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Croup: What to do when a child has a barking cough

Sometimes, kids’ symptoms are scarier than their actual illness. Thankfully, that’s the case with croup. Characterized by a barking cough, croup is an infection of the upper airway found most often in children under the age of 6. The infection is most common in the fall and winter due to its main cause — swelling around the airway following irritation from a cold or the flu.

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How can parents identify croup?

The most obvious sign of croup is a seal-like barking cough. This cough is often worse at night and can be heard along with noisy breathing. These symptoms typically last three to five days and are consistent across the three types of croup:

Viral croup

Caused by a viral infection of the voice box and windpipe, viral croup can follow a cold. Sometimes, beyond the barking cough and noisy breathing, children with viral croup will also have a fever.

Spasmodic croup

Unlike viral croup, spasmodic croup is not associated with a fever and can be caused by asthma or allergies. This type of croup can be scary because it often intensifies at night causing the child to wake with trouble breathing.

Croup with stridor

Stridor, or noisy breathing caused by a narrowed or obstructed airway, results in a high-pitched breathing sound. In rare cases, the stridor can cause serious difficulty breathing, in which case the child needs to be taken to the hospital.

How is croup treated?

Most often croup can be treated at home similarly to a cold. Using a humidifier and pushing fluids can help soothe your child’s throat and lessen symptoms. Keeping your child calm is important because crying or agitation can make breathing more difficult. If your child has a fever, acetaminophen or ibuprofen (for children older than 6 months) can be used.

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Some parents try taking their child in a steamy bathroom or into the cool night air, but there is no research showing that these home remedies are helpful.

Croup is not contagious. However, it often is prompted by viral infections like cold or flu, which are contagious. Frequent hand-washing and a flu vaccine can help prevent these and, ultimately, croup.

In most cases, croup is a minor illness that will take a few days to get better. If a child’s symptoms don’t improve after five days, or if they worsen, call a pediatrician. Also, if stridor is present while resting, the child should see a doctor to ensure breathing isn’t being restricted. Steroids may be prescribed to reduce inflammation in the airway if the child’s breathing gets too difficult.