Croup (laryngo-tracheo-bronchitis)

What is croup?

Croup is an infection of the throat, vocal cords (or larynx), and large airways of the lungs. It can be caused by several different viruses. When children younger than 5 years of age have the infection, it’s called croup. In older children, it’s called laryngitis.

How does croup spread?

Croup is most common in the winter and early spring. The viruses that cause croup spread the same way as a common cold:

• By touching the hands of someone who has the infection.
• By touching something that has been touched by someone who has the infection.
• By coming in contact with the virus in the air, after an infected person has coughed or sneezed.

What are the symptoms?

• It often begins like a cold, but then the child develops a fever and cough.
• The lining of the throat and larynx (voice box) becomes red and swollen.
• Your child’s voice gets hoarse and they develop a cough that sounds like a bark. This is often worse at night.
• Your child may have difficulty breathing, and it may be rapid and noisy.
• Activity that increases the rate of breathing (even crying or excitement) could make your child sound worse.
• Your child may become tired because of the extra work it takes to breathe.

What can parents do? 

In most cases, croup sounds worse than it actually is and will clear up on its own within 5 to 7 days. In severe cases, your child’s breathing can become difficult and they will have to be treated in hospital. Antibiotics are not used to treat croup because it is caused by a virus, not by a bacteria.

• Keep your child as calm and comfortable as possible and offer plenty of fluids.
• Give acetaminophen or ibuprofen for fever. Ibuprofen should only be given if your child is drinking reasonably well. Do not give ibuprofen to babies under 6 months of age without first talking to your doctor.
• Clear nasal congestion with a bulb syringe and saline (saltwater) nose drops. 
• Take your child outside for a few minutes if it’s a cold day. Breathing in the cool air may ease symptoms.
• Do not give over-the-counter cough and cold medicines to children younger than 6 years old unless your doctor prescribes one. The only exception is medication used for fever.
• If you give medication for fever, read the instructions carefully and do not give more often than listed on the label. 
• See your doctor if symptoms continue or worsen. Your doctor might prescribe a medicine to help relieve the symptoms.

For cases of very mild croup, your child may continue to attend a child care facility or school once they feel well enough to take part in activities.

Talk to your doctor or go to the hospital if your child:

• Has a fever for more than 72 hours or is younger than 6 months and has a fever.
• Has rapid or difficult breathing, or bluish coloured lips.
• Is drooling a lot.
• Is refusing to swallow because of a very sore throat.
• Has a hard time lying down because it is hard to breathe.
• Is lethargic (drowsy and listless).