Is your child’s coughing a sign of the common cold – or something worse? That depends. If the coughing sounds like the “barklike” cough, your child just might have croup – a  children’s respiratory disease that blocks the airway to the lungs (1).

See the video below by pediatrician Dr. Paul Thomas for examples of the raspy, “barking” croup cough (6):

In severe cases, children with croup may develop serious breathing difficulties and other complications, like ear infections, asphyxiation, and pneumonia (1).

But what is croup – and how can you tell the difference between croup and the common cold?

What is croup?

croup cough what is croup

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Croup is a viral respiratory condition – caused most commonly by the “common cold” (parainfluenza) virus in the fall season (5) – that makes the airway to the lungs to swell up, mostly in children 6 months to 3 years old (1, 7).  However, any child 3 months to 15 years old may contract it (7).

Being a viral infection, croup is also highly contagious, by air or by physical contact, for 7 to 10 days following exposure to the virus (3). Parents and adults may therefore contract the croup virus as well, though it may manifest more commonly as the common cold or laryngitis, as adult airways are bigger and are not easily obstructed by swelling (8).  Croup in adults is possible but extremely rare; the symptoms of croup for adults are similar to the symptoms of children’s crop, except they tend to be more severe (9).

Croup can seem similar to common cold at first (7). Children with croup may initially exhibit cold-like symptoms, like a stuffy nose, coughing, fever, and fatigue (7). However, they may soon develop distinctive symptoms of croup as well, like a raspy voice, breathing difficulties, and a cough that mimics a dog or seal’s barking (7).

Most cases of croup are mild and may pass in 48 hours. However, if a child with croup does not recover within 48 hours or shows moderate to severe symptoms of croup, the child should be taken to a doctor (1).

In a typical North American city, less than 10% of children contract croup every year, with less than 5% of these children needing hospitalization from severe croup symptoms (7).

Symptoms of Croup

croup cough what is croup

Common symptoms of croup include (2,4):

  • Hoarse, “barking” croup cough
  • Raspy voice
  • High-pitched, squeaking sounds that accompany breathing (i.e. “stridor“)
  • Fast, labored breathing
  • Noticeable retractions of the skin (i.e. the skin between the ribs pulls when breathing)
  • Being unable to walk or talk due to breathing difficulties
  • Pale, bluish color around the mouth
  • Dry, sticky mouth (from dehydration)
  • Few or no tears when crying (from dehydration)
  • Thirst or peeing less (from dehydration)
  • Sunken eyes
  • Drooling
  • Having difficulty swallowing
  • Extreme fatigue
  • Restlessness, distress, or agitation
  • Being unusually quiet or still

These symptoms might get worse at night.

However, it is possible for your child to exhibit many croup-like symptoms without suffering from croup. Your child may not have croup if (4):

  • He/she does not have raspy, “barking” coughs. In this case, he/she may have the common cold instead.
  • He/she wheezes often and eats less than usual. This may indicate bronchiolitis, not croup.
  • He/she coughs frequently and “whoops” when breathing in. This could be indicative of the whooping cough.

Children that were born prematurely may be at greater risk of contracting croup (2). Children with a history of asthma and lung disease may also be at higher risk of developing croup (2).

Treatment for Croup

croup cough what is croup

Treatment options for croup can include at-home care, medication, and hospitalization, depending on the severity of the infection. Some of the most common treatment options for croup include:

  • Hydration. You should give your child plenty of fluids to prevent dehydration, a common symptom of croup and cold-like viral infections (4). However, you should not keep your child in a steamy room (e.g. a bathroom after a hot shower) or get them to inhale steam (4).
  • Rest. Any child with a viral infection like croup should have plenty of sleep and rest.
  • Calming the child. Anxiety and restlessness will only worsen the symptoms of croup (8). You should try your best to keep your child calm and assure them that everything will turn out fine (8).
  • Steam. Taking a steamy shower or breathing in steam from a bowl of hot water can help relieve respiratory symptoms. You can also run a humidifier in the room at night. 
  • Homemade vapor rub. The right mix of natural ingredients applied to the chest can help soothe cough and congestion. Find our favorite recipe here!
  • Medicine. You should not give cough or cold medicine to children with croup (4). However, you can address their cold-like symptoms, like fevers, with child-appropriate doses of acetaminophen (to a child of any age) if desired. In children with mild croup, a single oral dose of dexamethasone, an anti-inflammatory allergy medicine, may help relieve swelling for up to 4 days (7). In children with moderate to severe croup, a mist of epinephrine or budesonide (anti-inflammatory medication), in conjunction with dexamethasone, may be more appropriate (7). However, these medications come with side effects so exercise with caution and discuss with your doctor if it is absolutely necessary.
  • Hospitalization. In severe cases of croup, your child may need breathing treatments, emergency doses of steroid medicine, or intubation at a hospital (1).

So the next time your child begins to show signs of cold-like symptoms, watch out for major symptoms of croup, like the “barking” croup cough. It could mean the difference between speedy recovery and serious breathing difficulties.

Sources:

  1. Petter, O. (2017). Parents warned to look out for ‘potentially dangerous’ cough in children. [online] The Independent. Available at: http://www.independent.co.uk/life-style/health-and-families/barking-cough-child-croup-outbreak-cases-rise-parents-warning-health-a7994381.html [Accessed 21 Nov. 2017].
  2. Kidshealth.org. (2017). Croup. [online] Available at: http://kidshealth.org/en/parents/croup.html [Accessed 21 Nov. 2017].
  3. Uofmhealth.org. (2017). Croup | Michigan Medicine. [online] Available at: http://www.uofmhealth.org/health-library/hw31906 [Accessed 21 Nov. 2017].
  4. National Health Service UK. (2017). Croup – NHS.UK. [online] Available at: https://beta.nhs.uk/symptoms/croup/?WT.mc_id=organic_split [Accessed 21 Nov. 2017].
  5. Rosekrans, J. (1998). Viral Croup: Current Diagnosis and Treatment. Mayo Clinic Proceedings, 73(11), pp.1102-1107.
  6. YouTube: paulthomasmd. (2017). CLASSIC CROUP: Live Diagnosis with Dr. Paul. [online] Available at: https://www.youtube.com/watch?v=P7VGxsxnJYE [Accessed 21 Nov. 2017].
  7. Johnson, D. (2017). Croup. [online] Aafp.org. Available at: http://www.aafp.org/afp/2016/0915/p476.html [Accessed 21 Nov. 2017].
  8. ChildrensMD. (2017). The croup has hit – ChildrensMD. [online] Available at: https://childrensmd.org/browse-by-age-group/newborn-infants/croup-hit/ [Accessed 22 Nov. 2017].
  9. Woo, P., Young, K., Tsang, K., Ooi, C., Peiris, M. and Yuen, K. (2000). Adult Croup: A Rare but More Severe Condition. Respiration, 67(6), pp.684-688.

Image and Video Sources:

  1. YouTube: paulthomasmd. (2017). CLASSIC CROUP: Live Diagnosis with Dr. Paul. [online] Available at: https://www.youtube.com/watch?v=P7VGxsxnJYE [Accessed 21 Nov. 2017].
  2. https://static.17h43.com/wp-content/uploads/2017/01/calmer-toux-enfant.jpg

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