Croup: When Your Child Needs Hospital Care

Croup is a common illness that affects the airways, making it hard for a child to breathe. It's most common in toddlers but can affect children between 6 months and 12 years of age. Another symptom is a loud barking cough that is worse at night. Trouble breathing and the barking cough can be scary for parent and child. Most children with viral croup also have low fever.

Symptoms to watch for

Most cases of croup can be treated successfully at home. However, children with severe cases of croup may need to be treated in the hospital. Call 911 or an ambulance right away if your child

• Makes a whistling sound (called stridor) that gets louder with each breath.

• Cannot speak because of a lack of breath.

• Seems to struggle to get a breath.

• Has a bluish color of the lips, mouth, or fingernails.

• Drools or has trouble swallowing.

Care of your child at the hospital

At the hospital, your child's doctor will decide the best way to treat your child. Treatments may include the following:

• Epinephrine. This medicine can help reduce swelling in the upper airways so that your child can breathe better. Epinephrine is given through a nebulizer. A nebulizer is a machine that turns liquid medicine into a fine mist. The mist is breathed in through a mouthpiece or face mask. Often, when this medicine is used, doctors prefer to continue to watch a child for several hours after it is given. This sometimes requires a stay in the hospital.

• Corticosteroids. These medicines can be useful in reducing inflammation in the body. They work in 2 ways. Systemic corticosteroids must go through the body to treat the inflammation in the upper airway. Inhaled or intranasal corticosteroids go directly to where the inflammation is. (Corticosteroids are not the same as anabolic steroids that are used illegally by some athletes to build muscle.)

• Oxygen. Sometimes when breathing is very difficult for a child, the body may not get enough oxygen and the work of breathing increases. Oxygen given through a mask or a small tube near the nose will make it easier to breathe.

When can my child go home?

As soon as your child's breathing improves, usually within a few hours, he will be allowed to go home. Sometimes a child with croup will stay in the hospital overnight for observation.

Care of your child at home

If your child has a mild case of croup, breathing in moist air may help.

• Bring your child into a bathroom where a hot shower is running. Let your child breathe in the moist air to help open her airway. However, do not leave a young child alone with the shower running.

• Use a cool-mist humidifier in your child's room.

• Take your child outdoors for a few minutes. Inhaling moist, cool night air may help open the air passages so that she can breathe more freely. Remember to dress your child for the cold weather.

If breathing in moist air doesn't help and you notice any of the "Symptoms to watch for" listed previously, your child needs to be taken to the hospital right away. Call 911 or an ambulance for help.

Keep your child healthy

The following are ways to keep your child healthy:

• Stop germs from spreading. Most cases of croup are caused by cold and flu viruses. Frequent hand washing with soap is the best way to prevent germs from spreading. You can also use a waterless hand cleaner.

• Avoid germs. Try to keep your child away from other children with croup or other upper respiratory infections (such as colds and flu).

• Avoid smokers. Do not let anyone smoke around your child, as it can make croup worse.