Croup – Diagnosis and Treatment
Diagnostic
Doctors identify croup by watching how a child breathes and checking the chest with a stethoscope. They also look at the throat.
Key signs include a barking cough, stridor, and sometimes a hoarse voice. In rare cases, doctors use X-rays or extra tests to rule out other conditions like acute epiglottitis.
X-rays may show a “steeple sign,” a classic narrowing of the airway seen in croup. However, this is not always needed unless the diagnosis is unclear.
Doctors also ask about symptoms like fever, trouble breathing, or symptoms that get worse at night. In some cases, they check the oxygen level using a fingertip sensor (pulse oximetry) to make sure the child is breathing well enough.
Most diagnoses are made based on the child’s symptoms and a brief physical exam. If symptoms are mild and clearly match croup, no additional testing is needed.
Treatment
Keeping Your Child Comfortable
Helping a child stay calm is important. Crying or being upset can make breathing problems worse.
Caregivers can soothe children by holding them, singing quietly, or reading soft stories. Giving a favorite blanket or toy and using a gentle tone can help.
Encourage small sips of water, juice, or clear fluids to keep the child hydrated.
Medicine Options
Doctors may suggest certain medications to reduce airway swelling and ease symptoms. Corticosteroids are often used.
| Medicine | How It Helps | How It’s Given |
|---|---|---|
| Corticosteroids | Reduces swelling, long-lasting | Pill, shot |
| Epinephrine | Fast swelling relief, short-lasting | Inhaled/nebulizer |
| Ibuprofen | Reduces pain, relieves fever | Pill, liquid |
These medicines come as pills or shots. Sometimes, just one dose is enough because they last a long time.
For more serious cases, doctors may give a nebulized medicine. This medicine acts fast to help with hard breathing but does not last long. Children may need to be watched for a few hours for possible repeat doses.
For mild discomfort or fever, doctors may recommend acetaminophen or ibuprofen (NSAIDs).
Hospital Care for Severe Symptoms
If symptoms are very serious, the child may need to stay in the hospital. Health care staff can watch closely and treat quickly if breathing gets worse.
Hospital treatments can include more doses of steroids or epinephrine. In rare cases, doctors may use intubation to help the child breathe.
Self-Care
Caring for a child with mild or moderate croup often involves simple steps at home. Staying calm is important, as anxiety or crying can make breathing harder.
Keeping the child comfortable with quiet activities, such as reading or playing a gentle game, may help reduce stress.
Moist air or cool air can help with breathing. Many families use a cool mist humidifier in the child’s room, as moist air can provide comfort.
Some caregivers sit with the child in a steamy bathroom by running hot water from the shower. If the weather is cool, opening a window for fresh air might also help.
While these measures are popular, there is limited evidence that they work, but some parents find them useful.
| Self-Care Tip | Details |
|---|---|
| Use a cool mist humidifier | Adds moisture to the air and may soothe breathing. |
| Soothe with cool or humid air | Let the child breathe steamy air in the bathroom or fresh cool air. |
| Position upright | Keep the child sitting up to help with easier breathing. |
| Offer fluids | Give breast milk, formula, water, or comforting fluids like soup. |
| Encourage resting | Allow more sleep to help the body recover. |
| Use fever reducers if needed | Acetaminophen or ibuprofen (for correct ages) can help comfort. |
| Skip cold medicine | Avoid over-the-counter cold drugs, especially for young children. |
Encourage the child to rest, as sleep helps recovery. Plenty of fluids are important.
Babies can continue with breast milk or formula. Older kids may like soups or frozen fruit pops, which can soothe a sore throat.
For fever or pain, use over-the-counter medicines like acetaminophen or ibuprofen, following the dosing directions. Avoid aspirin for children and teens recovering from flu-like symptoms or chickenpox, as it can raise the risk of Reye’s syndrome.
Do not give nonprescription cough and cold medications to children with croup. These do not help and can be unsafe, especially for those younger than two years old.
Coughing with croup may seem to improve during the day but can return at night. Some caregivers stay nearby during the night to respond quickly if symptoms get worse.
Getting Ready for the Visit
Steps You Can Take Beforehand
Preparing can help make the appointment more helpful. Try these steps:
- List All Symptoms: Write down what signs your child has, when they started, and what makes them better or worse.
- Write Down Medications: Include names, doses, and how often your child takes each one, including supplements or vitamins.
- Prepare Questions: Bring a written list of things you want to ask the healthcare provider.
Tip: Bringing notes and your child’s medicines can help make sure nothing important is missed.
| Item to Prepare | Example |
|---|---|
| Symptoms list | Cough at night, barking sound |
| Medication record | Acetaminophen, 5 mL every 6 hours |
| Questions for provider | Should my child rest or stay home from school? |
What the Healthcare Provider May Ask
During the visit, the healthcare provider will ask questions to better understand your child’s situation.
Expect questions such as:
What symptoms does your child have?
Has your child had a fever or trouble swallowing?
How long have these symptoms lasted?
Is the cough getting worse, and how quickly?
Does your child’s cough get worse at night?
Has your child had croup before?
Has your child been around anyone who is sick?
Does your child have any other illnesses or medical conditions?
Are your child’s vaccines up to date?
Prepare to talk about these topics. This can help the provider care for your child more effectively.
