Croup – Symptoms and Causes
Understanding Airway Infections
A healthy airway allows air to move freely through the throat and into the lungs. In children, these passages are naturally smaller than in adults.
When functioning properly, the voice box (larynx), windpipe (trachea), and breathing tubes (bronchi) remain clear and open, allowing normal breathing sounds and comfortable air flow.
When viruses infect the upper airway, tissues around the voice box and windpipe become swollen and irritated. This narrowing creates the distinctive barking cough that sounds similar to a seal.
Children may also make a high-pitched whistling noise (stridor) when breathing in. This condition typically affects younger children and generally isn’t dangerous. Most cases can be managed at home without hospital care.
Common symptoms include:
- Barking, seal-like cough
- Hoarse voice
- Difficulty breathing
- Whistling sound when inhaling
Most children recover completely within a few days with proper care and rest.
Symptoms
Croup typically starts as a common cold. As the condition progresses, a child may develop several distinctive signs:
- A harsh, barking cough that worsens with crying and anxiety
- Elevated body temperature
- Voice changes and hoarseness
- Difficulty breathing or noisy breathing
These symptoms often become more severe during nighttime hours. Most children experience these symptoms for about 3 to 5 days before they begin to improve.
The cycle of distress and coughing can make symptoms worse, as anxiety tends to intensify the barking cough.
When to See a Doctor
Call your child’s doctor if croup symptoms are bad, get worse, continue for more than 3-5 days, or don’t improve with home care.
Get emergency medical help right away if your child:
- Makes loud, squeaky sounds when breathing in and out
- Has noisy breathing even when calm
- Starts drooling or has trouble swallowing
- Seems worried, upset, or very tired
- Breathes faster than normal
- Works hard to breathe
- Shows blue or gray color around the mouth, nose, or fingernails
These signs may indicate that your child isn’t getting enough oxygen, which requires immediate medical attention.
Causes
Croup most commonly results from viral infections, with parainfluenza virus being the main culprit.
Children typically contract these viruses through exposure to infected respiratory droplets in the air when someone coughs or sneezes nearby. These virus particles may also land on toys, doorknobs, and other surfaces.
When a child touches a contaminated surface and then touches their eyes, nose, or mouth, the virus can enter their body and cause infection.
Risk Factors
Children aged 6 months to 3 years face the highest risk of developing croup. This age group is particularly vulnerable because:
- Small airways: Young children have naturally smaller respiratory passages.
- More severe symptoms: Their small airway size leads to more noticeable symptoms.
- Age limitation: Croup rarely affects children older than 6 years.
The condition almost never occurs in older children because their airways have grown larger and can better handle inflammation.
Complications
Most children with croup have mild symptoms that improve with home care. However, in some cases, the condition can become more serious.
The swelling in the airway can sometimes become severe enough to make breathing difficult. This requires immediate medical attention.
In rare instances, a bacterial infection may develop alongside the viral infection that causes croup. This secondary infection can worsen breathing problems and needs emergency treatment.
Prevention
To stop croup before it starts, use common methods for preventing colds and flu.
Wash hands with soap and water for at least 20 seconds often. This simple step makes a big difference.
Keep children away from sick people.
Teach kids to cough or sneeze into their elbows rather than their hands. Clean surfaces that people touch frequently.
Make sure your child’s vaccines are current.
The diphtheria and Haemophilus influenzae type b (Hib) vaccines help protect against some rare but dangerous throat infections. Currently, there isn’t a vaccine that works against parainfluenza viruses, which often cause croup.
