Croup is a common childhood condition characterized by inflammation of the windpipe (trachea), airways to the lungs (bronchi), and voice box (larynx). It typically affects children between 6 months and 3 years of age, peaking in 1-year-olds, and is more common during late autumn and early winter months. While rare in adults, children may experience croup more than once.

Symptoms of Croup

Children with croup often have:

• A barking cough that resembles a seal’s bark.
• A harsh sound known as stridor when they breathe in, often more noticeable during crying or coughing.
• A hoarse voice and difficulty breathing due to airway obstruction.
• Cold-like symptoms may appear before the onset of croup symptoms, which usually worsen at night and can last a few days to two weeks.

When to Seek Medical Attention

Call 999 or go to A&E if your child:

• Has severe difficulty breathing, rapid breathing, or cannot drink fluids.
• Displays distress, agitation, or abnormal drowsiness.
• Shows blue or pale skin, particularly around the lips or extremities.
• Experiences retraction of skin around the ribs or chest during breathing.

Contact your GP if your child:

• Is under 3 months old with a fever of 38°C or above.
• Is 3 months or older with a fever of 39°C or above.
• Has a distinctive barking cough and makes a harsh noise when breathing in.

Diagnosis of Croup

A GP diagnosis typically involves checking the child’s symptoms and listening to their cough. You may be asked to:

• Record your child’s cough to show the GP.
• Provide details about recent illnesses or infections.
• Have a pulse oximetry test to measure oxygen levels.
• Your GP may rule out other conditions with additional tests.

Avoid checking your child’s throat yourself, as it could trigger airway spasms, making breathing worse.

Treatment for Croup

Most cases of croup are mild and can be managed at home by:

• Keeping your child upright and comforting them to reduce distress, as crying may worsen symptoms.
• Ensuring they drink plenty of fluids to prevent dehydration.

Medication:

• A single dose of oral corticosteroid like dexamethasone or prednisolone may be prescribed to reduce throat swelling. Possible side effects include restlessness, vomiting, and upset stomach.

Pain Relief:

• Children’s paracetamol may help lower fever and ease discomfort.
• Aspirin should not be given to children under 16 years of age.

Avoid using cough medicines or decongestants as they are ineffective and may cause drowsiness, which can be dangerous for children with breathing difficulties.

Hospital Treatment: Severe cases may require hospital treatment, such as administering adrenaline or oxygen.

Causes of Croup

The condition is primarily caused by a virus, often the parainfluenza virus, and is spread through close contact with infected individuals or contaminated surfaces. Other viral causes include:

• Influenza A and B (flu viruses)
• Measles (in unimmunised children)
• Rhinovirus (common cold virus)
• Enteroviruses
• Respiratory syncytial virus (RSV)

Less common causes include:

• Inhalation of a small object (foreign body)
• Inflammation of the epiglottis
• Severe allergic reactions (anaphylaxis)
• Exposure to irritants like chemicals
• Acid reflux

Preventive Tips

• Wash hands regularly to reduce infection risk.
• Immunization against flu and measles can help prevent some causes.
• Minimize exposure to known irritants and allergens.

Croup often improves with supportive care, but it is important to monitor symptoms and seek medical advice as necessary, especially if symptoms worsen or new concerns arise.