Few things scare a parent more than a baby with breathing issues. Croup, with its characteristic barking cough leads to more than $56 million in annual health care costs in the United States, according to a 2004 report published in "American Family Physician."
Even though croup accounts for about 15 percent of emergency room visits for respiratory infections, most infants with croup need only treatment for symptoms and don't require hospitalization, explains the same report.
Definition
Croup encompasses a group of disorders that involve the voice box, windpipe and large airways in the lungs. The label of croup results when inflammation in these airway components leads to a coarse, barking-like cough, obstruction to air during inspiration heard as stridor and hoarseness.
Most babies with infectious croup show other signs of illness such as a runny nose or a low-grade fever.
Causes
Often given as a diagnosis, croup really describes a group of symptoms or characteristics rather than a single disease. As such, a variety of causes have been defined.
Most often, croup results from a virus. Parainfluenza viruses cause 75 percent of croup cases, explains MedlinePlus, a website of the National Institutes of Health. Respiratory syncytial virus--RSV--and influenza virus contribute to many of the remaining viral cases of croup.
Less often, bacterial infections lead to croup. Bacterial tracheitis--inflammation of the windpipe from bacteria--can be fatal and fortunately remains rare.
Non-infectious processes result in croup symptoms as well. Inhaling a foreign object presents with similar signs.
Signs and Characteristics
The part of the airway most affected by croup sits between the vocal cords and the windpipe. In children and infants, this subglottic area is already narrow. Any further narrowing, such as by inflammation in croup, causes changes in breathing sounds, explains the "Otolaryngologic Clinics of North America" in a June 2008 review article.
Stridor refers to a high-pitched whistling sound most obvious when your baby takes in a breath. Sometimes heard without a stethoscope, stridor results from swelling in the windpipe. You may notice that stridor gets worse in an infant after exertion, such as crying.
The "croupy cough" resembles the sound of a seal barking, making it easy to identify and distinguish from other types of cough.
Wheezing, heard best with a stethoscope, comes from involvement of the smaller airway components of the lungs.
Treatment
Sixty percent of children with croup that go to the emergency room don't require any treatment at all, says "Otolaryngologic Clinics of North America."
At home, try to make your child more comfortable. Ask your doctor about medications to treat symptoms. Even medicines approved for older children present risks in infants so never give them without your pediatrician's approval.
Cool air seems to improve the symptoms of croup. MayoClinic.com recommends a cool mist humidifier to help your baby sleep better at night. During the day, do what you can to keep your infant from crying or fussing excessively, as swelling will worsen and breathing will become more difficult.
If treatment in the hospital becomes necessary, your baby will likely be given oxygen in a cool mist. In severe cases where danger of airway closure exists, doctors may give inhaled or injected medications to reduce the swelling and improve oxygen levels.
Warning
Most cases of croup remain mild throughout the course and resolve after a few days. Some potentially dangerous causes and complications mean that it's always better to consult your physician with symptoms of croup. If your child seems to have trouble getting enough air, drools excessively, sits up and forward to breathe better, breathes very rapidly or has blue discoloration of the lips or fingertips, go to the emergency room right away.
Information on this site or the Internet in general and should not be used to diagnose or treat symptoms. Attempts at self-diagnosis and treatment may be harmful and often cause delays in obtaining professional medical care. Call or visit your physician with any new or concerning health issues.
References
- "American Family Physician"; Viral Croup; Doug Knutson, M.D., Ann Aring, M.D.; February 2004
- "Otolaryngologic Clinics of North America"; Epiglottitis and Croup; Steven E. Sobol, M.D., Syboney Zapata, M.D.; June 2008
- MayoClinic.com: Croup
- MedlinePlus: Croup
