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Croup 101: Symptoms, Causes and Treatments

This sometimes scary respiratory infection is important to have on your radar.


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That sharp, barky cough is a telltale sign that your kid has croup. Most of the time, this cold-like affliction will pass quickly, but not always. Here’s what to know.

Who Gets It

Croup is a respiratory infection that causes inflammation in the windpipe and the area directly below the voice box. It typically strikes during fall and winter and is usually (but not always) mild, lasting three to seven days. While it’s most common in kids ages 3 months to 5 years (6 percent of kids under 6 catch it every year), anyone can get it—it’s not bothersome in older children and adults because as people grow and their windpipes become larger, they can accommodate the swelling from croup without showing symptoms.

Symptoms

“The area just below the voice box is the narrowest part of the airway in a child, so croup causes a very specific type of barking cough that usually gets worse at night,” says Dr. Shawn Ralston, chief of inpatient pediatrics at Dartmouth-Hitchcock Medical Center and a spokesperson for the American Academy of Pediatrics (AAP). In more serious cases, it may also cause a stridor, which is a high-pitched whistling/wheezing sound made when your child struggles to inhale. Croup is often accompanied by signs of a cold, such as sneezing, a runny or stuffy nose or a low-grade fever.

How It Spreads

Viral croup is highly contagious (it spreads through coughing, sneezing and close contact) and is the most common type of croup, usually caused by the parainfluenza virus. Other viruses, such as adenovirus, measles and influenza, can cause croup, as well. 

Less common, spasmodic croup, can be caused by an allergy, breathing in something that irritates your airways or even acid reflux. This type of croup tends to manifest suddenly and is usually not accompanied by a fever. 

Treatment

Treatment options are generally the same for all types of croup, and in all but the most severe cases, home remedies are sufficient. “A child will cough more and have extra trouble breathing while lying down, so sleeping slightly upright often helps,” says Ralston. If he’s 1 year or older, you can prop him up with his pillows (never put a pillow in a crib with an infant, as it increases the chance of SIDS). 

Steam showers can help too, as can taking them from the steam shower directly outside into cool air. “Cool air makes the blood vessels in the upper airway constrict, which will reduce the swelling,” explains Dr. Lee Brooks, a pediatric pulmonologist in Voorhees, NJ, clinical professor of pediatrics at the Children’s Hospital of Philadelphia and the University of Pennsylvania and spokesperson for the AAP. 

Prevention

Like any virus, diligent hand washing and use of hand sanitizer is key to avoid catching it in the first place, and while you can’t vaccinate against croup specifically, you can vaccinate against certain viruses that cause croup, such as influenza and the measles. If you think your child has croup due to allergies, irritants or acid reflux, talk to your doctor about how to eliminate or treat the possible causes. 

Dina Roth Port is a freelance writer for national publications and author of Previvors: Facing the Breast Cancer Gene and Making Life-Changing Decisions

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