Croup is a hoarse, barky cough. It is also called laryngotracheobronchitis and is due to an infection affecting the larynx, trachea and bronchii. The vast majority of croup is due to viruses.
Croup often begins around 11pm or 1am with the child waking up with a harsh, barky cough. There can be a honky sound as the child breathes in. The child can be crying and upset, which exacerbates the sound.
The first episode of croup can be scary. In most cases, as the parents lift the child out of bed to soothe him or her, the honky sound will lessen. Some time-honored middle of the night treatments for croup are running the shower to steam up the bathroom, or wrapping the child in a blanket and sitting outside on the stoop. Cool, moist air helps lessen the congestion around the vocal cords and helps the child feel better. There are many instances where parents have rushed the child to the ER, and the croupy cough has markedly improved with the combination of cool air and the child sitting upright in their car seat.
How to treat croup
First, try to relax the child. Lift the child out of the crib and walk into the living room. Stroke the side of the face – this will help the child swallow and clear the phlegm. It will also help reassure the child.
Depending on the weather, wrap the child with a blanket and coat and sit outside or by the window for a few minutes. You can also try running the shower. As your child relaxes, you can let them sleep with you the rest of the night. You can position him or her on the couch, or in a stroller. You can also put some Vicks or a eucalyptus ointment on the chest. (Remember to never leave it at the bedside where the child might eat it).
What do I do if my child is not improving?
If your child is not improving with these measures, and is acting as if he or she is struggling to breathe, and making squeaky sounds with every breath, you should go to the Emergency Room. Call 911 and the EMT team will transport you and your child. Most children with croup do not need to go to the ER. They will still have a congested, phlegmy, barky cough, but will be breathing comfortably and not making strained, high pitched sounds as they try to breathe in.
You can give your child an antihistamine like benadryl (dephenhydramine). The dose can be repeated in 4-6 hours.
|6-12 months old||1/4 tsp=1.25mL|
|12-24 months old||1/3 tsp=1.75mL|
|2-5 years old||1/2 tsp=2.50mL|
If you have a prescription for liquid steroids from a previous episode of croup or asthma, you can use it. The dose is 1mg/kg. This is about 1 teaspoon = 5mL of 15mg/tsp Prelone for a 35 pound child. You can give a dose of steroids the first and second night of croup.