Kids MD

CARING FOR CROUP

By Dr. Heather Joyce

Waking up to your child coughing and struggling to breathe can be one of the most frightening situations as a parent. If you have ever experienced this, it’s hard to forget the sound of the barking, seal-like cough and wheezing.

Croup is caused by a virus and often comes with fever, runny nose, cough and a hoarse voice, as well as difficulty breathing. Multiple viruses can lead to croup, including parainfluenza, influenza, RSV and COVID-19. Symptoms are caused by swelling in the vocal cords. The high-pitched wheezing noise when breathing in is called stridor. Croup can be mild with solely a barky cough or severe with cough, stridor and difficulty breathing.

With mild symptoms, supportive care with nasal saline, honey (for kids older than 1), humidified air and ibuprofen or acetaminophen is appropriate. If your child wakes up with sudden difficulty breathing, though, take these steps: „ Remain calm, and calm your child. I know – easier said than done – but anxiety will make your child worse. „ Turn your shower on in your smallest bathroom to the hottest setting, closing vents and doors. „ While steam is filling up the bathroom, take your child outside in the cold air. If it is not cold outside, hold your child in front of an open freezer. „ Sit with your child in the steam-filled bathroom for 10 to 20 minutes. „ If stridor continues after these steps or your child appears blue, is drooling or is struggling to breath, seek medical care; urgent care or the emergency department are appropriate. There, your child will receive a dose of steroids and possibly a breathing treatment. On rare occasions, children need to stay in the hospital for humidified oxygen and frequent breathing treatments.

If your child falls back to sleep without stridor or difficulty breathing after these steps, then call your pediatrician the next day. A dose of steroids can help decrease the severity and length of symptoms. Typically, croup lasts three to five days, and the worst symptoms are nights two and three, so a trip to your pediatrician can help you and your child get a better night’s sleep. ln For more information or to find a pediatrician, visit mercy.net/laduenews. Dr. Heather Joyce is a pediatrician and pediatric medical director of Mercy Clinic in the St. Louis area.