Croup

What is croup?

Croup is a viral infection causing swelling of the upper airway of babies and children.

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Does my baby have croup?

Children with croup may have a ‘barking’ cough; breathing difficulty; a hoarse voice; and a rasping noise when inhaling. Cold symptoms like a runny or blocked nose, a cough, and a temperature are usually also present. Your child’s croup symptoms may be worse at night.

What to do if my baby has croup?

Usually symptoms are mild and subside within a few days. Looking after your child at home as with any viral illness, ensuring that they drink plenty of fluids and using pain relief is usually all that is needed.

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When to see a doctor?

If you are worried about your baby, the symptoms are getting worse or not improving, you should see a doctor. In some cases an oral steroid medication or nebuliser may be needed to help ease the airway swelling and help ease breathing difficulty. Some children have recurrent episodes of croup and a medical assessment is recommended to ensure there are no other causes to the symptoms.

You should call 999 or go to your nearest accident and emergency department if; your child is displaying signs of severe breathing difficulty, which might involve their breathing sounding abnormal, or their stomach and chest wall appearing to suck in (recession); they develop a pale, blue or grey colour on their skin or lips; they get a very high temperature suddenly; or if they appear abnormally still and quiet.

Fortunately this kind of situation is rare and children make a quick and complete recovery.

What are the symptoms of croup?

It is normal for croup to start as a cold, and in some cases, a child will develop symptoms which are commonly associated with a cold. These symptoms can include: a dry barking cough that can worsen with crying; laboured or noisy breathing; and a hoarse voice. These symptoms are usually worse at night.
Croup symptoms will typically last from three to five days.

There are some, more severe, symptoms which require that you seek medical attention immediately. These symptoms include: difficulty swallowing; drooling; severe difficulty breathing; or cyanosis – the development of blue or greyish skin at the mouth, nose or fingernails.

Is croup contagious to adults?

Croup is caused by respiratory viruses and therefore is a contagious condition, but croup symptoms tend only to affect children. A child may pass the virus to an adult, but the virus does not usually affect adults in the same manner that it affects children. This is because adults have larger upper airways in the lungs than children.

What causes croup?

Croup is normally caused by the parainfluenza virus, and other respiratory viruses. The virus spreads when a child breathes in air droplets after a person who is infected coughs or sneezes. Droplets can also be present on surfaces and can be passed when a child touches an object, before touching their nose, eyes or mouth.
Swelling around the windpipe, vocal cords and bronchial tubes which is caused by the virus leads to the common croup symptoms.

How is croup treated?

Most of the time, a child with croup can be looked after at home comforting and calming your child; giving your child fluids; encouraging rest; and using simple pain relief such as paracetamol for children.

Medications – such as oral steroid medicine (dexamethasone) and nebulised steroids (budesonide) and in more severe cases nebulised adrenaline ( epinephrine) – may be prescribed for children whose symptoms have continued past five days, or are worsening.
For cases of croup in which your child is displaying severe symptoms, he or she might need to go to hospital for monitoring and to be given additional treatments.

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