are no available formulations of inhaled adrenaline for easy home use. If your child has a nebuliser at home for severe asthma it might be possible to prescribe adrenalin for home use for use in such a machine.
Cortisone tablets can be prescribed, but they are not recommended to prescribe for children who have had occasional, or lighter croup attacks. These are potent drugs that should not be taken unnecessarily or overdosed. However, if your child suffers repeated attacks, consult a doctor if it is possible to have cortisone tablets at home to be able to curb an attack.
Cough medicines, such as Mollipect, Cocillana and Lepheton, do not help against croup.
Croup or wheezing?
Croup is caused by a swelling in the upper airways, the voice box, giving a barking cough and inspiratory harsh sounds. Wheezing, or viral asthma, is caused by an inflammation of small airways periferically in the lungs. The wheezing sounds comes at the expiration phase of breathing, and the cough is wheezy, whistling.