When Melissa Sheridan’s daughter, Stella, had a telltale ‘barky cough', she knew right away her 8-month-old had croup.
“It sounded like a seal,” the Virginia-based mom told TODAY Parents of the notorious croup cough her daughter experienced. “She went from congested and a little sick one day to struggling to breathe well, couldn't lay her down to sleep, and she had incessant coughing that sounded like a rough bark or almost like a broken dog toy.”
Panicked, Sheridan took her daughter to the emergency room where she received a croup diagnosis.
“She recovered on her own fine, but it was very alarming,” Sheridan said.
What is croup?
“In simple terms, croup is an illness that causes irritation and inflammation around the vocal cords and the airway below them,” Dr. Jane Sneed, pediatrician at The Children’s Clinic in Jonesboro, Arkansas, told TODAY Parents.
What causes croup?
The most common cause of croup is a viral infection.
“Multiple viruses can cause a croup-like syndrome, but we also see spasmodic croup, usually caused by an allergic trigger,” Sneed said.
With both viral croup and spasmodic croup, the symptoms are nearly identical with two exceptions: viral croup is frequently associated with fever, while allergic croup is not, tending to be more recurrent.
“Croup prefers littles—those between 6 months and 5 years of age on average—and is more frequent during months with significant weather changes and more viral infections, including spring and fall,” Sneed shared.
Is croup contagious?
Viral croup is contagious for several days following the beginning of symptoms.
“Parents should always make sure their children have not had fever for at least 24 hours,” Sneed said.
Sneed shared that parents of children with croup always present the same story: their children go to bed with a slight runny nose or cough and start to cough more throughout the night as the drainage down the back of their throats begins to irritate their airways.
“The timing is classic and predictable, taking place somewhere between midnight and 3 AM, usually when there are significant temperature drops in either direction overnight,” Sneed said, sharing that parents are typically awakened to high-pitched wheezing on the monitor, known medically as stridor.
What croup sounds like
The croup cough Sheridan’s daughter experienced is synonymous with croup.
“They are frequently crying, but have a raspy voice or no voice at all,” Sneed said. “They have a deep, barky cough—with a classic description of seal-like—and retractions in addition to their stridor.”
Sneed shared that the most important factor in croup treatment is recognizing when your child needs urgent help.
“Normally, what happens is the parent runs to the child and tries to console them,” Sneed said. “Frequently, getting them to calm down goes a long way,” she shared, noting that if a child has underlying airway anomalies or chronic lung disease, you should head to an emergency department as soon as possible.
For otherwise healthy children experiencing croup, Sneed suggests shutting the bathroom door, turning on the shower, and letting the bathroom steam up.
“Most parents make a pallet on the bathroom floor and do this for 30 to 60 minutes,” she said. “It frequently helps, and they can do this as long as needed.”
Sneed also recommends keeping children elevated.
“I have seen through the years that if these actions do not help, the family loads up for the emergency department, [and] the child improves while driving there,” Sneed explained, saying the only difference was exposure to cool night air. “Consequently, I would have parents sit outside with their children for 10 to 15 minutes to see if they can get some relief. If sitting outside is not an option, I have also had families open their freezer doors and sit in front of it.”
Medical management for croup is oral steroids and sometimes a breathing treatment.