| Croup is an infection that commonly occurs in children aged six months to three years in the late fall and winter. There are different viruses that can cause croup and they include the parainfluenza virus, RSV, and more rarely the influenza virus or adenovirus. While these viruses will usually just cause cold symptoms in older children and adults, in younger children they can cause inflammation and infection in the lower throat, including the windpipe (trachea) and voice box (larynx). This causes swelling and building up of mucus and other secretions that can cause narrowing of these air passages. It is this narrowing that causes the distinctive cough, which sounds like a barking seal. Your child may also make another noise, called stridor, which is a loud, high pitched sound that your child may make when breathing in and is often confused with 'wheezing' by many parents.
The barking cough of croup most commonly begins in the middle of the night, and most children had been fine earlier in the night when they went to bed. Your child may have had cold symptoms for a few days already and then wakes up with a loud, dry, barking cough.
While there is no cure for croup, some steps you can take to improve your child's breathing include increasing the moisture or humidity of the air he is breathing. This can be done by taking your child into the bathroom, closing all of the doors and windows and turning on all of the hot water. This will fill the room with steam and warm moisture and may help loosen the mucus and soothe the inflammation in his throat. Be sure to stay with your child and keep him away from direct contact with the hot water. This treatment may take up to 15-20 minutes to become effective. Keep in mind that it will not make the cough go away, it should, however, help him to breath better.
Another way to improve your child's breathing is to take him outside, where the air will be cooler and probably more humid than the dry air inside the house. A cool mist humidifier may also help.
While no medications are used for mild symptoms of croup, if your child is having a moderate or severe attack, your physician may prescribe a steroid medication to help decrease the inflammation in your child's lower throat. Another medicine called racemic epinephrine may also be given as a breathing treatment in a hospital setting if needed.
The first night of symptoms of croup are usually the worse, and while your child may be totally fine during the next day, symptoms may return the next night (but usually they are not as bad). Symptoms usually last about 5-6 days, but the first few nights are usually the worst.
Since there are different viruses that can cause croup, it is possible to get it more than once.
You should seek help from your physician if your child isn't improving with these measures or if he is having a lot of trouble breathing. Some signs that your child is having difficulty breathing, include a fast breathing rate, flaring of his nostrils, retracting (where you can see the muscles moving in and out between his ribs and at the base of his neck), being lethargic or inconsolable, making the harsh, stridor noise when he is breathing in, or if he is turning blue. You should seek emergency care for any of these signs.
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