01 Oct It’s Croup Season
By Ruben J. Rucoba, MD
“His cough sounds just like a barking dog,” Samantha (not her real name) told me. Her 3-year-old son, Emmitt (also not his real name), was up the night before, coughing that strange, barky cough. He had a low-grade fever and a mild runny nose, but the worrisome symptom was the cough. Although other illnesses can cause that, the barky cough is the tell-tale sign of croup, a common viral infection of young children and often seen at this time of year.
Many viruses can cause croup, so children can get it more than once. It causes a narrowing of the airway, so they often have a hoarse voice, that distinctive cough, and at times, trouble breathing with a notable loud sound on breathing in, called stridor. This is NOT wheezing, though parents often call it that the first time they hear it.
At home, cool moist air often decreases the symptoms, so if it’s cool and foggy outside, wrap your child up and go outside. Opening the freezer door to breathe in the cool air also sometimes helps.
The next best thing is warm moist air, which you can make by letting your shower run as hot as possible and steaming up the bathroom. Don’t put your child in the very hot water but let her sit in the bathroom and breathe the steamy air.
For most children, croup is a benign illness, but if you are worried about the way your child is coughing or breathing, call us, and we can help. If your child truly is having trouble breathing, call 911 or go to the nearest hospital emergency department (not urgent care). Some worrisome signs to look for: struggling with each breath, nostrils flaring out with each breath, grunting (actually making a grunting sound with breathing out each time), muscles in between ribs sinking inward with each breath (looks like the ribs are pulling out with each breath).
Emmitt was coughing a lot and having stridor the night before I saw him, but was not coughing at all in our office, and was breathing easily without stridor. That is typical with croup: the symptoms are usually worse at night. It takes a few days for the illness to resolve, so I knew that he would be struggling at least one more night, possibly more. So, I treated him with decadron, an oral steroid that will open up his airway and allow him to breathe easier. I warned his mother that he will still have the barky cough, but he will breathe comfortably. Sure enough, he slept better that night, and within a few days, was back to normal.
If your child has a barky cough, call your pediatrician, and let us guide you. After all, we’re here when you need us.