Croup in babies – The Tell Tale Signs

Croup can be a frightening experience for any parent, but knowing the tell-tale signs can help ease the fright and help you get the right treatment for your baby.

Is it croup?

Croup may start with a runny nose or cough – nothing to cause too much concern – but can escalate quickly. It usually becomes obvious in the middle of the night, when your baby or child wakes during the night with a barking cough and difficulty breathing.

Here, some mums tell us how croup presented in their babies and children:

“My daughter had her first bout of croup at 18 months and she regularly contracted it up until about the age of 6 years. Initially I thought she had laryngitis as her voice, even though words weren’t very clear then, had a husky sound. That night the cough started, and I immediately recognised the seal-like sound that other mums had told me about.” – Sarah Wayland, mum of two and stepmum of two more

“My daughter initially seemed miserable and very sniffly, like a bad cold. She woke in the early hours of the morning struggling to breath and quite distressed. My gut instinct, and the seal-like cough, told me it was croup.” – Donna T, mum of two

“It presented similar to a cold during the day then very quickly turned into croup that night. She woke up early in the night coughing and crying. We knew as soon as we heard the wheeze and seal sound that it was croup. As it progressed she sounded as though she had lost her voice. Her breathing was very noisy, quick and shallow.” – Lauren Beth, mum of two

So, things to look out for include:

  • noisy breathing
  • harsh, barking cough, often described as “seal-like”
  • hoarse voice
  • difficulty breathing.

What is Croup?

Croup is an infection of the throat and windpipe, usually affecting babies and children under five years old – though it does sometimes appear in older children. Since babies and children are small, their airway is narrow and the infection causes swelling of the airway, making it difficult to breathe.

When the air is cooler at night, the swelling may worsen. Croup is more common in the cooler months, too.

Do you need to seek help?

Vaccines for measles, Haemophilus influenzae (Hib), and diphtheria now protect children against many of the more dangerous forms of croup. These days, most cases of croup last a couple of hours and reappear for the next few nights.

Mild cases of croup occur when your baby or child has the barking cough but does not have noisy breathing and is not struggling to breathe.

These cases can be treated by:

  • Comforting your child – being upset can make breathing difficult
  • Offering frequent drinks
  • Some parents like using a vaporiser to moisten the air. Always read the label and follow the directions for use.

However, you should get urgent medical attention if your baby or child:

  • is obviously unwell
  • has a high fever
  • has difficulty breathing or is breathing more quickly
  • makes a noise while breathing
  • has difficulty swallowing
  • is restless, anxious or sweating
  • has a bluish tinge to the lips.

Getting treatment

If croup doesn’t settle and medical treatment is required, the following options are available:

  • Steroids – these may be oral or inhaled and can decrease the length of the croup episodes.
  • Nebulised adrenalin – in severe cases hospitals may give adrenalin to relieve swelling in the windpipe until the steroids start working.

Sarah Wayland describes her experience getting treatment for her daughter’s croup:

“I ended up in emergency with her that first time as she couldn’t catch her breath and was distressed (so was I). We had a history of asthma in the family and it made me nervous. Once they explained to me what was happening and we were given redipred [a steroid] I felt far more in control. Exhausted but with a plan! It meant that subsequent winters I was prepared, I had an action plan with the GP and I knew how quickly the cough could develop especially at night.”

While croup can be a distressing experience for all involved, knowing the symptoms and treatment options can help. And, remember, it generally resolves within just three to four days. If symptoms persist seek medical advice.

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