How to Identify and Treat Croup in Children: Home Remedies & When to Seek Help
It’s the most wonderful time of the year! Can you hear the tune in your head? I sure can. December is one of my favorite months. My kids, who attend year-round school, are tracked out for most of the month, giving us extra time to enjoy holiday crafts and baking. However, for many parents, this time of year also brings added anxiety about sickness. Large family gatherings are fun but can also become breeding grounds for the germs that love to circulate during colder months. While RSV and pneumonia are getting a lot of attention this year, another common respiratory illness is often overlooked: croup.
Croup is an upper respiratory illness that often scares parents and can lead to unnecessary emergency room visits. So, let’s talk about croup: how to identify it, what to do if your child has it, and when to seek medical attention.
What is Croup?
Croup is most commonly caused by the parainfluenza virus, though it can also be caused by other viruses, such as the flu, COVID, rhinovirus, adenovirus, or even RSV. Croup primarily affects children between 6 months and 3 years old, and it’s almost non-existent in children older than 6 years.
Croup is different from other respiratory infections because it causes inflammation and swelling in the throat, particularly in the larynx (voice box) and upper trachea (windpipe). This swelling can make it difficult for children to breathe, leading to potentially serious complications.
How to Know if Your Child Has Croup
Croup often begins like any other respiratory illness, with nasal congestion, cough, and fever. However, the key symptom that distinguishes croup is the development of a “barking” cough—a very distinctive, seal-like sound that is difficult to miss.
As a pediatrician, I could often hear the “croup cough” from across the room, even before a child entered the exam room. It's THAT recognizable.
In most cases, croup is mild, and children recover at home without needing medical intervention. So, what can you do at home to help if your child has a persistent barking cough from croup?
Home Remedies for Croup
Cool Air: One of the oldest tricks in the book! A blast of cold air can help reduce inflammation in the throat almost immediately. If it's cold outside, bundle your child up and take a walk in the chilly air. If it’s not cold where you live, you can achieve similar results by standing in front of an open freezer.
Mist Therapy: A cool mist humidifier can help keep the air in your child’s room moist and soothe their airways. Alternatively, you can create steam by running a hot shower and sitting in the bathroom with your child. Just be cautious of the water temperature if you get into the shower. I remember doing this for my middle child one night when I wasn’t sure whether a trip to the ER was necessary. Thankfully, the steam helped calm his symptoms and we were able to wait until morning for a pediatric visit.
Encourage Fluids: Croup can come with a sore throat and fever, making it difficult for children to drink. Offering fluids, such as water, electrolyte solutions (like Gatorade or Liquid IV—but check with your pediatrician for age-appropriate options), watered-down juice, jello, or popsicles can help keep them hydrated.
Fever Reducers: Tylenol or Motrin can help reduce fever and alleviate discomfort. Be sure to follow the correct dosage based on your child's age and weight.
When to Seek Medical Attention for Croup
If you’re following these home remedies and your child’s symptoms aren’t improving, or if they develop any of the following signs, it may be time to seek medical help:
Stridor: This is a high-pitched sound heard when your child inhales. It indicates that the airway is inflamed and obstructed, making it harder for your child to breathe. Stridor often accompanies fast breathing and retractions—when the muscles around your child’s neck and abdomen work harder to help them breathe.
Spasmodic Cough: This typically worsens at night, leading to persistent coughing episodes that make it difficult for your child to take a deep breath between coughs. It can cause severe breathing difficulty, fast breathing, and retractions, leading to exhaustion.
Dehydration: With a fever and sore throat, your child may refuse fluids. If your child isn’t urinating at least three times a day or every 8 hours, they may need medical attention for dehydration. Keep an eye on their hydration and contact your healthcare provider if necessary.
In moderate cases of croup, doctors may prescribe an oral steroid to reduce inflammation in the airway. In severe cases, usually in the emergency room, a IV steroid or intramuscular injection may be used to quickly reduce inflammation.
My Experience with Croup
Has your child ever had croup? It was one of the most terrifying illnesses my son experienced when he was 1 year old. I was home alone with both kids while my husband was traveling for work. I’m grateful I had a few home remedies on hand, as they allowed me to manage his symptoms and avoid a trip to the ER in the middle of the night.
I hope this guide helps you understand how to manage croup at home and when to seek medical attention.
For a real-life example, check out my Instagram @nuanced_newborns to hear what the hallmark “barking cough” and stridor sound like.
