Croup

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This advice is intended for parents/carers taking their child home after consulting a doctor.  Your doctor may recommend different treatments depending on your child's condition.

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What is croup?
  • Croup can be caused by several viruses which affect the airways including the voice box, windpipe and lungs, causing them to swell and become narrower
  • It usually affects babies and young children between the ages of one and three years old
  • Your child may have:

    • A cough – the cough is usually harsh and barking. This ‘croupy cough’ is due to inflammation and swelling of the vocal cords in the voice box
    • Noisy breathing symptoms – the inflammation can narrow the voice box and windpipe and cause an extra noise called a stridor. This noise is normally heard on breathing in
    • Breathing may become difficult if the narrowing becomes worse
    • Other symptoms – these may include a runny nose, hoarseness and a sore throat. Croup may follow a cold but can also appear without any earlier illness. Children may also experience a high temperature (fever), general aches and pains and be off of their food
    • The symptoms of croup appear worse at night. They usually peak after one to three days and then improve. A mild but irritating cough may persist for a further week or so
  • Generally, croup is worse in the first few days of the illness although breathing difficulty and noisy breathing may last up to a week. The cough usually lasts longer.  Once the illness settles, there is no long term damage to the chest
How can I help my child?
  • Stay calm in order to reassure your child – children with croup may become distressed and crying may make their symptoms worse
  • Sit your child upright on your lap if their breathing is noisy or difficult. Let them find the most comfortable position
  • Encourage your child to drink cool drinks regularly (little and often) to help soothe their throat and keep them hydrated
  • Give your child paracetamol or ibuprofen liquid, following the instructions on the bottle, which can help for the pain in their throat as well as a fever
  • If their temperature is high, dress them in cool, loose clothes (if any) and don’t use anything warmer than a sheet to cover them in bed
  • Stay with your child, or check them regularly, as you need to know if the symptoms are getting worse
  • Since viruses cause croup, antibiotics will not help
  • Some people find that taking their child outside in the cool, fresh air helps to relieve their symptoms
  • Breathing in moist air (“steam treatment”) has often been advised, but there is no evidence to prove it helps the symptoms. The risk of burns from steam is more dangerous to your child than the croup itself so steam treatment is not recommended
  • Steroid medications reduce airway swelling quickly. They have been shown to be effective, and your doctor may feel that these would benefit your child if their breathing is a concern
How long does croup last?

The chart above show how long croup lasts in children. The faces represent 10 children who have croup.
Green faces are those children who have recovered within that time period.
Diagram taken from www.whenshouldiworry.com

When should I get help?

 

If your child has any of the following:

  • Is going blue around the lips
  • A harsh breath noise as they breathe in (stridor) present all of the time (even when they are not upset)
  • Has pauses in their breathing or has an irregular breathing pattern
  • Is too breathless to talk / eat or drink
  • Becomes pale, mottled and feels abnormally cold to touch
  • Becomes extremely agitated (crying inconsolably despite distraction), confused or very drowsy (difficult to wake)
  • Develops a rash that does not disappear with pressure (the ‘Glass Test’)
  • Is under 1 month of age with a temperature of 38°C /100.4°F or above

You need urgent help.

Go to the nearest Hospital Emergency Department or phone 999

 

If your child has any of the following:

  • Has laboured/rapid breathing or they are working hard to breath – drawing in of the muscles below their lower ribs, at their neck or between their ribs
  • A harsh breath noise when they breathe in (stridor) present only when they are upset
  • Seems dehydrated (sunken eyes, drowsy or no urine passed for 12 hours)
  • Is becoming drowsy (excessively sleepy)
  • Drooling and has difficulty swallowing saliva
  • Is 1-3 months of age with a temperature of 38°C /100.4°F or above or 3-6 months of age with a temperature of 39°C / 102.2°F or above (but fever is common in babies up to 2 days after they receive vaccinations)
  • Seems to be getting worse or if you are worried

You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS 111 - dial 111

 

  • If none of the features in the red or amber boxes above are present

Self care

Continue providing your child’s care at home. If you are still concerned about your child, contact your GP or call NHS 111 – dial 111

Content adapted with permission from the what0-18.nhs.uk resource produced by the Healthier Together initiative