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Facts and advice about croup and barking cough. This blog is written by pediatricians for parents. ‘False’ croup, viral croup or croup as we know it today, manifests itself as a barking cough, often at night, in young children. Sometimes children have trouble breathing. Interestingly, the ‘real’ croup caused by diphtheria, has been eliminated in most countries thanks to effective vaccination programs. When we talk about the disease today, we refer to ‘false’ croup, which is a viral disease.

Barking coughs may be croup

What does croup sound like? This video will allow you to see and hear a child experiencing croup. The coughs are special barking sounds, typical of croup. You can also see how difficult it is for the child to breathe (pay attention to the child’s chest).

Click here to see a child with croup coughing.

Mild croup is noticeable only by the barking cough. Severe croup is when the child also has difficulty breathing, or their inhalation becomes noisy and sounds ‘harsh’.

What causes ‘false’ croup?

The cough and other associated signs and symptoms of croup are due to swelling of the upper respiratory tract (around the vocal cords) and appear in conjunction with colds. ‘False’ croup is also called laryngitis, or acute obstructive laryngitis. In some children, the disease tends to recur with colds.

When do I need to seek medical care for croup?

Mild croup where the child is experiencing a light barking cough without the labored breathing, is not dangerous. However, it usually affects both children and parents’ sleep. Learn how to assess whether your child has difficulty breathing in the post about labored breathing in children.

Severe croup, where the child has difficulty breathing, and every inhalation is noisy, can become dangerous. In rare cases, often in young children, and children with particularly narrow or malformed respiratory tract, the condition can become life-threatening if it is not treated in hospital.

What should I do when my child gets croup?

Keep the child calm!

When your child has a coughing attack, you should, at the highest priority, keep the child calm.

This is so important! When a child with croup gets upset, the coughing begin. And I believe that it exacerbates the swelling of the airways itself. Take your child up into your arms, comfort and sing their favorite lullaby. If they stop coughing and fall asleep, position them slightly upright on your lap or against your chest. If they sleep peacefully for an hour, you can place them in their bed.

Does cold air help relieve croup?

Cold air is often recommended to relieve ‘false’ croup. There are no scientific studies done on whether cold air helps. There are a couple of small studies done to see if inhaling steam helps, but they have shown no benefit.

Feel free to try, though. If you cannot calm your child, try to sit down with them wrapped in a blanket by an open window. If it helps, great! Then allow them to sleep under extra thick duvets with open windows.

When do we go to the hospital?

If your child has frequent repeated coughing attacks associated to croup, and sleep becomes impossible; go to the pediatric emergency room or emergency room. There is effective treatment!

If your child has a barking cough and difficulty breathing; go to the pediatric emergency room!

If your child has a barking cough and is struggling to breath to the point where they panic; or if they have to devote so much energy to breathing that they lie slack; call the emergency services and request an ambulance!

Treatment for croup

There are two effective medications for croup:

Inhaled adrenaline – This works within 30 minutes but the effect does not last longer than two hours.
Corticosteroid tablets (dissolved in water before giving them to the child) – This is effective within 6 hours and works for 12 hours, but not 24 hours after the dose is given.

Medicines for croup on prescription

Unfortunately, doctors cannot prescribe inhaled adrenaline for home use. It is only available via inhalation machines and is not available for home use for the treatment of croup. If your child has really severe asthma, then a doctor can prescribe adrenaline via a nebulizer.

Corticosteroid tablets can be prescribed, but should not be given to children who have only had the occasional, or mild croup attacks. These are strong drugs that should not be taken unnecessarily or overdosed. However, if your child has repeated attacks, check with a doctor whether you can get corticosteroid tablets to have at home. Corticosteroids decreases the length of coughing attacks.

Cough medicines (such as Robitussin, Benylin and Lepheton) do not help against croup.

Croup or asthma?

Croup is a swelling in the vocal cords, which gives a barking cough and bee-like sounds upon inhalation. Some children tend to get croup when they have a cold. Asthma is the inflammation of small bronchial tubes in the lungs. The wheezing is evident upon exhalation, where the child squeezes out air and it becomes prolonged. The cough often sounds squeaky.

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