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How to Identify the Dreaded Croup Cough (and What to Do About It)

Darkness has a way of amplifying fear doesn’t it?

When you were a child, it was the monsters under your bed. Now that you’re a parent, it’s that dreaded croup cough that leaves you stressed and sweating.

Good news. You don’t have to panic, you just have to be prepared. So when that first barking cough rings out, you’ll know exactly what to do.

How to Identify a Croup Cough

  1. A barking cough, often compared to a seal’s call.
  2. Wheezing and gasping for breath
  3. Noisy breathing

That’s the short version, sure, but in order to get you calmed down and quietly confident, you’re going to need more than just the “short” version. Here’s how to treat that croup cough effectively.

I consulted the smartest doctor I could find to help me out with this one: my husband, Jake. He specializes in emergency medicine and, in addition to seeing a few of our own kids through croup, he has treated it numerous times in the emergency room. Using his editorial skills, my experience, and Google’s best research archives, let’s begin our journey with the basics.

The Dreaded Croup Cough:
What Exactly Is It?

According to the American Academy of Pediatrics (AAP), croup causes the voice box (larynx) and windpipe (trachea) to swell. This swelling “causes the airway below the vocal cords to become narrow and makes breathing noisy and difficult.”

Croup is most common in children between the ages of 3 months and 5 years because their windpipe is so small. The larger the windpipe becomes, the less likely swelling will get in the way of breathing.

There a few different kinds of croup:

  • Viral Croup: This type often starts out like a cold, but then slowly turns into a barking cough. It can be accompanied by a fever, hoarseness, and noisy breathing.
  • Spasmodic Croup: This type comes on suddenly, often in the middle of the night. Your child may have gone to sleep completely fine, but then wakes up in the middle of the night, gasping for breath.

Gasping for breath, noisy breathing, barking coughs. All terrifying for parents. Especially at night. So, let’s look at each of these croup symptoms a little more specifically.

The Dreaded Croup Cough:
The Symptoms

Whether it comes on fast or slowly transitions from a common cold, it’s important to know exactly what you should be watching and listening for. Here are the basic croup symptoms:

  • Barking cough: The croup cough is distinctive and the most common symptom. It’s low-pitched and actually sounds similar to a seal bark.
  • Shortness of breath: Your child may have trouble catching her breath because of the swelling in her windpipe.
  • Stridor: Stridor is noisy breathing that occurs due to obstructed airflow through a narrowed airway. It sounds like a high-pitched whistling sound during the inhale and exhale.

Here’s an example of what all those things can look like together. (You’ll be happy to know that little girl is happy and healthy today, six years later!)

Heather’s kids would frequently get croup, and one of the best tools they had was a stethoscope gifted by her Father-in-Law (also an ER doc). They would use it listen to the lungs, catch the early wheezing, and confidently know when it was time to pack up the van and head to urgent care. (She also used it to let the older siblings listen to prenatal ones, but that’s for a different article…)

The Dreaded Croup Cough:
Your Treatment Options

First things first, if you think your child might have croup, call your pediatrician or the after-hours nurse. Your doctor is your first line of defense, and she can help you determine how best to treat your child. If caught early enough, you may be able to avoid the more nerve-wracking symptoms with a prescribed medication. Doctors are here to help you, so let them!

Additionally, though, it’s good to have some home remedies up your sleeve as well as the knowledge of when you need to take your child to the hospital.

Croup Treatment at Home

There are some ways you can ease the symptoms of croup from home.

  • Calm your child down. A croup cough and labored breathing can be scary for kids, but the symptoms are only worsened with crying. Take advantage of your child’s comfort items or a favorite song, and, first things first, do your best to calm him down.
  • Push cool, humidified air. The steam from a good humidifier can also help ease labored breathing by opening up airways.
  • Breathe cold air. Cold air can help decrease swelling, so you might see improvements if you stand next to an open window or the open freezer door with your child.
  • Keep your child upright. The Mayo Clinic notes that sitting upright with your child may help make breathing easier.

When to Go to the Hospital

When croup is at play, err on the side of caution. If your child is wheezing while breathing (like this child here) take her to the closest emergency room or call 911 even if you haven’t yet tried any of the home remedies. When it comes to wheezing and young children, it’s always best to have a medical professional look things over.

Here are a few other symptoms that should require an immediate hospital visit:

  • Difficulty breathing
  • A whistling sound that gets louder with each breath
  • Stridor when resting
  • Difficulty speaking because of a lack of breath
  • Bluish lips or fingernails
  • Excessive drooling or inability to swallow saliva
  • Your child isn’t making improvements with the home remedies.

Jake says that it isn’t uncommon for your child’s condition to improve dramatically by the time he gets to the hospital because of the cold air on the drive over. If this happens, don’t worry. Your doctor is going to believe how sick your child is.

Once at the hospital, the doctors will check your child’s vital signs. They will need your help keeping your child calm and as still as possible. From there, they will most likely give your child steroids and/or a nebulizer. With certain medications, your child may need to be observed in the emergency room for up to four hours.

If your child’s vital signs and symptoms improve after observation, he may be sent home. However, if he continues to have stridor at rest, difficulty breathing, or persistently abnormal vital signs, he will likely need to be admitted to the hospital for further treatments.

For additional help with what to expect at the hospital, don’t forget to check out Karen’s helpful article about how to prepare for that unpreparable trip to the emergency room.

Dreaded, but Not Terrifying

Croup will always be a dreaded illness; there’s no way around it. It’s always scary to watch your child cough deeply or struggle to breathe, but with a better understanding of what exactly croup is as well as how you can help treat it at home, you can waylay the croup cough panic that often strikes with the setting sun.

Instead, you can have a plan for exactly what to do when you hear that first barking cough.

Set up your video monitor, get your humidifier chugging away, and

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