As a mum, there are few things more frightening than seeing your child struggling to breathe. But every year, thousands of parents go through this ordeal when their child contracts croup.
Here’s your guide to what croup is and what to do if you’re worried your child may have it.
What is croup?
Croup is a common childhood illness that affects the upper respiratory system, causing inflammation of the windpipe, voice box and the airways to the lungs. It can be scary to witness, but usually, it can be treated at home – although some children develop severe symptoms and will need to be admitted to hospital.
Croup is usually caused by a virus, although sometimes, it’s triggered by an allergic reaction, breathing in irritants or inhaling a small object like a bead or a nut.
It is most common in children between six months and three years old – although it can affect younger babies and older children – and is more common in autumn and winter.
Spotting the signs of croup
The main symptoms of croup are:
- A barking cough
- A grating sound when your child breathes in – known as stridor
- A hoarse, croaky voice
- Difficulty breathing
The symptoms tend to be worse at night. Sometimes children also have cold symptoms, including a runny nose, sore throat and high temperature.
What to do if you think your child has croup
If your child has the symptoms of croup, it’s important to take her to the GP.
Although it can usually be treated at home, sometimes children need hospital treatment. Your GP will be able to decide if that’s necessary.
Don’t try to check their throat yourself: this can make their airway go into a spasm, and worsen their breathing difficulties.
How to treat croup
If your child is well enough to stay at home, the GP is likely to prescribe a single dose of a steroid medication to reduce the swelling in her throat. You can give her age-appropriate paracetamol to bring down a temperature and help her feel more comfortable. Also, try to make sure she drinks plenty of fluids, even if she doesn’t feel like eating.
Crying often makes the symptoms of croup worse, so if your child is distressed, try to comfort her, holding her upright on your lap to ease her breathing.
Because it tends to be worse at night, you might want to sleep in their room, or use a baby monitor, so you can hear if there are any changes in her breathing.
You might have heard that inhaling steam (for example by sitting with your child in a steamy bathroom) can help to relieve croup symptoms, but the latest NHS advice is not to do this: there’s no evidence it works.
The NHS also advises that cough medicines or decongestants won’t help ease the symptoms of croup. These treatments often have drowsy side effects, which can be dangerous when a child has breathing difficulties.
When to get urgent help
Although most cases of croup are mild, it’s important to look out for the signs that your child is seriously unwell. These include:
- Severe breathing difficulties
- An increased breathing rate (they’re too breathless to feed or talk) or ‘silent chest’ (you’re unable to hear sounds of breathing
- Worsening of your child’s cough or stridor
- Distress and agitation
- Dark, blue-tinged or pale skin
- The skin around their ribs and chest appears to be pulled in and tight, making the ribs and bones of the chest more visible
- Abnormal drowsiness or sleepiness
- A rapid heart rate or a falling heart rate
- A very high temperature
- Inability to drink fluids.
If your child has any of these symptoms, take her straight to your nearest A&E or call an ambulance. You should also get urgent medical attention if her croup symptoms seem to be getting worse.
What does hospital treatment involve?
If your child ends up in A&E with croup, she might be put on a nebuliser. This usually helps to relieve symptoms within 10 to 30 minutes, and the effects last about two hours. She’ll probably also be given a dose of steroids to reduce the swelling in their airways.
If she’s finding it hard to breathe and is getting distressed, she might be given oxygen through a mask.
Usually, children who are seen in A&E with croup are stabilized quickly and don’t need to be admitted to a ward. In the severest of cases, they may need to have a tube inserted into their windpipe through their mouth or nose to help them breathe; this would mean a longer hospital stay, but is very rare.
Recovering from croup
Croup can be very upsetting for you and your child, but even severe cases usually clear up within a few days, although sometimes, it can last as long as two weeks.
Children can get croup more than once, but unfortunately, it’s hard to prevent. The best way to protect your child is to make sure you both wash hands frequently. It’s also important to take her for all her routine immunizations, as these help to protect against some of the viruses that can cause croup.