Croup is typically diagnosed by a doctor. He or she will:
- Observe your child's breathing
- Listen to your child's chest with a stethoscope
- Examine your child's throat
Sometimes X-rays or other tests are used to rule out other possible illnesses.
The majority of children with croup can be treated at home. Still croup can be scary, especially if it lands your child in the doctor's office, emergency room or hospital. Treatment is typically based on the severity of symptoms.
Comforting your child and keeping him or her calm are important, because crying and agitation worsen airway obstruction. Hold your child, sing lullabies or read quiet stories. Offer a favorite blanket or toy. Speak in a soothing voice.
If your child's symptoms persist beyond three to five days or worsen, your child's doctor may prescribe these medications:
- A type of steroid (glucocorticoid) may be given to reduce inflammation in the airway. Benefits will typically be felt within a few hours. A single dose of dexamethasone is usually recommended because of its long-lasting effects.
- Epinephrine also is effective in reducing airway inflammation and may be given in an inhaled form using a nebulizer for more-severe symptoms. It's fast acting, but its effects wear off quickly. Your child likely will need to be observed in the emergency room for several hours before going home to determine if a second dose is needed.
For severe croup, your child may need to spend time in a hospital to be monitored and receive additional treatments.
Lifestyle and home remedies
Croup often runs its course within three to five days. In the meantime, keep your child comfortable with a few simple measures:
- Stay calm. Comfort or distract your child — cuddle, read a book or play a quiet game. Crying makes breathing more difficult.
- Provide humidified or cool air. Although there's no evidence of benefit from these practices, many parents believe that humid air or cool air helps a child's breathing. For moist air, you can use a humidifier or sit with the child in a bathroom filled with steam generated by running hot water from the shower. If it's cool outside, you can open a window for your child to breathe the cool air.
- Hold your child in a comfortable upright position. Hold your child on your lap, or place your child in a favorite chair or infant seat. Sitting upright may make breathing easier.
- Offer fluids. For babies, breast milk or formula is fine. For older children, soup or frozen fruit pops may be soothing.
- Encourage rest. Sleep can help your child fight the infection.
- Try a fever reducer. If your child has a fever, over-the-counter medicines, such as acetaminophen (Tylenol, others), may help.
- Skip the cold medicines. Over-the-counter cold preparations aren't recommended for children of any age, and can be harmful in children less than 2 years of age. Plus nonprescription cough medicines won't help croup.
Your child's cough may improve during the day, but don't be surprised if it returns at night. You may want to sleep near your child or even in the same room so that you can take quick action if your child's symptoms become severe.
Preparing for your appointment
In most cases of croup, your child won't need to see a doctor. However, if your child's symptoms are severe or aren't responding to home treatment, you should call your doctor.
What you can do
Before your appointment, make a list of:
- Your child's symptoms, including how long they have been occurring, what if anything makes them better or worse
- Any medication your child is taking, including over-the-counter medications, vitamins, herbs and other supplements, and their dosages
- Questions to ask your child's doctor
What to expect from your doctor
Your child's doctor will likely ask a number of questions to help determine the best course of treatment:
- What are your child's symptoms?
- Has your child had a fever or difficulty swallowing?
- How long has your child been experiencing symptoms?
- Has your child's cough become progressively worse? If so, how rapidly?
- Have you noticed a pattern to your child's cough? For instance, does it get worse at night?
- Has your child had croup in the past?
- Has your child recently been exposed to other sick children?
- Does your child have any other medical conditions?
- Are your child's vaccinations up to date?
Your doctor will ask additional questions based on your responses and your child's symptoms and needs. Preparing and anticipating questions will help you make the most of your time with the doctor.