February 5, 2023/Children's Health

How To Care for Your Child’s Croupy Cough

Steam, cold air and extra snuggle time can help manage that seal pup bark

Baby coughing in white crib.

Perhaps nothing will throw your bedtime routine for a loop quite like the sound of your little one seemingly transformed into a seal pup. The sound of your kid’s barking cough is enough to send shivers down your spine and have you running to the medicine cabinet as you ransack the house for a solution.

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But fear not, parents and caregivers! While it sounds alarming, a croup cough usually isn’t anything serious and should be short-lived. What’s more: There are ways to help your kid feel better faster.

We talked with pediatrician Kimberly Giuliano, MD, about croup and home remedies to help your tot get better (and back to bed).

What is croup?

Croup is a common respiratory infection in children that causes the upper airway to swell. That makes it difficult for little ones to breathe.

You’re more likely to see (or should we say, hear) croup during the fall and winter months. It’s most severe in children under the age of 3 and is rarely seen in kids over the age of 5.

That’s because as kids grow, so do their windpipes. So, when older kids have an infection that affects their airway, it doesn’t get in the way of their breathing in quite the same way.

Croup is most commonly caused by viruses, but occasionally, bacteria is the cause.

“Croup usually starts off as mild cold symptoms. Then, children will develop a hoarse voice similar to laryngitis,” Dr. Giuliano explains.

What a croup cough sounds like

The biggest red flag for croup is the signature seal-like barking cough, which is typically worse at night. It can be very high-pitched and can be unsettling — even downright scary — for kids and their caregivers alike.

“The average cough with a cold is either very dry and throaty or a deeper cough that sounds wet and mucus-like,” notes Dr. Giuliano. “The cough that comes with croup is very distinctive. It’s different from any other cough parents have heard before.”

Croupy coughs may also come with a harsh, raspy, vibrating wheeze when your child inhales. That’s called stridor, and it may sound as if they have an object lodged in their throat. If you notice your child wheezing or making a high-pitched whistle when they breathe in, you’ll want to be sure they aren’t, in fact, choking.

In addition to coughing and wheezing, croup can cause:

  • Difficulty breathing.
  • Difficulty bending their neck.
  • Fever (which can be high).
  • Restlessness or nervousness at night or when it becomes harder to breathe.

How long does it last?

Croup will likely clear up on its own within about five or six days, depending on the severity of the infection. If it continues past that, you may consider calling your pediatrician to see if further action is needed.

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Croup is contagious, and sick kids can pass their germs on to others. While older kids and adults won’t develop the croup cough, they may still get sick when your child “shares” those germs. Croup can easily pass between small children, so it’s best to keep your kiddo away from other little ones for at least three days after they become sick. If they had a fever, keep them home until they are 24 hours fever-free.

Home remedies

While croup isn’t typically dangerous, it can be uncomfortable for your child. And particularly when it comes on at night, it can put a real damper on your whole family’s need for sleep.

Dr. Giuliano says most kids can ride out croup at home. And there are a few things you can do to help them feel better fast.

Steam

One way to help calm the cough is to introduce some steam.

“Breathing in moist air can help a child who is having breathing difficulties,” Dr. Giuliano says.

Take your child into the bathroom, shut the door and turn the shower on high using hot water to get the room nice and steamy. Steaming for 10 minutes or so can help to relax their airways.

Similarly, running a humidifier in your child’s room can help add some moisture to dry air and bring on some relief.

Cold

Another trick that may ease croup breathing problems is to cool things down. Think of the last time you sprained your ankle. You probably used an ice pack to take down the swelling. Cold air can similarly reduce swelling in your child’s airway.

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There are a few methods to help chill out a cough. If it’s cold outside, you could take your child out for a bit to play in the yard or go on a cool winter walk. Similarly, you could go for a short drive with the windows down at least partway.

Another method that may work is to have your child stand in front of an open freezer door. (Just for a few minutes. No one is recommending giving your little one frostbite!)

Keep upright

Lying down can make it harder to breathe. Hold your child upright on your lap or encourage them to sit upright on their own if they’re old enough. If your child is at least 1 year old, you can help keep them more inclined at bedtime with an extra pillow to two under their head. But remember, babies under 1 year of age shouldn’t have pillows, pillows, bumpers, blankets or anything else in their bed.

Keep things calm

We all know that whining, yelling and crying can be part of the territory when you have kids, particularly sick ones. But getting worked up can make things worse. Even on a good day, crying can leave kids struggling to catch their breath. When they’re down with croup, crying can make it even harder to get air into their swollen windpipe.

For that reason, the American Academy of Pediatrics suggests keeping your child comfortable may be one of the best routes to caring for croup. Offer plenty of reassurance, comforting hugs and calm activities, like reading books or doing puzzles.

Skip the cough meds

We know you want to make your kiddo better fast, but Dr. Giuliano advises steering clear of treating croup with over-the-counter cough or cold medicines.

“Cold medicines can cause significant side effects,” she warns. “In addition, research has shown that for croup and other kinds of coughs and colds, they’re really not any more effective than giving your child a placebo.”

If your child is running a fever and acting unwell, you can use an over-the-counter fever-reducing medication and other methods to break their fever.

When to call your pediatrician

Severe croup can lead to other complications, such as ear infections, respiratory distress or pneumonia.

“If your child is having increasing breathing difficulties, they could be at risk for complications,” Dr. Giuliano says. “A child who’s struggling to breathe should be evaluated urgently.”

Stridor, or a wheezing noise when breathing in, is another reason to call the doctor. Mild stridor can be treated with steroids to prevent more significant breathing problems.

If your child has croup that doesn’t improve in a few days or gets worse over time, it’s probably time to call their pediatrician. They may recommend medication or breathing treatments to help your seal pup — er, child — get back to normal.

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