What to Do About a Barky, Croupy Cough?

Croup causes inflammation of a child’s upper airways (the voice box and windpipe) and is due to a virus.  It causes a child to have a barky cough and a hoarse voice, especially during crying. Croup typically occurs during the fall and early winter months and in kids under the age of 5. Most of the time croup is a mild illness. There are some children who seem to be more prone to croup when they start with cold symptoms. In many cases, the harsh barking cough similar to a seal occurs at nighttime and seems to respond the best to moist air. We recommend you take your child into a steam-filled bathroom by running a hot shower or placing a cool mist humidifier at the bedside. Also, taking your child out into the cold air can provide relief for the cough.

Croup usually lasts 3-7 days and is contagious for the first three days or until the fever resolves. Some children may only present with a common cold after being exposed to croup.

If we evaluate your child in the office, we may prescribe steroids to help decrease the swelling in the upper airways. Antibiotics are not necessary since croup is caused by a virus and not a bacterial infection.

If your child has any of the following signs, then you should take him/ her to the closest emergency room for evaluation:

• difficulty breathing (rapid and/or labored)

• retractions (this is when the skin tugs inward in between the ribs with each breath)

• stridor (a high pitched “eeee” sound that occurs when your child breathes in)

• blue or pale color around the mouth

• excessive drooling (this could indicate a foreign body or other life-threatening condition)

Your child may receive a breathing treatment in the emergency room that contains epinephrine if they have a severe case of croup.