Croup, for parents who haven’t been through it before it can be a pretty frightening experience, and one that might need urgent medical attention.

Australian paediatric doctor Dr Nelu, who has worked in some of the busiest emergency departments in the country, shared her tips.

“Knowing a bit about it might be able to help you recognise the symptoms and prepare you for when it hits, shares Dr Nelu…”

What is it?

Croup is a viral infection that causes inflammation and swelling of the voice box and windpipe / the top of your child’s breathing tube. It usually effects children from 6 months of age to around 6 years of age and some children can get it more than once. It generally lasts up to 4 days and is usually worst on the 2nd or 3rd night.

What happens when your child has croup?

Croup usually starts with upper respiratory symptoms such as cough or runny nose (like a cold)

Then they develop MILD symptoms such as:
– HOARSE VOICE: this might be noticed when crying or speaking
– Cough then changes to a HARSH, BARKING or SEAL LIKE COUGH (I don’t like to encourage ‘Doctor Google’ but if you type “croup cough” in to YouTube there are lots of videos. If you hear it once you’ll know what it sounds like. Please don’t read the gibberish out there about it!)
In the 2nd or 3rd night (or sooner) they can develop more SEVERE symptoms of croup:
– NOISY / SQUEAKY BREATHING SOUND called a “Stridor” (again….have one quick listen on YouTube! Please note there are other things that can cause stridor. One of the more severe causes is no longer seen because of immunisations so always make sure your children are immunised where possible)
– HEAVY BREATHING: sucking in under their ribs to breathe, sucking in the neck with each breath, becoming very distressed with the breathing

** The last two symptoms NOISY BREATHING and HEAVY BREATHING may be worrying symptoms and might indicate when your child should be seen by a doctor immediately

How can we treat it?

Because Croup is caused by a virus we have no treatment for it.

Doctors can prescribe a single or 2 day course of steroids which helps with the inflammation in MILD symptoms (hoarse voice and barking cough).
For more SEVERE symptoms (stridor and heavy breathing) your child should be assessed by a doctor immediately and they may need another medication called Adrenaline via a nebuliser which acts very quickly to help with the swelling of the voice box and windpipe allowing oxygen to get in to the lungs adequately.

What can you do?

For MILD croup symptoms (barking cough, hoarse voice) with no stridor (noisy breathing) or heavy breathing you can try the following:

– See the GP to assess if they need oral steroids
– Try to keep your child calm and distracted when possible (when they are irritated or upset the symptoms can get worse)
– They may be a bit more clingy and more settled with a parent around, especially at night time when it usually gets a bit worse
– If they are really miserable you can try Paracetamol (e.g. Panadol) or Ibuprofen (e.g. Neurofen) at the correct doses to help make them feel a bit better
– There is no harm in trying vaporisers or steam which might help some children, but this doesn’t have a proven effect and does not replace medications when it is required

For SEVERE croup symptoms (noisy breathing / stridor, heavy laboured breathing) see a doctor immediately / or call the ambulance if concerned as they may require additional medication to reverse the swelling quickly.

If your child turns BLUE AROUND THE LIPS or becomes very PALE AND LETHARGIC call the ambulance immediately
Croup can be a medical emergency so it is important to recognise these symptoms and seek medical attention if you have any concerns.

Share your comments below.

More tips from Dr Nelu:

• 10 things all parents should know.
• Doctor Issues Warning About This Health Product